Use POS 19 for off campus outpatient locations

Why This Topic Matters

Correctly identifying whether a location is on campus or off campus can affect outpatient claim reporting and how services are evaluated under CMS policy. The article helps readers understand the scope of the guidance and why Medicare billing teams may need to verify location status with CMS or their Medicare administrative contractor.

Article Sections

1. CMS guidance on POS 19

   Introduces the new place of service designation and the CMS communication that announced it. The section frames the policy change for off-campus outpatient services.

2. Campus definition and location status

   Discusses how campus status is defined for health care purposes and why a separate address alone may not determine whether a location is on campus or off campus. It also notes the need to confirm status with CMS or Medicare contractors when appropriate.

3. Three-day payment rule and provider-based facilities

   Summarizes the relationship between the new place of service designation and the existing three-day payment policy. The section also addresses claims handling considerations for provider-based facilities and outpatient settings.