POS 52: Psychiatric Facility-Partial Hospitalization
Partial hospitalization program (PHP) — 4+ hours of structured treatment per day.
CMS description
“A facility for the diagnosis and treatment of mental illness that provides a planned therapeutic program for patients who do not require full time hospitalization, but who need broader programs than are possible from outpatient visits to a hospital-based or hospital-affiliated facility.”
When to use POS 52
Partial hospitalization program (PHP) — 4+ hours of structured treatment per day.
Reimbursement
PHP-specific HCPCS codes apply.
Common billing issues
- Documentation of medical necessity for PHP level of care
Frequently asked questions
What is POS 52?
Psychiatric Facility-Partial Hospitalization. A facility for the diagnosis and treatment of mental illness that provides a planned therapeutic program for patients who do not require full time hospitalization, but who need broader programs than are possible from outpatient visits to a hospital-based or hospital-affiliated facility.
When do I use POS 52?
Partial hospitalization program (PHP) — 4+ hours of structured treatment per day.
How does POS 52 affect reimbursement?
PHP-specific HCPCS codes apply.
What are common POS 52 billing issues?
Documentation of medical necessity for PHP level of care.
Other POS codes
- POS 01 — PharmacyUsed primarily for vaccines administered at a pharmacy and pharmacist-rendered s
- POS 02 — Telehealth Provided Other than in Patient's HomeSince 2022, POS 02 must be used for telehealth when the patient is anywhere OTHE
- POS 03 — SchoolUsed for services provided in a school setting — typically school-based health c
- POS 04 — Homeless ShelterHealth services provided at a homeless shelter, typically by mobile clinics, str
- POS 05 — Indian Health Service Free-standing FacilityIHS billing only. Special encounter rates apply.
- POS 06 — Indian Health Service Provider-based FacilityIHS billing only, provider-based hospital outpatient setting.
Sources
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