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POS 11: Office

POS 11 is the CMS place of service code for Office, defined as location, other than a hospital, skilled nursing facility (SNF), military treatment facility, community health center, State or local public health clinic, or intermediate care facility (ICF), where the health professional routinely… On Medicare professional claims paid under the physician fee schedule, POS 11 takes the non-facility rate (Pub. 100-04, chapter 26).

Compiled from CMS files by the QuickIntell RCM Editorial Team · Data effective · Method: reference methodology · Report a data correction

Data currency: CMS Place of Service code set: CMS page last modified February 17, 2026; code table updated May 2, 2024 (effective August 1, 2024). Next CMS release: no fixed schedule (CMS posts new place of service codes on its code set page, usually months before Medicare's effective date).

Place of service code
11
Medicare fee schedule rate
Non-facility rate
Pub. 100-04, chapter 26, section 10.5
In effect since
Before 2003
Reported on
Professional claims
CMS-1500 item 24B or the 837P
Setting group
Offices, clinics and urgent care

CMS definition of POS 11

Location, other than a hospital, skilled nursing facility (SNF), military treatment facility, community health center, State or local public health clinic, or intermediate care facility (ICF), where the health professional routinely provides health examinations, diagnosis, and treatment of illness or injury on an ambulatory basis.

CMS Place of Service code set, Office

POS 11 is one of the long-standing codes that CMS lists without a date, meaning it was in effect on or before January 1, 2003 (Medicare Claims Processing Manual, Pub. 100-04, chapter 26, section 10.5).

Facility or non-facility rate for POS 11

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 “Office” 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.

Use POS 11 for services in an office the practitioner maintains. Office space inside a hospital or on its campus counts only when it is separately maintained and is not a provider-based department of the hospital under 42 CFR 413.65; that use of POS 11 is subject to the physician self-referral rules (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.

POS 11 vs POS 22: what changes

POS 11 is an office the practitioner maintains; POS 22 is the hospital's on-campus outpatient department. Medicare pays POS 11 at the non-facility rate and POS 22 at the facility rate, because in the hospital department the hospital carries the cost of the setting and bills its own facility claim. A practitioner's office space on a hospital campus qualifies for POS 11 only when it is separately maintained and is not a provider-based department (chapter 26, section 10.5).

Place of service 11 and 22 compared
POSSettingMedicare rateIn effect since
11OfficeNon-facility rateBefore 2003
22On Campus-Outpatient HospitalFacility rateBefore 2003

Denials when POS 11 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.

See QuickRCM for claim readinessSee QuickCode for coder reviewBook a meeting

Frequently asked questions

What is place of service code 11?

POS 11, Office, is defined by CMS as follows: Location, other than a hospital, skilled nursing facility (SNF), military treatment facility, community health center, State or local public health clinic, or intermediate care facility (ICF), where the health professional routinely provides health examinations, diagnosis, and treatment of illness or injury on an ambulatory basis. POS 11 is one of the long-standing codes that CMS lists without a date, meaning it was in effect on or before January 1, 2003 (Medicare Claims Processing Manual, Pub. 100-04, chapter 26, section 10.5). It sits in the offices, clinics and urgent care group with POS 17, POS 20, POS 49, POS 50, POS 71 and POS 72.

Does POS 11 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 11 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 "Office" 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 11?

Use POS 11 for services in an office the practitioner maintains. Office space inside a hospital or on its campus counts only when it is separately maintained and is not a provider-based department of the hospital under 42 CFR 413.65; that use of POS 11 is subject to the physician self-referral rules (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.

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.