Wiki Home and Nursing Facility Services

[ckeeney]

I have been reviewing the 2023 guidelines for the recently updated E&M services and had some questions. We are a specialist group that has been providing services to rest home, assisted living, group home, etc facilities. Some of these services may now fall into the nursing facility category. I am not familiar with the definition of POS 54 which seems to me to be the most appropriate for the licensed intermediate care facilities for individuals with intellectual disabilities. Would that be the one reported with the nursing facility service codes? For services in the types of facilities that were previously reported with POS 13 and 14 and now are considered Home, would these now transition to POS 12? Or would 13 and 14 still be appropriate? Then there is the question about patients receiving day care only at these facilities and are seen by our providers when they are at the facility. How do we report these?

 

[jkyles]

Hi there, the places of service will not change, and the place of service will still be where ever the visit occurred.

POS 54 is the code for Intermediate Care Facility/Individuals with Intellectual Disabilities. Visits in that setting will be reported with nursing facility codes.