Place of Service POS 11 in medical billing refers to services provided within the vicinity of a physician’s office, and these services are reported in CMS-1500 Box 24B. While POS codes appear to be simple, the reimbursement methodology depends upon their correct usage.
POS codes affect the audit exposure and payer compliance for POS 11 non-facility rates. Non-facility reimbursement rates are typically higher than facility-based payments. Any intentional or unintentional incorrect reporting in POS 11 codes can result in overpayments, compliance findings, or recoupments. For accurate claim submissions in 2026, understanding the applications of POS 11 is essential.
As per CMS place of service 11, POS is defined as
| A location, other than a hospital or facility, where the health professional routinely provides health examinations, diagnoses, and treatment on an ambulatory basis. |
The qualifying office settings are
Ultimately, the POS classification is based upon ownership and billing structure.
POS is reimbursed under the non-facility reimbursement rates. CMS assumes that the provider bears the overhead practice costs, including office supplies, rent, and staff payments.
Non-facility reimbursement is a payment methodology of Medicare in which the expense component of a practice is entirely paid to the provider, rather than being split between a professional fee and a separate facility payment.
Hospital-based POS codes split reimbursements between the provider and the facility, while providers operating in an office setting bear full operational responsibility, so CMS applies a higher relative value unit (RVU) payment under POS 11. Misreporting POS 11 raises audit risks and inflates the reimbursements.
POS 11 vs Other Common Place of Service Codes
| POS Code | Description | Ownership Model | Reimbursement Type |
| POS 11 | Office | Non-facility rate | Non facility rate |
| POS 22 | Outpatient hospital | Hospital-owned | Facility rate |
| POS 12 | Home | Patient location | Non-facility (context-specific) |
| POS 49 | Independent clinic | Clinic owned | Facility rate |
Provider-based clinic rule:
If a clinic meets CMS provider-based criteria, then POS 22 is applied regardless of its physical separation from the provider.
During the COVID-19 public health emergency, CMS temporarily permitted using POS 11 for telehealth services to maintain payment parity. This flexibility was not permanent, and now this exception has been phased out by CMS.
Now in 2026, CMS expects telehealth services to be reported using:
Using POS 11 for virtual visits in 2026 may result in overpayment reviews or payment audits, unless it is explicitly allowed by payer policy.
At present, in 2026, Place of Service (POS) remains bound to true office-based and non-facility settings. In contrast, it is true that POS 11 yields higher reimbursement rates; practices’ Place of Service (POS) 11 coding decisions should be based on compliance rather than on profit potential.
Practices need to verify how the service was delivered, whether in person or virtual, clearly understand payer-specific rules, and confirm the practice’s ownership structure to correctly report POS. Consistently applying these rules is one way to protect practices from audits, denials, and repayment demands.
POS 11 is reported in Box 24B of the CMS-1500 claim form.
POS 11 will make additional payments as the carrier receives full off-site compensation, including the cost of training expenses.
Private practices, institutional clinical workplaces,, and non-clinical clinics qualify for POS 11.
In 2026, telehealth will have to follow CMS rules, typically using POS 10 and POS 11 for home only when payer guidelines are appropriate.
Incorrect POS 11 reporting can result in overpayments, audits, chargebacks, or compliance penalties.
POS 11 applies to workplaces without a facilities fees, while POS 22 applies to outpatient clinics for health institutions with facility-based fees.
POS 12 is used when services are provided in a patient's home and are reimbursed according to special non-facility rules.
POS 49 refers to an independent hospital that is typically reimbursed during the facility's fee process.
POS rejections usually occur due to inconsistencies between the supplier's scope, documentation and explicit POS code.
POS 24 represents services performed in an ambulatory surgical center (ASC) and follows facility-based reimbursement rules.
Payment posting occurs after the claim is determined and records the charge to the payer or patient to resolve the debt within the sales cycle process.
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