CMS definition of POS 03
A facility whose primary purpose is education.
(Effective January 1, 2003)
POS 03 has been in the national code set since January 1, 2003.
Facility or non-facility rate for POS 03
Medicare pays a physician fee schedule service billed with this code at the non-facility rate. The non-facility rate carries the larger practice-expense component, because the practitioner bears the cost of the space, the clinical staff, the equipment and the supplies used for the service.
Chapter 12, section 20.4.2 of the Medicare Claims Processing Manual lists this setting as “School” on its non-facility list. The rule behind the list is that the code reflects where the beneficiary received the face-to-face service, except that services to a registered hospital inpatient or outpatient are paid at the facility rate wherever the encounter took place.
When POS 03 entered the national code set in 2003, Medicare contractors were told to crosswalk it to POS 11; that mandate has been lifted, and Medicare pays physician services in a school at the non-facility rate (chapter 26, section 10.5).
Not every service has two rates: when the facility and non-facility amounts are the same, as they are for the professional component of a diagnostic test, the place of service does not change the payment. Outpatient therapy and comprehensive outpatient rehabilitation facility services are always paid at the non-facility rate.
Denials when POS 03 does not fit the claim
A place of service that conflicts with the procedure, the patient's registration or the payer's policy comes back with one of three codes. Claim adjustment reason code 5 means the procedure code or bill type is inconsistent with the place of service; reason code 58 means the payer considers the setting inappropriate or invalid for the service; and remark code M77 marks a missing, incomplete, invalid or inappropriate place of service. Medicare returns a line whose POS is missing, unassigned or incompatible with a site-specific procedure as unprocessable with CARC 16 and M77, so the fix is a corrected claim rather than an appeal (Pub. 100-04, chapter 26, section 10.6).
Where QuickIntell fits with place of service
QuickRCM covers eligibility, claim readiness, denials, posting and A/R with configurable automation and human review, the stage where the place of service code is checked against the setting, the registration and the modifier before the claim goes out, and where CARC 5, CARC 58 and M77 denials are worked.
Frequently asked questions
What is place of service code 03?
POS 03, School, is defined by CMS as follows: A facility whose primary purpose is education. POS 03 has been in the national code set since January 1, 2003. It sits in the schools, shelters, workplaces, outreach, mobile units and mass immunization group with POS 04, POS 09, POS 15, POS 18, POS 27 and POS 60.
Does POS 03 pay the facility or the non-facility rate?
The non-facility rate. Medicare Claims Processing Manual, Pub. 100-04, chapter 26, section 10.5 designates POS 03 NF, so a physician fee schedule service billed with it is paid at the non-facility rate, the higher practice-expense amount paid when the practitioner carries the cost of the space, staff, equipment and supplies. Chapter 12, section 20.4.2 lists it as "School" on the non-facility list. Services whose two rates are equal, such as the professional component of a diagnostic test, pay the same either way (chapter 12, section 20.4.2).
When should a claim use POS 03?
When POS 03 entered the national code set in 2003, Medicare contractors were told to crosswalk it to POS 11; that mandate has been lifted, and Medicare pays physician services in a school at the non-facility rate (chapter 26, section 10.5).
Sources
Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-10. Verify against the primary file before billing or contracting decisions. The reference methodology explains how each figure is computed from these files.
- CMS Place of Service Code Set (professional claims)Version CMS page last modified 2026-02-17; code table updated 2024-05-02 · effective 2024-08-01 · file code-sets.htmlSHA-256 d3a3caf2216784af…
- Medicare Claims Processing Manual, Pub. 100-04, chapter 26: Completing and Processing Form CMS-1500 Data SetVersion Rev. 12779, issued 2024-08-09 · effective 2024-08-09 · file clm104c26.pdfSHA-256 4fae39895fea412a…
- Medicare Claims Processing Manual, Pub. 100-04, chapter 12: Physicians/Nonphysician PractitionersVersion Rev. 13316, issued 2025-07-24 · effective 2025-07-24 · file clm104c12.pdfSHA-256 ca5ded3c8c676a23…
- CMS Place of Service Codes for Professional Claims (printable PDF)Version Place of Service Codes for Professional Claims, updated 2024-05-02 · effective 2024-05-02 · file website-pos-database.pdfSHA-256 cfe3ca7e3b130e5d…
Disclaimer
The definition is reproduced from the CMS Place of Service code set; the Medicare rate and instructions are from Pub. 100-04, chapters 12 and 26. Medicaid and commercial plans publish their own place of service rules. Not legal, clinical or billing advice.
Found a figure that does not match the CMS file? Report a data correction with the CMS file and the value you expected; the request reaches the editorial team through the contact form.