HL7 Terminology (THO)
4.0.0 - Publication International flag

This page is part of the HL7 Terminology (v4.0.0: Release) based on FHIR R4. The current version which supercedes this version is 5.2.0. For a full list of available versions, see the Directory of published versions

NamingSystem: CMS Place of Service Codes (POS)

Official URL: http://terminology.hl7.org/NamingSystem/CMSPlaceofServiceCodes Version:
Active as of 2022-04-07 Responsible: Centers for Medicare & Medicaid Services Computable Name: CMSPlaceofServiceCodes

Place of Service Codes are two-digit codes placed on health care professional claims to indicate the setting in which a service was provided. The Centers for Medicare & Medicaid Services (CMS) maintain POS codes used throughout the health care industry.

This code set is required for use in the implementation guide adopted as the national standard for electronic transmission of professional health care claims under the provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). HIPAA directed the Secretary of HHS to adopt national standards for electronic transactions. These standard transactions require all health plans and providers to use standard code sets to populate data elements in each transaction. The Transaction and Code Set Rule adopted the ASC X12N-837 Health Care Claim: Professional, volumes 1 and 2, as the standard for electronic submission of professional claims. This standard names the POS code set currently maintained by CMS as the code set to be used for describing sites of service in such claims. POS information is often needed to determine the acceptability of direct billing of Medicare, Medicaid and private insurance services provided by a given provider.

Summary

Defining URLhttp://terminology.hl7.org/NamingSystem/CMSPlaceofServiceCodes
NameCMSPlaceofServiceCodes
Statusactive
Definition

Place of Service Codes are two-digit codes placed on health care professional claims to indicate the setting in which a service was provided. The Centers for Medicare & Medicaid Services (CMS) maintain POS codes used throughout the health care industry.

This code set is required for use in the implementation guide adopted as the national standard for electronic transmission of professional health care claims under the provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). HIPAA directed the Secretary of HHS to adopt national standards for electronic transactions. These standard transactions require all health plans and providers to use standard code sets to populate data elements in each transaction. The Transaction and Code Set Rule adopted the ASC X12N-837 Health Care Claim: Professional, volumes 1 and 2, as the standard for electronic submission of professional claims. This standard names the POS code set currently maintained by CMS as the code set to be used for describing sites of service in such claims. POS information is often needed to determine the acceptability of direct billing of Medicare, Medicaid and private insurance services provided by a given provider.

PublisherCenters for Medicare & Medicaid Services

Identifiers

TypeValuePreferred
OID2.16.840.1.113883.15.5true
URIhttps://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Settrue

History

DateActionAuthorCustodianComment
2022-04-28reviseJessica BotaHTARemove Version Specific Information from CMS Place of Service Description; UP-307
2021-03-24createJessica BotaStructured DocsNew CS/NS: CMS-PlaceofServiceCodes;UP-61