Guide

POS 11, 10, and 02: the place-of-service map

Summary

Office visits use POS 11, telehealth delivered while the patient is at home uses POS 10, and telehealth delivered anywhere else uses POS 02 — CMS defines the full code set, and the choice determines whether a claim pays the facility or non-facility rate. Getting it wrong doesn't just risk a denial: for many codes it changes the payment amount itself, because the fee schedule prices non-facility settings higher to cover overhead a facility visit doesn't require the clinician to carry.

By Gale Editorial · Updated 2026-07-26. Every figure cited to a dated source. How we write.

The three codes that cover almost every visit

Place of service (POS) codes tell a payer where a service happened, and three of them cover the overwhelming majority of an outpatient practice's claims: 11 for a service delivered in the clinician's own office, 10 for telehealth delivered while the patient is in their home, and 02 for telehealth delivered anywhere else. CMS maintains the full code set, and each code carries a specific, published definition rather than a description a practice gets to interpret 1Ref 1Centers for Medicare & Medicaid Services (2026).Place of Service Code Set.That the POS code set (office 11, home 10, telehealth in patient's home 10, telehealth other 02, etc.) is defined by CMS and determines facility vs non-facility payment..

The distinction between 10 and 02 exists specifically because Medicare pays telehealth differently depending on where the patient is, not just whether the visit happened by video — a detail that trips up practices treating 'telehealth' as one undifferentiated category rather than two distinct billing situations.

A patient's location can also change visit to visit even when the clinician's own setup doesn't, which is why POS has to be confirmed at the start of each encounter rather than defaulted from whatever the last visit used. A patient who joins from a car or a workplace one week and from home the next genuinely changes which code applies, even though nothing about the service itself changed.

Why the code changes what you're actually paid

POS doesn't just describe the visit — for many codes, it sets the payment amount, because the Medicare Physician Fee Schedule prices the same CPT code differently depending on whether the setting is facility or non-facility. A non-facility rate, which typically applies to POS 11 and to telehealth billed to the patient's home, is generally higher than the facility rate, because it assumes the clinician's own practice is absorbing overhead a facility would otherwise cover 2Ref 2Centers for Medicare & Medicaid Services (2026).Physician Fee Schedule Search.That CMS publishes a public Physician Fee Schedule look-up tool showing the national and locality payment amount for a code, including its facility and non-facility rates..

That means selecting the wrong POS on an otherwise correct claim can under-pay or over-pay a visit even when every code and modifier is right — worth checking against the fee schedule's own facility and non-facility columns for a code billed often, rather than assuming the two rates are close enough not to matter.

Commercial contracts don't always mirror Medicare's facility/non-facility structure exactly, but many are built on the same underlying fee-schedule logic, which makes understanding the Medicare version worth the time even for a practice that bills mostly commercial payers — it's the clearest public model of how POS and payment connect.

Telehealth POS: whether the code is even payable, not just which one

Choosing between POS 10 and 02 only matters if the CPT code itself is on Medicare's telehealth list in the first place — CMS publishes the definitive list of which codes are payable as telehealth each year, including which are permanent additions, which are temporary, and which allow an audio-only encounter 3Ref 3Centers for Medicare & Medicaid Services (2026).List of Telehealth Services.That CMS publishes the definitive annual list of codes payable as Medicare telehealth, including which are permanent versus temporary and which allow audio-only delivery. As of July 2026.. A code that isn't on that list doesn't become billable by attaching a telehealth POS to it.

The POS communicates where the visit happened, not whether telehealth delivery is covered for that service at all — two separate questions a claim has to answer correctly, and getting the second one wrong isn't something the POS field can fix regardless of which of the two telehealth codes gets used. Working through the telehealth billing matrix once, code by code, is what actually settles both questions together rather than one visit at a time.

Because the list changes from year to year — and some additions are explicitly temporary — the correct habit is checking the current list each year a practice relies heavily on telehealth, not trusting a list saved from a prior year's billing setup. A code that was temporarily payable by telehealth one year is not guaranteed to stay that way the next.

Where the code lives on the claim, and what a mismatch triggers

On a professional claim, POS is its own designated field, separate from the CPT code and any modifier, per the NUCC's own instructions for completing the claim 4Ref 4National Uniform Claim Committee (2026).1500 Claim Form.That the NUCC maintains the 1500 claim form and its instruction manual, including that place of service has its own designated field separate from the procedure code and modifier.. A payer's system cross-checks the POS against the code and modifier together, so an internally inconsistent combination — a telehealth modifier paired with an office POS, for instance — reads as an error rather than simply an unusual claim.

When that mismatch causes a denial rather than a rejection, the remittance explains it through a standard adjustment reason code, since Claim Adjustment Reason Codes are the maintained, public list payers use to explain exactly why a line was paid differently than billed 5Ref 5X12 (2026).Claim Adjustment Reason Codes.That CARCs are the standard, public code list explaining why a claim or line was paid differently than billed, including a POS-and-modifier mismatch. — worth reading the specific code rather than assuming the denial is about something else entirely.

A practice that sees this specific kind of denial repeatedly is usually looking at a workflow gap rather than a one-off mistake: whoever documents the visit and whoever submits the claim aren't reliably passing along the same information about where the patient actually was — the same handoff problem that shows up separately when rendering vs billing npi gets confused on a claim submitted by more than one person.

When coverage, not just payment, depends on the setting

Some services carry Medicare coverage rules tied specifically to where they're delivered, documented in a Local Coverage Determination or a national coverage policy rather than in the fee schedule itself — both are searchable in the public Medicare Coverage Database 6Ref 6Centers for Medicare & Medicaid Services (2026).Medicare Coverage Database (MCD) Search.That NCDs and MACs' LCDs/articles are searchable in the public Medicare Coverage Database, which is where setting-specific coverage rules — separate from the fee schedule's payment amounts — are documented.. A service covered in an office setting isn't automatically covered the same way when delivered by telehealth, or vice versa.

A POS choice can occasionally be a coverage question and not only a payment one, which is a different and more consequential kind of mistake than a simple rate difference — a coverage denial doesn't reprocess at a different rate the way a facility/non-facility mismatch often does.

Checking the coverage database for a code new to the practice, before assuming coverage travels automatically across settings, avoids a denial that has nothing to do with how the claim was coded and everything to do with where the service actually happened. This is worth doing once per new code rather than assuming last year's coverage rule still applies unchanged.

Building the POS decision into intake, not into memory

The most reliable practices decide POS at the point of scheduling — office, home telehealth, or other-location telehealth — rather than leaving it to whoever submits the claim later to reconstruct from a note. That single decision then drives the CPT, modifier, and POS combination together, instead of three separate judgment calls made at different points in the billing cycle.

A short reference card mapping the practice's most common visit types to their correct POS, kept next to the fee schedule reference described above, turns this into a five-second lookup rather than a recurring source of denials.

The habit is worth revisiting whenever the practice adds a new visit type — a group format, a new telehealth platform, a home-visit program — since each one introduces a POS decision that didn't exist in the reference card before, and an untested assumption is where these mismatches tend to originate.

Common questions

POS 11 covers a service delivered in the clinician's own office. It's the default for the vast majority of in-person outpatient visits and generally carries the non-facility payment rate, which is priced higher than the facility rate for the same code to account for the overhead the practice itself absorbs.

POS 10 means the telehealth visit happened while the patient was in their home. POS 02 covers telehealth delivered from any other location — a workplace, a vehicle, another clinical site. The distinction affects payment because Medicare's telehealth payment rules differ by where the patient was during the visit, not just that the visit occurred by video.

For many codes, yes. The Medicare Physician Fee Schedule prices the same CPT code differently for facility versus non-facility settings, so choosing the wrong POS can under-pay or over-pay a visit even when every other part of the claim is correct.

Check CMS's published list of telehealth-eligible services for the current year — it names which codes qualify, which are permanent versus temporary additions, and which allow audio-only delivery. Attaching a telehealth POS to a code that isn't on that list doesn't make it billable as telehealth.

An internally inconsistent combination, like a telehealth modifier paired with an office POS, typically reads to a payer's system as an error and denies, with the remittance's adjustment reason code explaining why. It's worth building the POS decision into the workflow at scheduling rather than reconstructing it from the note afterward.

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References

1.Centers for Medicare & Medicaid Services (2026). Place of Service Code Set. Centers for Medicare & Medicaid Services (CMS). link ✓That the POS code set (office 11, home 10, telehealth in patient's home 10, telehealth other 02, etc.) is defined by CMS and determines facility vs non-facility payment.
2.Centers for Medicare & Medicaid Services (2026). Physician Fee Schedule Search. Centers for Medicare & Medicaid Services (CMS). link ✓That CMS publishes a public Physician Fee Schedule look-up tool showing the national and locality payment amount for a code, including its facility and non-facility rates.
3.Centers for Medicare & Medicaid Services (2026). List of Telehealth Services. Centers for Medicare & Medicaid Services (CMS). link ✓That CMS publishes the definitive annual list of codes payable as Medicare telehealth, including which are permanent versus temporary and which allow audio-only delivery. As of July 2026.
4.National Uniform Claim Committee (2026). 1500 Claim Form. National Uniform Claim Committee (NUCC). link ✓That the NUCC maintains the 1500 claim form and its instruction manual, including that place of service has its own designated field separate from the procedure code and modifier.
5.X12 (2026). Claim Adjustment Reason Codes. X12. link ✓That CARCs are the standard, public code list explaining why a claim or line was paid differently than billed, including a POS-and-modifier mismatch.
6.Centers for Medicare & Medicaid Services (2026). Medicare Coverage Database (MCD) Search. Centers for Medicare & Medicaid Services (CMS). link ✓That NCDs and MACs' LCDs/articles are searchable in the public Medicare Coverage Database, which is where setting-specific coverage rules — separate from the fee schedule's payment amounts — are documented.

https://www.gale.care/for-providers/cm-pos-codes-11-10-02 · 6 sources. Competitor details are cited to dated public sources and maintained as they change; figures are estimates, not commitments. Synthetic demonstration.

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