Place of Service in Rehab

Tags: pos reimbursement medicare

Overview

Place of Service (POS) codes indicate where the service was rendered. This significantly impacts reimbursement rates for PM&R services.

Common POS Codes

Code	Setting	Description
11	Office	Private physician office.
22	Outpatient Hospital	Hospital owned clinic.
31	SNF	Skilled Nursing Facility (Part A).
32	SNF	Skilled Nursing Facility (Part B).
51	Psych Hospital	Inpatient Psychiatric Facility.
61	Comprehensive Rehab	Inpatient Rehab Facility (IRF).

Impact on Billing

• Office (11): Higher physician reimbursement.
• Facility (22, 31, 32): Lower physician reimbursement; facility bills the overhead.
• Therapy Thresholds: Medicare therapy caps may apply differently based on setting.

Incident-To Rules

Incident-to billing is generally not allowed in SNF or Hospital settings. It is primarily an Office (POS 11) benefit.

00 PM&R Coding MOC Medical Necessity in Rehab