ED Coding & Reimbursement Alert - 2016 Issue 7
Place of Service: Face POS 19 Game-Changer for Outpatient Billing
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Article Overview
This article covers a Medicare outpatient billing update centered on revised place-of-service coding for hospital-based and provider-based clinics. It explains the policy background behind the change, highlights why the update matters for physician payment under Medicare, and discusses the general distinction between on-campus and off-campus outpatient settings. It is relevant to coders, billers, and physicians who submit Medicare claims for outpatient services.
Why This Topic Matters
The article addresses a billing change that can affect how outpatient claims are reported and paid under Medicare, especially for services furnished in hospital-based clinic settings. Understanding the update helps practices recognize the broader payment implications of place-of-service selection.
Article Sections
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New and revised place-of-service definitions
Introduces the updated outpatient place-of-service framework and presents the revised definitions relevant to hospital-based clinic reporting.
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Focus on Medicare instruction
Summarizes the Medicare policy guidance behind the coding update and the reason CMS gave for the change.
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Understand off-campus to master POS coding
Explains the broader campus concept used for reporting and describes how the article frames the on-campus versus off-campus distinction for outpatient settings.
What You Will Learn
- The policy background for the outpatient place-of-service update
- How the article frames the distinction between campus-based and off-campus clinic settings
- Why the change is relevant to Medicare outpatient billing
- What general payment-policy concepts are associated with the updated place-of-service framework
Who Should Read This
- Medical coders
- Medical billers
- Physician practices
- Hospital-based outpatient departments
- General surgery billing staff
- Medicare claims staff
Codes Discussed
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