Place of Service

Place of service is a two-digit code on every medical claim that says where the care happened. Code 11 is a doctor's office. Code 22 is a hospital outpatient department. Code 24 is a surgery center. Code 23 is an emergency room. Code 02 and code 10 are telehealth. The code does not describe what was done; it describes where, and plans pay different amounts for the same procedure depending on the answer.

That is the whole reason it matters. The exact same doctor doing the exact same steroid injection is paid one amount at place of service 11 and a different, usually higher, amount at place of service 22, and at 22 a facility fee appears alongside the professional fee. When a hospital buys a physician practice, the office visits often start going out with place of service 22 or 19 instead of 11, even though the patient never left the same exam room. Employers reviewing their claims files can see this shift as a line-by-line change in place-of-service codes across a whole clinic. Place of service also drives what you owe under your own plan: many plans charge a copay for an office visit at POS 11 and apply the deductible and coinsurance to the same visit at POS 22.

The takeaway: if a bill for a routine visit looks bigger than it used to, look at the place-of-service code on the claim. A change from 11 to 22 or 19 means a facility fee has entered the picture, and it is fair to ask why.