Wiki Off Campus Outpatient POS

[missyah20]

Good Morning,

One of the CRNAs that we bill for has an opportunity to work at an outpatient center that is considered off campus, billed with a place of service 19. Does anyone have any experience with this? Is it something that needs to be specifically stated in the providers contracts with insurers?

I was leaning more towards a no since they can be paid with a place of service 22 (on campus outpatient center) at the location they are currently at.

Thanks for any insight!

 

[thomas7331]

Place of service 19 would be for a clinic that the hospital has designated as provider based. This status primarily affects hospital reimbursement and wouldn’t impact outside providers. You would need to contact the hospital to find out whether or not this particular location meets the criteria for that designation and if so, bill place of service 19 instead of 22. If you are billing professional claims, these two place of service codes will be paid exactly the same. It should not be necessary for it to be stated in the provider’s contract and I imagine most payers would not be particular if you billed one or the other since it wouldn’t cause an overpayment either way.