Published September 18, 2015

To Be, or Not to Be…On Campus, Is the Question—New Guidance on Place of Service Codes

On August 6, 2015, the Centers for Medicare & Medicaid Services (CMS) announced Place of Service (POS) code 22 will be revised to On Campus-Outpatient Hospital, and a new POS code 19 will be created for Off Campus-Outpatient Hospital. These changes are effective for services furnished on or after January 1, 2016. For now, there will be no difference in Medicare payments between POS codes 22 and 19.

Key Considerations:

  1. These updates apply only to professional services billed on CMS 1500 claim forms.
  2. A hospital must identify those sites of services that qualify as “on campus” versus those that are “off campus.” 42 CFR 413.65(a)(2) defines “campus” as “the physical area immediately adjacent to the provider’s main buildings, other areas and structures that are not strictly contiguous to the main buildings but are located within 250 yards of the main buildings, and any other areas determined on an individual case basis, by the CMS regional office, to be part of the provider’s campus.”
  3. A hospital must ensure billing staff members are aware of the POS updates and the hospital’s designations and begin appropriately applying the correct POS code for services furnished with dates of service on or after January 1, 2016.

For assistance implementing these changes or other Medicare Physician Fee Schedule requirements, or to request a speaker on coding and compliance issues, contact one of the experts listed below at  PYA (888) 420-9876.

Additional resource:

https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/MM9231.pdf

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