In the world of medical billing and coding, accuracy and clarity are essential—not just for compliance, but also for proper reimbursement. One term that often appears in medical claims is Place of Service 22. In this article, we’ll break down the Place of Service 22 description, its significance, and how it impacts healthcare providers and payers.
What is Place of Service 22?
The Place of Service (POS) code 22 refers to a “On Campus-Outpatient Hospital.” This code is used in medical billing to specify that services were provided in an outpatient department of a hospital that is located on the hospital’s main campus.
Place of Service 22 Description (Official)
According to the Centers for Medicare and Medicaid Services (CMS), the official Place of Service 22 description is:
“On Campus-Outpatient Hospital – A portion of a hospital’s main campus where outpatient services are provided.”
This setting includes locations such as hospital-owned clinics, infusion centers, and diagnostic departments that operate within the main hospital facility but provide outpatient care.
Why is POS 22 Important?
Using the correct Place of Service code is critical in determining the correct payment amount for a claim. Here's why POS 22 matters:
Billing Accuracy: Misidentifying the service location can lead to claim denials or underpayments.
Reimbursement Rates: Reimbursement may vary depending on whether the service is billed as an outpatient hospital (POS 22) versus a physician office (POS 11).
Regulatory Compliance: Healthcare providers must follow HIPAA and CMS guidelines when submitting claims.
POS 22 vs POS 19: What’s the Difference?
Both POS 22 and POS 19 relate to outpatient hospital services, but there is a key distinction:
| POS Code | Description | Location Type |
|---|---|---|
| 22 | On Campus-Outpatient Hospital | On the hospital’s main campus |
| 19 | Off Campus-Outpatient Hospital | Away from the main campus |
If a patient receives outpatient care at a facility not physically attached to the hospital campus, then POS 19 should be used.
Common Services Billed Under POS 22
Some examples of services commonly billed under POS 22 include:
Outpatient surgeries
Diagnostic imaging (CT, MRI)
Chemotherapy and infusion therapy
Laboratory testing
Outpatient physical therapy
Best Practices for Using POS 22
To ensure compliance and accurate reimbursement when using Place of Service 22, follow these best practices:
Verify the service location: Ensure that the service is provided on the hospital’s main campus.
Use updated CMS guidelines: POS codes and definitions may change—always use the most recent documentation.
Train billing staff: Make sure your billing team understands the distinctions between POS codes.
Final Thoughts
Understanding the Place of Service 22 description is essential for any healthcare provider, medical biller, or coder working in the outpatient setting. Using the correct POS code not only streamlines the claims process but also ensures you receive proper reimbursement without compliance risks.
At DWP Medical, we emphasize the importance of accurate coding and billing practices to help providers avoid claim denials and optimize revenue. Staying informed about POS codes like 22 is just one part of delivering compliant and efficient medical billing services.
For more updates on medical billing, CPT codes, and reimbursement strategies, stay tuned to our blog or subscribe to our newsletter.
