Seriously, does anyone truly miss waiting an hour in a doctor’s lobby? The truth is that the era is basically over. Following the massive, necessary adoption of remote care models, nailing the exact Place of Service (POS) code isn’t just a tedious billing requirement—it’s the single most important action you can take to protect your revenue cycle management. Get this one little two-digit code wrong, and you risk a serious slowdown in payments, claim rejections, and unnecessary compliance issues.
This guide is designed to make the complexities of POS 10 in medical billing entirely straightforward. We’ll outline its mandatory use, cover the crucial CMS updates for 2025, and give you a clear, practical system to make sure every virtual claim your team submits is filed correctly the first time.
Understanding POS 10
What Does POS 10 Mean in Medical Billing?
In the often-convoluted world of medical billing, a POS code is simply a quick, two-digit flag on a professional claim form (CMS-1500 form) that identifies the precise physical location where a service was delivered. POS 10 has one non-negotiable definition: it is the specific code used to flag a telehealth service furnished via technology while the patient is physically located, safe, and comfortable, in their own home.
It’s important to stress what “home” means here: it refers to a private residence—be it temporary or permanent—that is decidedly not an institutional care facility like a hospital or a skilled nursing facility. This focused code lets payers instantly differentiate visits provided to the patient at their residence from every other kind of medical setting.
Why Was POS 10 Introduced for Telehealth?
Before the pandemic completely rewrote the rules for healthcare, nearly all remote services were broadly billed using the older, generic POS 02. The Centers for Medicare & Medicaid Services (CMS) and commercial insurance quickly realized that this catch-all code was insufficient for tracking the huge volume of patients receiving care delivery right where they live. POS 10 was rolled out to achieve three crucial things:
- To cleanly and accurately track data on home-based telehealth encounters.
- To facilitate different—and usually higher—reimbursement rates.
- To enforce clear compliance with rapidly changing federal policies.
Difference Between POS 10 and POS 02 Explained Simply
The distinction is straightforward, yet absolutely critical: it’s entirely about the patient’s location during the call.
- POS 10: The patient is at home (their private residence).
- POS 02: The patient is somewhere other than their home (e.g., their workplace, school, or an affiliate clinic).
This minor geographical detail has a profound impact on the final payment rate you actually receive.
Comparison Table: POS 10 vs POS 02 vs POS 11
| POS Code | Location Name | Typical Service Location | Medicare Payment Rate |
| 10 | Home Telehealth | Patient’s private residence | Non-Facility Rate (NF) |
| 02 | Telehealth – Other Than Home | Clinic, school, or external setting | Facility Rate (F) |
| 11 | Office | In-person visit to the physician’s private practice | Non-Facility Rate (NF) |
The Role of POS 10 in Today’s Healthcare
When Should Providers Use POS 10?
Providers are required to use POS 10 every single time a covered telehealth service is delivered in real-time and the patient is physically present in their home during the time of service. This rule is consistent across all relevant specialties, including mental health and primary care.
How Insurance Companies Process POS 10 Claims
Insurance companies rely on the POS code to quickly assess the associated overhead costs linked to the service. When they see a claim filed with POS 10, they recognize the provider is billing for a non-facility setting. This instructs them to process the claim at the higher non-facility rate, which mirrors the payment for an in-person office visit (like POS 11). The logic is simple: the physician or provider is incurring their own practice overhead, and the payment reflects that.
Reimbursement Impact and Payment Rate Differences
Here’s the clearest financial takeaway: the POS code truly dictates your cash flow. POS 10 pays out at the full non-facility payment rate; POS 02 triggers the lower facility payment rate. Consistently filing home-based virtual services with the wrong code is the quickest way to hemorrhage revenue via downcoding.
Which Payers and Insurances Support POS 10?
Both Medicare and Medicaid have made the use of POS 10 mandatory. Since the Centers for Medicare & Medicaid Services (CMS) leads the charge, almost all major commercial insurers have also adopted this code, though you absolutely must verify their individual policies for specific modifiers or documentation requirements.
CMS Updates and Federal Guidelines (2025 Edition)
Latest CMS Announcement on Telehealth Billing Codes
In the 2025 Medicare Physician Fee Schedule Final Rule, CMS firmly committed that POS 10 will remain a required code for home telehealth. A key update is the permanent allowance for certain audio-only telehealth services when the patient is at home and either can’t or won’t use video technology.
Covered Telehealth Services Under Medicare and Medicaid
A vital reminder: only services specifically listed on the CMS List of Telehealth Services are eligible for reimbursement when furnished virtually, no matter which POS code is used. Providers must diligently check the list of telehealth services to confirm their CPT codes are covered.
Coding, Modifiers, and Documentation
Correct Coding Practices for POS 10
When billing for a telehealth visit from the home, always use the appropriate in-person E/M CPT codes (e.g., 99203 or 99214) paired directly with POS 10.
What Modifier to Use with POS 10 (Common Examples)
Modifiers act as a simple flag for the delivery method used:
- Modifier 95: Used for synchronous (real-time) audio-video telehealth. This is the standard, most common modifier for POS 10.
- Modifier 93: Used specifically for approved audio-only telehealth when the patient is at home and meets the exception criteria.
- Modifier FQ: Used by Federally Qualified Health Centers and Rural Health Clinics when billing audio-only services.
Documentation Requirements for Claim Approvals
Detailed documentation is your strongest defense against a claim denial or audit. Your medical notes must clearly record:
- The exact date and time of the service.
- The patient’s location (at home) and their consent.
- The type of communication used (e.g., “secure, HIPAA-compliant video link”).
- If audio-only was necessary (Modifier 93), the specific reason video was not an option.
Compliance and Risk Management
Why Accuracy Matters in Place-of-Service Coding
There is a direct, unbreakable link between accuracy in POS coding and the financial health of your practice. Misreporting the place of service is a huge red flag that leads to audit risk, possible overpayment recoupment, and lengthy denial management processes.
Common Compliance Risks in Telehealth Billing
Compliance is most frequently compromised by: (1) confusing POS 10 and POS 02, (2) forgetting the required modifiers (like 95 or 93), and (3) insufficient documentation proving the patient’s home location and their consent.
POS 10 vs. POS 11 – In-Person vs. Virtual Visits
Key Distinctions Between the Two Codes
- POS 10 = Virtual care (delivered via telecommunications).
- POS 11 = In-person care (patient and physician in the same room).
How Incorrect Code Selection Affects Reimbursements
Confusing POS 10 with POS 11 can incorrectly suggest an in-person visit, leading to processing confusion. However, both codes are intended to pay at the higher non-facility rate, provided the appropriate telehealth modifiers are correctly applied with POS 10.
Policy Framework for Using POS 10
I. Purpose and Scope of the Code
The core policy objective is to ensure accurate reimbursement and compliance for telehealth services delivered to a patient in their residence. Its scope covers all providers and practices billing Medicare and Medicaid.
III. Procedures and Claim Submission Rules
Procedures strictly demand that POS 10 must be used for home telehealth and must be paired with Modifier 95 (for audio-video) or Modifier 93 (for audio-only), while using standard in-person E/M CPT codes.
Best Practices for Telehealth Billing
Verifying Patient Location Before Submission
This is the non-negotiable best practice. Confirm the patient’s location during the encounter and clearly note it in the chart. Never rely on the POS code from a prior visit.
Pairing Codes with Correct Modifiers
Implement strong, automatic checks in your billing systems to ensure that POS 10 is immediately paired with Modifier 95 for routine synchronous services.
Common Mistakes and How to Avoid Them
Misusing POS 02 Instead of POS 10
This is the most financially damaging error, as it guarantees the lower facility payment rate. Prevent this by strictly training your medical billers to ask: Was the patient in their private home? If the answer is yes, POS 10 is the only correct code.
Missing Modifiers and Incomplete Documentation
A claim submitted with POS 10 but missing Modifier 95 is a common cause for immediate denial. Documentation requirements are absolute: no detail, no approval.
Impact on Reimbursement and Compliance
How Proper Coding Maximizes Claim Approvals
By accurately employing the correct POS code and modifiers, you demonstrate adherence to payer policies, which dramatically speeds up claim approvals and maximizes the appropriate reimbursements.
The Connection Between Accuracy and Audit Risk
Inconsistent POS code usage is a massive red flag for CMS. Maintaining high accuracy drastically reduces the chance of an audit, safeguarding your practice from severe penalties.
Future of POS 10 in Telehealth Billing
Upcoming CMS Policy Changes
While POS 10 has achieved permanent status, CMS continues to scrutinize which specific services and technologies are covered. Providers must remain vigilant for future official CMS bulletins.
How Remote Care Models Are Evolving
The path of healthcare delivery is firmly set toward hybrid models. POS 10 acts as the foundational financial anchor for this future, serving as the core metric for the growth of home telehealth.
Related Telehealth Place of Service Codes
| POS Code | Description |
| 02 | Telehealth Other Than Home |
| 10 | Home Telehealth |
| 11 | Office Visit |
| 22 | Outpatient Hospital |
Final Thoughts:
POS 10 in medical billing is the essential code for home telehealth and ensures you receive the higher non-facility rate. Mastery involves using the right CPT code paired with POS 10 and the correct modifier (95 or 93), all supported by clear, auditable documentation.
Why POS 10 Matters for Modern Telehealth. For providers committed to modern healthcare delivery, mastering POS 10 is vital. It is the core tool for financial sustainability and rigorous compliance in the ever-expanding virtual care era.
Steps Forward for Billing Teams and Providers. Ensure your medical billers are fully updated on all current CMS policies. Implement routine internal audit checks and utilize modern billing systems to automatically verify POS 10 accuracy.
We Are Here to Help
Connect with CareSolution MBS. Get a Free Consultation
Frequently Asked Questions
What is POS in medical terms?
POS is the abbreviation for Place of Service, a code used to indicate the location where a healthcare service was performed.
What is the difference between POS 2 and POS 10?
POS 2 (now POS 02) is for telehealth when the patient is not in their home. POS 10 is specifically for telehealth when the patient is in their private home residence.
What modifier is used for POS 10?
Modifier 95 is the primary modifier used for POS 10 (audio-video telehealth). Modifier 93 is used for approved audio-only services.
What are POS 11 and POS 22?
POS 11 is an in-person visit to a physician’s office. POS 22 is an outpatient hospital setting.
