Facility, Place of Service on Claim Forms | News | APMA
Facility, Place of Service on Claim Forms

September 5, 2023

Medical Claims Denied Stamp

Updated on October 23, 2023

Do you see patients in a nursing facility? If so, it is important to include the correct place of service on claim forms.  

POS 32“Nursing Facility”

POS 31“Skilled Nursing Facility”

Oftentimes, the same facility may care for patients under both of these stay types. The onus is then placed on the provider to determine the correct place of service for every patient they care for. Patients who are under a POS 32 stay are typically in the facility for long-term care. Patients who are under a POS 31 stay have typically been transferred to a skilled nursing facility within 30 days of discharge from a medically necessary inpatient hospital admission of at least three consecutive days. Skilled nursing facility stays do not typically last more than 100 days.

Because skilled nursing facility stays can potentially be fewer than 100 days, members are encouraged to rely on the patient’s admission status with the facility to determine nursing facility versus skilled nursing facility status rather than relying only on the number of days of the stay.

Reference: Place of Service Code Set—www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set

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