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2018 New CPT codes

00731  Anesthesia for upper gastrointestinal endoscopic procedures, endoscope introduced proximal to duodenum; not otherwise specified ...

Medicare Payments based on Place of Service codes (POS)


The list of settings where a physician’s services are paid at the facility rate include:

Inpatient Hospital (POS code 21);

Outpatient Hospital (POS code 22);

Emergency Room-Hospital (POS code 23);

Medicare-participating Ambulatory Surgical Center (ASC) for a Healthcare Common Procedure Coding System (HCPCS) code included on the ASC approved list of procedures (POS code 24);

Medicare-participating ASC for a procedure not on the ASC list of approved procedures with dates of service on or after January 1, 2008. (POS code 24);

Skilled Nursing Facility (SNF) for a Part A resident (POS code 31);

Hospice – for inpatient care (POS code 34);

Ambulance – Land (POS code 41);

Ambulance – Air or Water (POS code 42);

Inpatient Psychiatric Facility (POS code 51);

Psychiatric Facility -- Partial Hospitalization (POS code 52);

Community Mental Health Center (POS code 53);

Psychiatric Residential Treatment Center (POS code 56); and

Comprehensive Inpatient Rehabilitation Facility (POS code 61).

Physicians’ services are paid at non-facility rates for procedures furnished in the following settings:

Pharmacy (POS code 01);

School (POS code 03);

Homeless Shelter (POS code 04);

Prison/Correctional Facility (POS code 09);

Office (POS code 11);

Home or Private Residence of Patient (POS code 12);

Assisted Living Facility (POS code 13);

Group Home (POS code 14);

Mobile Unit (POS code 15);

Temporary Lodging (POS code 16);

Walk-in Retail Health Clinic (POS code 17);

Urgent Care Facility (POS code 20);

Birthing Center (POS code 25);

Nursing Facility and Skilled Nursing Facilities (SNFs) to Part B residents - (POS code 32);

Custodial Care Facility (POS code 33);

Independent Clinic (POS code 49);

Federally Qualified Health Center (POS code 50);

Intermediate Health Care Facility/Mentally Retarded (POS code 54);

Residential Substance Abuse Treatment Facility (POS code 55);

Non-Residential Substance Abuse Treatment Facility (POS code 57);

Mass Immunization Center (POS code 60);

Comprehensive Outpatient Rehabilitation Facility (POS code 62);

End-Stage Renal Disease Treatment Facility (POS code 65);

State or Local Health Clinic (POS code 71);

Rural Health Clinic (POS code 72);

Independent Laboratory (POS code 81); and

Other Place of Service (POS code 99).


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