It’s not every day that CMS releases new place of service codes, but on August 9th, the agency issued one that every healthcare provider should know.
Check out details of the new POS code, along with tips on using place of service codes so you can get paid for your services.
Welcome POS 66
Last month, CMS issued Transmittal 12779, which announced the debut of POS 66 (Programs of all-inclusive care for the elderly [PACE] center). The effective date of the change is August 1, 2024, and the implementation date is January 6, 2025.
A PACE center is a location or facility that provides comprehensive social and medical services as part of the PACE program. For instance, the uses for this POS code might include primary care, physical therapy, social work, personal care, nutritional counseling and more.
Going forward, if your provider sees a patient at a PACE center, they should submit their Medicare claim using POS 66.
Place of Service Codes Affect Reimbursement
Your payer may adjust the amount of reimbursement you receive based on which place of service codes you report. For instance, many fee schedules (including Medicare) list a reimbursement amount for non-facility services and a separate amount for facility services. Therefore, if you use the wrong POS code, you could collect the wrong amount of money, or even face denied claims.
Train Your Team on Place of Service Codes
The best way to ensure that you report the most accurate place of service codes is to train your staff on the most up to date list of POS options and explain how to use them. For instance, it’s important to know that place of service codes should always be listed in box 24B of the CMS-1500 form, whether it’s the electronic form or the paper equivalent. Without this two-digit POS code, you’re likely to see claims denied.
Bookmark CMS’ list of POS codes on your computers at the office and print it out for staff members who are most likely to be filing and submitting claims. If you frequently report the same POS code over and over again (such as POS 11, Office), then staffers may want to commit that one to memory.
Place of service codes are just one part of being able to collect maximum reimbursement for your services. Discover additional patient billing strategies with our three-part online training series, Patient Billing Tactics: Compliantly Get Paid More. Register today!
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