Place of Service Codes List - Medical Billing

Place of Service 12

Place of Service 12 in Medical Billing:

Place of Service 12 is also called as POS 12 in Medical billing. Place of Service 12 indicated when the patient receives the medical services in patients “Home”.

POS 12 Description:

POS 12 is a place other than a facility or hospital, where the patient receives health care services in a private residence.

Frequently asked questions on place of service 12 :
  1. When billing for medical services provided at place of service- patient’s home (POS 12), which address we need to report in block# 32? Do you put the patient’s home address or provider’s office address? Or is there a guideline that states that when you bill a service for patient’s home visit, you must have their home Address or patient address on the block# 32 on the claim form?

Answer: When you bill a home visit for a patient, then the claims need to be reported with place of service 12 in the block# 24B and provider’s office (practice) address at the bottom (Block# 32)

2) Patient’s exam for sleep concerns in the wellbeing of their home, which place of service needs to be reported?

Answer: If the Health Sleep Test device is shipped to the patient’s home, the place of service 12 needs to be reported.

3) When billing for Durable Medical Equipment, which place of service to be used?

Answer: Patients uses the Durable Medical Equipment at home (Either Rental or purchased items), place of service 12 is to be indicated on claim form when billing Durable Medical Equipment codes.

4) When billing the services provided at the patient’s home we use place of service 12. Do we need to use the patient’s home address at the bottom on HCFA Claim form?

Answer: Place of Service 12 indicates the services rendered at patient home. So the practice address to be mentioned at the bottom of HCFA Claim form, because place of service is enough for insurance to direct to the patient’s home address (Which will be on top of the HCFA claim form).

5) Does Insurance pay home visits claims billed with office visit E/M Codes 99201-99215 with place of service 12?

Answer: No.

Insurance will never pay the claim and they will deny the claim when office visit codes (99201-99215) billed with place of service 12.Because the services performed in home, but claim billed with an incorrect E/M office visit codes which is an incorrect.

Some providers even do fraudulent for getting paid, for example:

When insurance company will deny the claim submitted with place of service 12 and E/M office visit codes (99201 through 99215), some providers may even try to bill the home visit claim with place of service 11 for E/M office visit codes (99201-99215) in order to get paid. But this is totally fraudulent, because the services are performed in a home and billing the claim as an office visit is fraud.

According to me home visit E/M code should be billed with either new patient codes (99341-99345) or established codes (99347-99350) along with place of service 12.