837 CLM Segment

837 CLM Segment Facility Code Values

On the 837 claim in the CLM segment in position CLM05-1 you will find facility codes also known as Place of Treatment (POT) codes.

Place of Treatment (POT) codes are alpha or numeric codes that indicate where a service was performed. The Centers for Medicare & Medicaid Services (CMS) designates and assigns these codes. Providers use the CMS codes on claims to indicate the location of the service, which is a necessary component for completed claims. The Claims Administration System (CAS) converts the CMS codes into CAS POT codes.

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List of POT Codes

CMS POS Code General Description of POT POT Definition
01 Pharmacy A facility or location where drugs and other medically related items and services are sold, dispensed, or otherwise provided directly to patients.
02 Telehealth The location where health services and health-related services are provided or received, through telecommunication technology.
03 School A facility whose primary purpose is education.
04 Homeless Shelter A facility or location whose primary purpose is to provide temporary housing to homeless individuals (for example, emergency shelters, individual, or family shelters).
05 Indian Health Service Free-standing Facility A facility or location, owned and operated by the Indian Health Service, which provides diagnostic, therapeutic (surgical and nonsurgical), and rehabilitation services to American Indians and Alaska Natives who do not require hospitalization.
06 Indian Health Service Provider-based Facility A facility or location, owned and operated by the Indian Health Service, which provides diagnostic, therapeutic (surgical and nonsurgical), and rehabilitation services rendered by, or under the supervision of, physicians to American Indians and Alaska Natives admitted as inpatient or outpatient.
07 Tribal 638 Free-standing Facility A facility or location owned and operated by a federally recognized American Indian or Alaska Native tribe or tribal organization under a 638 agreement, which provides diagnostic, therapeutic (surgical and nonsurgical), and rehabilitation services to tribal members who do not require hospitalization.
18 Place of employment/worksite A location, not described by any other POS code, owned and operated by a public or private entity where the patient is employed, and where a health professional provides on-going or episodic occupational medical, therapeutic, or rehabilitative services to the individual.
19 Off Campus-Outpatient Hospital 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.
20 Urgent Care Facility Location, distinct from an emergency room, office, or clinic, whose purpose is to diagnose and treat illness or injury for unscheduled, ambulatory patients seeking immediate medical attention.
21 Inpatient Hospital A facility, other than psychiatric, which primarily provides diagnostic, therapeutic (both surgical and nonsurgical), and rehabilitation services by, or under, the supervisor of physicians to patients admitted for various medical conditions.
22 On Campus-Outpatient Hospital A portion of a hospital’s main campus which provides diagnostic, therapeutic (both surgical and nonsurgical), and rehabilitation services to sick or injured persons who do not require hospitalization or institutionalization.
Outpatient Hospital
POT W is applied in two situations:

The claim is submitted with only basic laboratory or radiology codes with certain qualifying revenue codes and the type of bill is 131, 132, 133, 134, 137 or 85x; or

The claim is submitted for a hospital outpatient clinic visit for assessment and management of a patient (with the corresponding G0463 code for the service), and the type of bill is 131.

23 Emergency Room – Hospital A portion of a hospital where emergency diagnosis and treatment of illness or injury is provided.
24 Ambulatory Surgical Center A freestanding facility, other than a physician’s office, where surgical and diagnostic services are provided on an ambulatory basis.
25 Birthing Center A facility, other than a hospital’s maternity facilities or a physician’s office, which provides a setting for labor, delivery, and immediate postpartum care and care of newborn infants.
26 Military Treatment Facility A medical facility operated by one or more of the Uniformed Services. Military Treatment Facilities (MTF) also refers to certain former United States Public Health Service (USPHS) facilities now designated as Uniformed Service Treatment Facilities (USTF)s.
27–30 Unassigned
31 SNF A facility which primarily provides inpatient skilled nursing care and related services to patients who require medical, nursing, or rehabilitative services, but does not provide the level of care or treatment available in a hospital.
32 Nursing Facility A facility which primarily provides to residents skilled nursing care and related services for the rehabilitation of injured, disabled, or sick persons, or, regularly, health-related care services above the level, or custodial care to other than intellectually disabled individuals.
33 Custodial Care Facility A facility which provides room, board and other personal assistance services, generally on a long-term basis, and which does not include a medical component.
34 Hospice A facility, other than a patient’s home, in which palliative and supportive care for terminally ill patients and their families is provided.
35–40 Unassigned
41 Ambulance – Land A land vehicle designed, equipped, and staffed for life-saving and transporting the sick or injured.
42 Ambulance – Air or Water An air or water vehicle designed, equipped, and staffed for life-saving and transporting the sick or injured.
43–48 Unassigned
49 Independent Clinic A location, not part of a hospital and not described by any other Place of Treatment code, that is organized and operated to provide preventive, diagnostic, therapeutic, rehabilitative, or palliative services to outpatients only.
50 Federally Qualified Health Clinics (FQHC)s A facility located in a medically underserved area that provides Medicare beneficiaries preventive primary medical care under the general direction of a physician.
51 Inpatient Psychiatric Facility A facility that provides inpatient psychiatric services for the diagnosis and treatment of mental illness on a 24-hour basis, by or under physician supervision.
52 Psychiatric Facility – Partial Hospitalization A facility for the diagnosis and treatment of mental illness that provides a planned therapeutic program for patients who do not require full-time hospitalization, but who need broader programs than are possible from outpatient visits to a hospital-based or hospital-affiliated facility.
53 Community Mental Health Clinic (CMHC) A facility that provides the following services: outpatient services, including specialized outpatient services for children, the elderly, individuals who are chronically ill, and residents of the CMHC’s mental health services area who have been discharged from inpatient treatment at a mental health facility; 24-hour-a-day emergency care services, or psychosocial rehabilitation services; screening for patients being considered for admission to State mental health facilities to determine the appropriateness of such admission; and consultation and education services.
54 Intermediate Healthcare Facility/Individuals with Intellectual Disabilities A facility which primarily provides health-related care and services above the level of custodial care to individuals with intellectual disabilities, but does not provide the level of care or treatment available in a hospital or SNF.
55 Residential Substance Abuse Treatment Facility A facility which provides treatment for substance (alcohol and drug) abuse to live-in residents who do not require acute medical care. Services include individual and group therapy and counseling, family counseling, laboratory tests, drugs and supplies, psychological testing, and room and board.
56 Psychiatric Residential Treatment Center A facility or distinct part of a facility for psychiatric care which provides a total 24-hour therapeutically planned and professionally staffed group living and learning environment.
57 Non-residential Substance Abuse Treatment Facility A location which provides treatment for substance (alcohol and drug) abuse on an ambulatory basis. Services include individual and group therapy and counseling, family counseling, laboratory tests, drugs and supplies, and psychological testing.
58–59 Unassigned
60 Mass Immunization Center A location where providers administer pneumococcal pneumonia and influenza virus vaccinations and submit these services as electronic media claims, paper claims, or via roster billing method. The immunization generally takes place in a mass immunization setting, such as a public health center, pharmacy, or mall, but can include a physician office setting.
61 Comprehensive Inpatient Rehabilitation Facility A facility that provides comprehensive rehabilitation services under the supervision of a physician to inpatients with physical disabilities. Services include physical therapy, occupational therapy, speech pathology, social or psychological services, and orthotics and prosthetics services.
62 Comprehensive Outpatient Rehabilitation Facility (CORF) A facility that provides comprehensive rehabilitation services under the supervision of a physician to outpatients with physical disabilities. Services include physical therapy, occupational therapy, and speech pathology services.
63–64 Unassigned
65 End-Stage-Renal Disease Treatment Facility A facility other than a hospital, which provides dialysis treatment, maintenance, and/or training to patients or caregivers on an ambulatory or home-care basis.
66–70 Unassigned
71 Public Health Clinic A facility maintained by either state or local health departments that provide ambulatory primary medical care under the general direction of a physician.
72 Rural Health Clinic (RHC) A certified facility which is located in a rural medically underserved area that provides ambulatory primary medical care under the general direction of a physician.
73–80 Unassigned
81 Independent Laboratory A laboratory certified to perform diagnostic and/or clinical tests independent of an institution or a physician’s office.
82–98 Unassigned
99 Other Place of Service Other place of service not identified in the listing.

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