Assisted and Independent Living - Shared Medical Office POS

[racingjay]

We provide primary care services to a large retirement campus which has residents residing in both independent and assisted living environments. Those residents are typically seen in their apartments and billed with POS 12 or 13, respectively. Recently, we were approached to potentially utilize a shared "medical office" at the community as needed. This is a space the facility provides for the benefits of the residents, and no lease or other formal agreement would be required for my providers to access the space. The equipment is already in the space, and our providers would only be providing incidental medical supplies for usage in caring for our patients.

The guidance I have found on this type of setting is very limited. Since this is not a dedicated space for the exclusive use of our providers and patients, I feel that POS 12 or 13 would still be the appropriate choice in this setting as compared to 11. Has anyone encountered a similar situation or have any definitive guidance they would be willing to share? We are Novitas JH.

Thanks in advance!

 

[thomas7331]

We provide primary care services to a large retirement campus which has residents residing in both independent and assisted living environments. Those residents are typically seen in their apartments and billed with POS 12 or 13, respectively. Recently, we were approached to potentially utilize a shared "medical office" at the community as needed. This is a space the facility provides for the benefits of the residents, and no lease or other formal agreement would be required for my providers to access the space. The equipment is already in the space, and our providers would only be providing incidental medical supplies for usage in caring for our patients.

The guidance I have found on this type of setting is very limited. Since this is not a dedicated space for the exclusive use of our providers and patients, I feel that POS 12 or 13 would still be the appropriate choice in this setting as compared to 11. Has anyone encountered a similar situation or have any definitive guidance they would be willing to share? We are Novitas JH.

Thanks in advance!

I agree with you. If the providers are not incurring any costs for the use or maintenance of the space, then POS 11 is not appropriate. Since the space is owned and provided by the facility at their own cost, I would continue to use the POS code that corresponds with the type of facility.