Improve the health of the people of Wisconsin by supporting and strengthening physicians' ability to practice high-quality patient care in a changing environment.

Revised place of service
guidelines effective April 1

Effective April 1, physicians and other health care professionals must comply with revised place of service (POS) coding instructions from the Centers for Medicare & Medicaid Services (CMS). Under the Medicare Physician Fee Schedule (MPFS), physicians and other health care professionals are required to report the setting, by selecting the most appropriate POS code, in which medically necessary services are furnished to beneficiaries.

Some key points to remember about this revision are:

  • The POS code reported is the physical location of the patient while services are being rendered.
  • The place of service (Item 24B of a CMS-1500 claim form or electronic equivalent) and the service locality (Item 32 of CMS-1500) may not match. The service locality is the location where the physician or other health care professional is physically standing when the service is completed.
  • Although related, date of service regulations are not affected by this revision. Physicians and other health care professionals should report the date on which the service for which they are billing was performed. If billing the professional component of a radiology procedure, report the date of service on which the professional interpretation was performed.

Detailed information is available in CMS Transmittal 2679. (This link was updated May 16, 2013.)

Back to March 21, 2013 Medigram