HealthCare News

Place of Service – Professional

Issue: #396 SEP2017

Topic: Coding/Billing

Blue Cross Blue Shield of North Dakota (BCBSND) follows Centers for Medicare & Medicaid Services (CMS) and CPT® guidelines for place of service billing on professional claims.

CPT® guidelines state that the place of service codes “should be used on professional claims to specify the entity where the service(s) were rendered.” In addition, BCBSND follows the CMS exception to this.

CMS further clarifies that in cases where the face-to-face requirement is obviated such as those when a physician/practitioner provides the professional component/interpretation of a diagnostic test, the place of service (POS) code assigned by the physician/practitioner will be the setting in which the beneficiary (in the case of BCBSND – member) received the technical component (TC) of the service.