POS 54: Intermediate Care Facility/Individuals with Intellectual Disabilities
ICF/IID residents.
CMS description
“A facility which primarily provides health-related care and services above the level of custodial care to individuals with intellectual disabilities but does not provide the level of care or treatment available in a hospital or SNF.”
When to use POS 54
ICF/IID residents.
Reimbursement
Medicaid-only typically.
Common billing issues
- State-specific Medicaid coverage rules
Frequently asked questions
What is POS 54?
Intermediate Care Facility/Individuals with Intellectual Disabilities. A facility which primarily provides health-related care and services above the level of custodial care to individuals with intellectual disabilities but does not provide the level of care or treatment available in a hospital or SNF.
When do I use POS 54?
ICF/IID residents.
How does POS 54 affect reimbursement?
Medicaid-only typically.
What are common POS 54 billing issues?
State-specific Medicaid coverage rules.
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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