US · guidance
CMS Pub. 100-04, ch. 32, § 140.2.2.1
Correct Place of Service (POS) Code for CR and ICR Services on Professional
Claims
(Rev. 3058, Issued: 08-29-14, Effective: 02-18-14, Implementation: 08-18-14)
Effective for claims with dates of service on and after January 1, 2010, place of service (POS) code 11 shall be
used for CR and ICR services provided in a physician’s office and POS 22 shall be used for services provided in
a hospital outpatient setting. All other POS codes shall be denied. Contractors shall adjust their prepayment
procedure edits as appropriate.
The following messages shall be used when contractors deny CR and ICR claims for POS:
Claim Adjustment Reason Code (CARC) 171 – Payment is denied when performed/billed by this type of
provider in this type of facility.
NOTE: Refer to the 832 Healthcare Policy Identification Segment (loop 2110 Service payment Information
REF), if present.
Remittance Advice Remark Code (RARC) N428 - Service/procedure not covered when performed in this place
of service.
Medicare Summary Notice (MSN) 21.25 - This service was denied because Medicare only covers this service in
certain settings.
Group Code PR (Patient Responsibility) - Where a claim is received with the GA modifier indicating that a
signed ABN is on file.
Group Code CO (Contractor Responsibility) – Where a claim is received with the GZ modifier indicating that
no signed ABN is on file.
History
(Rev. 3058, Issued: 08-29-14, Effective: 02-18-14, Implementation: 08-18-14)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
6794cddea8fa73dcb535eb70a71ef9ef96a4a4da9e078c0b316b892e693a05aa
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