Is POS 02 or 10 for telehealth?

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Place of Service (POS) code 02 is used for telehealth services when the patient is located in a facility or somewhere other than their home, while POS 10 is used when the patient is in their home.

Key Differences

  • POS 02 (Other than Patient's Home):
    • Definition: Patient is located in a facility, clinic, hospital, or other medical setting outside their residence.
    • Reimbursement: Paid at the lower facility rate because it accounts for facility resources and overhead.
  • POS 10 (Patient's Home):
    • Definition: Patient is located in a private residence or non-facility setting during the virtual visit.
    • Reimbursement: Paid at the higher non-facility rate (comparable to an in-office visit rate).

Compliance and Billing Best Practices

  • Location Based: The code must reflect the physical location of the patient at the time of the encounter, not the provider.
  • Software Defaults: Check your electronic health record (EHR) billing templates, as many default automatically to POS 02 and can trigger audits or underpayments if the patient was actually at home.
  • Payer Rules: Review individual commercial or state guidelines, as some non-Medicare payers may enforce specific modifier requirements (such as Modifier 95 for synchronous audio-video) alongside the POS code.

You can check official documentation through the Centers for Medicare & Medicaid Services guidelines.

What POS code should I use for a telehealth visit?

Use POS 10 if the patient is in their private home during the telehealth visit, or POS 02 if the patient is at any other location (such as an office, school, or outside facility).

Place of Service (POS) Options

  • POS 10 (Telehealth Provided in Patient's Home): Use when the patient connects from their personal residence. This typically triggers non-facility pricing.
  • POS 02 (Telehealth Provided Other than in Patient's Home): Use when the patient is located somewhere other than a private home, such as a clinic, workplace, or facility. This typically triggers facility pricing.

Key Billing Rules

  • Patient Location: The code depends on where the patient is sitting, not where the provider is located.
  • Modifiers: You may still need to add a modifier like 95 (synchronous video/audio) or 93 (audio-only) depending on your payer's rules.
  • Payer Guidelines: Always double-check specific requirements with your Official CMS Place of Service Code Set or private insurance guidelines, as some commercial or Medicaid plans enforce unique rules.

What POS do you use for telehealth?

For telehealth billing, use Place of Service (POS) Code 10 when the patient is in their home, and use POS Code 02 when the patient is located anywhere else.

Telehealth POS Codes

  • POS 10 (Telehealth Provided in Patient's Home): Use this code when the patient receives the virtual service while physically located in a private residence. This option typically triggers the non-facility (in-office) payment rate.
  • POS 02 (Telehealth Provided Other Than in Patient's Home): Use this code when the patient is at a location outside of a private residence, such as a clinic, hospital, school, or workplace. This option often triggers a facility payment rate.

Best Practices for Billing

  • Base it on the patient: The POS code must reflect where the patient is sitting during the visit, not where the provider is located.
  • Add modifiers: Pair your POS code with Modifier 95 for synchronous audio-video visits, or Modifier 93 for audio-only encounters, depending on payer requirements.

What modifier do I use for telehealth visits?

Use Modifier 95 for live audio-video visits, and Modifier 93 for audio-only phone calls.

Common Telehealth Modifiers

  • Modifier 95: Live, real-time interactive audio and video communication (the standard video visit).
  • Modifier 93: Real-time audio-only communication (telephone calls), used when video is not available or the patient does not consent to video.
  • Modifier FQ: Audio-only communication used specifically by Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs).
  • Modifier GT: Interactive audio and video used exclusively on institutional claims billed by Critical Access Hospital (CAH) Method II providers.
  • Modifier GQ: Asynchronous "store-and-forward" telecommunications (limited to specific federal demonstration projects in Alaska and Hawaii).

Place of Service (POS) Codes Matter

Along with the modifier, you must report the correct Place of Service code to designate where the patient was during the encounter:

  • POS 10: Telehealth provided in the patient's home (reflects higher non-facility rates).
  • POS 02: Telehealth provided in a location other than the patient's home (facility setting).

Note: Payer rules vary. For instance, Medicare often identifies telehealth primarily via the Place of Service code rather than a modifier for standard video visits, while many commercial and private insurers still require Modifier 95. Always verify guidelines with your specific insurance carrier or CMS Telehealth Guidelines.

What does the modifier 02 represent in telehealth billing?

In telehealth billing, 02 typically refers to a Place of Service (POS) code—specifically POS 02—rather than a modifier, representing telehealth services provided when the patient is located somewhere other than their home (such as a clinic, hospital, or other facility setting).

Key Details About POS 02

  • Patient Location: It signals that the patient was at an outside site or facility during the virtual visit, contrasting with POS 10, which is used when the patient is in their private residence.
  • Based on the Patient, Not Provider: The code describes where the client or patient is sitting, not where the practitioner is located.
  • Reimbursement Impact: Under many fee schedules like Medicare, services billed under POS 02 often map to the lower facility rate because they assume facility-based overhead, whereas home-based POS 10 often maps to the higher non-facility rate.

POS 02 vs POS 10 Telehealth Place of Service Codes Explained DocVilla

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What is the difference between POS 02 and POS 10 for telehealth billing?

The main difference between Place of Service (POS) code 02 and POS code 10 is the physical location of the patient during the telehealth visit.

Patient Location Definitions

  • POS 10 (Telehealth in Patient's Home): Used when the patient is located in their home (private residence, apartment, or temporary lodging like a hotel) at the time of the virtual visit.
  • POS 02 (Telehealth Other than in Patient's Home): Used when the patient is located anywhere else besides their home, such as a clinic, office, hospital, or skilled nursing facility.

Reimbursement and Payment Rates

  • POS 10: Generally paid at the non-facility rate, which reflects the higher overhead costs of care delivered to a residential setting and matches standard in-office payment levels for many payers.
  • POS 02: Generally paid at the lower facility rate, acknowledging that the encounter took place in a setting where facility overhead applies.

How to code telehealth visits in 2026?

Coding telehealth visits in 2026 requires knowing that Medicare and commercial payers use entirely different rules, as outlined by the Billing For Healthcare Guide.

Medicare Payer Rules

  • Standard E/M Codes: Medicare does not reimburse the dedicated CPT codes 98000 through 98015.
  • Required Coding: Use standard office visit codes (99202–99215) paired with the correct Place of Service (POS) code and modifiers.
  • Virtual Check-ins: Use CPT 98016 for brief 5-to-10 minute audio or video check-ins with established patients (replacing old code G2012).
  • Review additional billing breakdowns at the MedLife MBS Reference.

Commercial Payer Rules

  • Dedicated CPT Family: Many commercial plans accept the AMA-created telemedicine set (98000–98015) for synchronous audio-video and audio-only visits.
  • Alternative Requirements: Some commercial contracts still follow Medicare's style and require standard E/M codes with a telehealth modifier instead.
  • Check specific plan contracts using insights from the MedSole RCM Overview.

Place of Service (POS) Codes

  • POS 10: Patient is at home (pays at the higher non-facility rate).
  • POS 02: Patient is located somewhere other than home (facility rate).

Key Modifiers

  • Modifier 95: Real-time audio and video interactive communication.
  • Modifier 93: Synchronous audio-only communication.

Is POS 10 still valid?

Yes, Place of Service (POS) code 10 is still fully valid and actively required by CMS and major insurers for home-based telehealth services.

Key Rules for POS 10

  • Definition: Use POS 10 when a patient receives telehealth services while physically located in their home (permanent or temporary residence).
  • Payment Rate: POS 10 triggers the higher non-facility payment rate under the Medicare Physician Fee Schedule because the provider bears the practice overhead.
  • POS 10 vs. POS 02: Use POS 10 strictly for home-based telehealth. Use POS 02 for telehealth provided when the patient is in a facility or location other than their home (like an office or clinic).
  • Payer Policies: While Medicare and many commercial carriers accept POS 10, some private insurance companies still require POS 02 for all telehealth claims, so always verify individual payer guidelines.

What code do I use for telehealth?

For Medicare and most commercial payers, report telehealth evaluation and management services using standard office visit codes such as CPT 99202–99205 for new patients and CPT 99211–99215 for established patients, paired with the correct place of service (POS) and modifier.

You can find the official guidance and updates through the CMS List of Telehealth Services.

Place of Service (POS) Codes

  • POS 10: Patient's home (non-facility rate)
  • POS 02: Location other than the patient's home, like a provider's office (facility rate)

Modifiers

  • Modifier 95: Synchronous interactive audio-video telemetry
  • Modifier 93: Synchronous audio-only communication (when video is unavailable or un-connectable)

Payer Differences

  • Medicare: Does not accept the dedicated CPT 98000–98015 telehealth family for payment, except for brief check-in code 98016 (which replaced G2012). Medicare requires standard office codes (99202–99215) with proper POS and modifiers.
  • Commercial Payers: Policies vary; some accept the dedicated CPT 98000–98007 (audio-video) and 98008–98015 (audio-only) ranges, while others follow Medicare's standard office code format.

What are the CMS list of telehealth services for 2026?

The official and complete CMS List of Telehealth Services for calendar year 2026 is published as a downloadable data file under the Medicare Physician Fee Schedule.

Key 2026 Additions and Policy Updates

CMS updated the 2026 telehealth policies by moving provisional services to the permanent list and adding specific new codes:

  • New Additions:
    • 90849: Multiple-family group psychotherapy
    • G0473: Group behavioral counseling for obesity
    • G0545: Infectious disease add-on code
    • 92622 & 92623: Auditory osseointegrated sound processor services
  • Streamlined Reviews: CMS removed temporary classifications, evaluating clinical effectiveness and utilization trends under a simplified framework.
  • Supervision Rules: Virtual direct supervision via real-time audio-video technology is permanently allowed (excluding 010 and 090 global surgery codes).

Categories of Covered Services

The comprehensive inventory spans multiple medical specialties and CPT/HCPCS code ranges, including:

  • Outpatient Evaluation and Management (E/M): Codes 99202–99215, 98966–98968, 99341–99350, G0513–G0514, G2211–G2212
  • Hospital, Nursing, and Critical Care: Codes 99221–99239, 99281–99316, G0425–G0427, G0545
  • Behavioral and Mental Health: Codes 90832–97158, G0410
  • Cardiological and Rehabilitation Services: Codes 93750–93798, G0422–G0423
  • End-Stage Renal Disease (ESRD) & Chronic Care: Dialysis-related services and chronic care management.

You can review the full, exact data file updates and look up specific billing codes directly on the CMS Telehealth Page.