Off-Campus Hospital Gains Place of Service Code

Off-Campus Hospital Gains Place of Service Code

Effective Jan. 1, 2016, the Centers for Medicare and Medicaid Services (CMS) is requiring the use of place of service (POS) code 19 Outpatient Hospital-Off campus to describe, “A portion of an off-campus hospital provider-based department which provides diagnostic, therapeutic (both surgical and nonsurgical), and rehabilitation services to sick or injured persons who do not require hospitalization or institutionalization.”

The 2015 Outpatient Prospective Payment System Final Rule defines the hospital campus to include, “the physical area immediately adjacent to the provider’s main buildings, other areas and structures that are not strictly contiguous to the main buildings but are located within 250 yards of the main buildings, and any other areas determined on an individual case basis, by the CMS regional office…”

Additionally, POS code 22 On Campus-Outpatient Hospital has been revised, effective Jan. 1, 2016 to describe, “A portion of a hospital’s main campus which provides diagnostic, therapeutic (both surgical and nonsurgical), and rehabilitation services to sick or injured persons who do not require hospitalization or institutionalization.”

Providers will report both of these POS codes in the outpatient department of a hospital. Per CMS, “Claims for covered services rendered in an Off Campus-Outpatient Hospital setting, or in an On Campus- Outpatient Hospital setting, if payable by Medicare, shall be paid at the facility rate. The payment policies that currently apply to POS 22 will continue to apply and will now also apply to POS 19, unless otherwise stated.”

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John Verhovshek

John Verhovshek

John Verhovshek, MA, CPC, is Managing Editor at AAPC. He has covered medical coding and billing, healthcare policy, and the business of medicine since 1999. He is an alumnus of York College of Pennsylvania and Clemson University, and a member of the Asheville-Hendersonville AAPC Local Chapter.
John Verhovshek

About Has 404 Posts

John Verhovshek, MA, CPC, is Managing Editor at AAPC. He has covered medical coding and billing, healthcare policy, and the business of medicine since 1999. He is an alumnus of York College of Pennsylvania and Clemson University, and a member of the Asheville-Hendersonville AAPC Local Chapter.

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