• Thursday, November 08, 2012RSS Feed

    New POS Code Established at APTA's Urging

    APTA's request for a new place of service (POS) code to indicate that a physical therapist (PT) delivered services at a patient’s worksite recently was granted by the Centers for Medicare and Medicaid Services (CMS). Place of service codes are 2-digit codes placed on health care claims to indicate the setting in which a service was provided. The new code is available for use effective January 1, 2013, but will not be effective for Medicare until May 1, 2013.

    The new code, POS 18, is named "place of employment-worksite." Per the description, the code should be used when physical therapy is delivered at "A location, not described by any other POS code, owned or 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."

    PTs delivering services that are appropriately reported using POS codes should check with payers to determine if they are prepared to accept POS 18.

    Examples of situations in which POS 18 can be used include, but are not limited to:

    • Job site analysis to identify potential accommodations – patient present and participating in the service
    • Job coaching to improve biomechanics at the work site – patient present and participating in the service
    • Physical therapy evaluation and treatment at the worksite
    • Functional capacity evaluations at the worksite to determine the worker's ability to perform specific job duties

    Currently, PTs are likely to report POS 99, known as "other place of service," when delivering services at the worksite. The addition of POS 18 will enable PTs, payers, and others using POS code data to more accurately identify where services are delivered. Health plans can use this information to implement payment differentials when providers are required to travel in order to deliver services, and to study the costs and benefits of alternative service delivery options.

    In its request to CMS for the new POS code, APTA noted that the provision of physical therapy (and other medical) services at the place of work reduces lost productivity, enhances the effectiveness of job-specific training, and improves access to services where transportation and other barriers may exist. The association also told the agency that workers are more likely to receive the health care services they need in order to remain productive in the workforce when services are easily accessible. Additionally, job-specific evaluation and training services, including job and/or ergonomic analysis, must be performed at the work site and therefore are not appropriately reported using other place of service codes (except POS 99, which is nonspecific).

    CMS maintains POS codes used throughout the health care industry. Additional information about POS codes is available on CMS' website. CMS will publish a change request in the near future to inform payers of the change. Meanwhile, the updated list of codes is available here.


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