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POS 19: Off Campus-Outpatient Hospital

POS 19 is the CMS place of service code for Off Campus-Outpatient Hospital, defined as a portion of an off-campus hospital provider based department which provides diagnostic, therapeutic (both surgical and nonsurgical), and rehabilitation services to sick or injured persons who do not require hospitalization… On Medicare professional claims paid under the physician fee schedule, POS 19 takes the facility rate (Pub. 100-04, chapter 26). CMS added it effective January 1, 2016.

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
19
Medicare fee schedule rate
Facility rate
Pub. 100-04, chapter 26, section 10.5
In effect since
January 1, 2016
Reported on
Professional claims
CMS-1500 item 24B or the 837P
Setting group
Hospital inpatient, outpatient and emergency department

CMS definition of POS 19

A portion of an off-campus hospital provider based department which provides diagnostic, therapeutic (both surgical and nonsurgical), and rehabilitation services to sick or injured persons who do not require hospitalization or institutionalization.

(Effective January 1, 2016)

CMS Place of Service code set, Off Campus-Outpatient Hospital

POS 19 has been in the national code set since January 1, 2016.

Facility or non-facility rate for POS 19

Medicare pays a physician fee schedule service billed with this code at the facility rate. The facility rate carries a smaller practice-expense component than the non-facility rate, because in a facility setting the facility, not the practitioner, bears the cost of the room, the staff and most supplies; where the facility is a Medicare provider it is paid for those costs on its own claim.

Chapter 12, section 20.4.2 of the Medicare Claims Processing Manual lists this setting as “Off Campus-Outpatient Hospital” on its 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.

POS 19 covers a provider-based department of the hospital located off the main campus. A practitioner who sees a registered hospital outpatient reports at least POS 19 or 22 wherever the face-to-face encounter took place, and that is what triggers the facility rate (chapter 26, sections 10.5 and 10.6).

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.

Medicare instructions for this setting

Chapter 26, section 10.5 gives special considerations for outpatient hospital departments that cover POS 19 and POS 22 together; the summary above restates the rule for POS 19, and the manual's full text is quoted on the place of service hub.

POS 19 vs POS 22: what changes

Both describe a hospital outpatient department and both pay the professional service at the facility rate; the split is location. POS 22 is a department on the hospital's main campus and POS 19 a provider-based department off the campus. CMS created POS 19 effective January 1, 2016 and renamed POS 22 from Outpatient Hospital to On Campus-Outpatient Hospital the same day. On the hospital's own outpatient claim, off-campus departments add HCPCS modifier PO or PN to their lines.

Place of service 19 and 22 compared
POSSettingMedicare rateIn effect since
19Off Campus-Outpatient HospitalFacility rateJanuary 1, 2016
22On Campus-Outpatient HospitalFacility rateBefore 2003

Denials when POS 19 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 19?

POS 19, Off Campus-Outpatient Hospital, is defined by CMS as follows: A portion of an off-campus hospital provider based department which provides diagnostic, therapeutic (both surgical and nonsurgical), and rehabilitation services to sick or injured persons who do not require hospitalization or institutionalization. POS 19 has been in the national code set since January 1, 2016. It sits in the hospital inpatient, outpatient and emergency department group with POS 21, POS 22 and POS 23.

Does POS 19 pay the facility or the non-facility rate?

The facility rate. Medicare Claims Processing Manual, Pub. 100-04, chapter 26, section 10.5 designates POS 19 F, so a physician fee schedule service billed with it is paid at the facility rate, the lower practice-expense amount paid when the setting rather than the practitioner carries the cost of space, staff and supplies. Chapter 12, section 20.4.2 lists it as "Off Campus-Outpatient Hospital" on the 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 19?

POS 19 covers a provider-based department of the hospital located off the main campus. A practitioner who sees a registered hospital outpatient reports at least POS 19 or 22 wherever the face-to-face encounter took place, and that is what triggers the facility rate (chapter 26, sections 10.5 and 10.6).

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.