However, for a service rendered to a patient who is an inpatient of a hospital (POS code 21) or an outpatient of a hospital (POS codes 19 or 22), the facility rate is paid, regardless of where the face-to-face encounter with the beneficiary occurred. In general, the POS code reflects the actual place where the beneficiary receives the face-to-face service and determines whether the facility or non-facility payment rate is paid. WellCare is implementing the following policy for Appropriate Place of Service (POS) Billing (IH146) with an effective date as of November 26, 2020.Īccording to CMS, facility or non-facility rate that a physician service is paid under the Medicare Physician Fee Schedule (MPFS) is determined by the Place of Service (POS) code that is used to identify the setting where the beneficiary received the face-to-face encounter with the physician, nonphysician practitioner (NPP) or other supplier.
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