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2013 New Place of service code (POS) for Place of Employment/Worksite


The Centers for Medicare & Medicaid Services (CMS) is establishing a new POS code: 18 – Place of Employment/Worksite; described as: “a location, not described by any other POS code, owned or operated by a public or private entity where the patient is employed, and where a health professional provides on-going or episodic occupational medical, therapeutic, or rehabilitative services to the individual.”

The Centers for Medicare & Medicaid Services (CMS) is establishing this POS code because:

1. Industry entities (other than Medicare) have identified a need to establish the delivery of occupational-related medical and rehabilitation services in the work place in order to: A) reduce employee time lost from work; and B) enable therapists to evaluate the work environment and provide rehabilitation services that are focused on returning the individual to their pre-injury state in a way that maximizes function in the workplace environment and reduces employee time lost.

2. As a Health Insurance Portability and Accountability Act of 1996 (HIPAA) covered entity, Medicare must comply with its standards and their implementation guides that are adopted by regulation. Specifically, the currently adopted professional implementation guide for the Accredited Standards Committee (ASC) X12 837 (Professional Health Care Claim) standards requires that each electronic claim transaction include a Place of Service (POS) code from the POS code set that CMS
maintains.

Therefore, while it has not identified an inherent need for this new code; as a payer, Medicare must be able to recognize any code from the POS code set that appears on the HIPAA standard claim transaction.

Reference: http://cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/MM8125.pdf


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