I'm not sure I understand what you mean when you say "additional adjustment". I am taking it to mean the payment is less than usual for those codes.
The payment for 99212-99215 would be less in an outpatient hospital setting than it would in the office. Payments for place of service 11 include support staff, rent, utilities, etc. When you use place of service 22 they reduce the payment to the physician because they are also pay the hospital for their costs, so the physician is only getting reimbursed for their personal services not the others that are involved in their private office.
Hope this helps,
Laura, CPC, CEMC
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