CMS revises instructions for new POS code 27

Wednesday, October 11, 2023

CMS recently revised its instructions for new place of service (POS) code 27, which is used to report services provided to unsheltered homeless individuals. POS code 27 (outreach site/street) became effective on October 1, and it is defined as follows:

  • A non-permanent location on the street or found environment, not described by any other POS code, where health professionals provide preventive, screening, diagnostic, and/or treatment services to unsheltered homeless individuals

The revisions will help the instructions to better align with broader CMS efforts to address economic, social, and other obstacles impacting Medicare beneficiary healthcare access, according to the change request.

The new code was created at the request of industry entities, said CMS. “It addresses a need for a code which helps identify care rendered to those who may be unable to access brick and mortar settings, as well as to potentially allow for the tracking of care provided through outreach sites,” according to the agency.

Although POS code 27 is effective for dates of service on or after October 1, Medicare Administrative Contractors (MAC) have until January 2, 2024, to implement it, according to the change request. However, MACs are to accept claims containing the new code in accordance with its effective date.

Revenue integrity professionals should review CMS guidance on the new code. Determine whether or not you need to add POS code 27 to your organization’s code list. Coordinate with your local MAC to ensure you report the code appropriately.

Editor’s note: Find more NAHRI resources on POS codes here.

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