POS 11 Billing Guide for Medical Offices

In the world of medical billing, using the correct Place of Service (POS) code is critical for clean claims, timely payments, and compliance with payer guidelines. One of the most commonly used codes in outpatient billing is POS 11. This guide covers everything medical offices need to know about POS 11 — what it is, when to use it, and how to avoid common mistakes.

What is POS 11?

POS 11 stands for "Office" in medical billing. According to the Centers for Medicare & Medicaid Services (CMS), POS 11 refers to:

“A location, other than a hospital, skilled nursing facility (SNF), military treatment facility, community health center, or independent clinic, where the health professional routinely provides health examinations, diagnosis, and treatment of illness or injury on an ambulatory basis.”

In simpler terms, POS 11 is used when services are provided in a typical medical office setting — where the patient comes in for a face-to-face visit with the healthcare provider.

When to Use POS 11

Use POS 11 when:

The patient is physically present in your main office or any affiliated office location.

The visit is a standard in-person, face-to-face encounter.

The provider bills for the service under their practice’s tax ID, and the location is not a facility like a hospital or nursing home.

Examples:

Scenario Use POS 11?

Patient seen in main clinic office ✅ Yes

Patient seen at secondary office (same billing) ✅ Yes

Face-to-face visit for follow-up care ✅ Yes

When Not to Use POS 11

There are many situations where another POS code is more appropriate. Here’s a quick breakdown:

Scenario Correct POS Why Not POS 11?

Telehealth visit (patient at home) POS 10 It’s virtual, not in-person

Home visit by provider POS 12 Service took place in patient’s home

Patient seen at hospital outpatient clinic POS 22 Facility-based care

Mobile van or outreach unit POS 15 Not a traditional office setting

Using the wrong POS code can result in claim denials or payer audits, so accuracy is essential.

POS 11 and Box 32 (Service Facility Location)

Even when using POS 11, don’t forget about Box 32 on the CMS-1500 claim form. This box should include the actual address where the service was provided — especially important if:

The provider sees patients at multiple office locations.

Office B is used but billed under Office A’s credentials.

Tip: Always ensure the correct location address is listed in Box 32 to avoid compliance issues.

Billing Tips for POS 11

Stay Updated: POS codes can change; regularly check payer policies and CMS updates.

Match Documentation: Ensure that documentation clearly reflects the service was delivered in an office setting.

Know Your Locations: If your group has multiple sites, keep a record of each location’s NPI and address.

Cross-check with CPT Codes: Some services may be bundled or reimbursed differently depending on the POS.

Common Mistakes to Avoid

Using POS 11 for Telehealth: Telehealth services must use POS 10 (or sometimes POS 02, depending on payer rules).

Wrong Address in Box 32: Using the billing office address instead of the service location can trigger audits.

Inconsistent Documentation: Clinical notes must support that the service was delivered in an office setting

Not Updating Billing Software: Ensure your billing system reflects any location or POS changes.

Final Thoughts

POS 11 is the go-to code for traditional office-based visits — but don’t let its frequency fool you. Accuracy in using POS 11 is just as important as with any other code. When in doubt, always verify with your payer, ensure documentation supports your coding, and align all claim details, including Box 32

Using POS 11 correctly helps reduce denials, speeds up reimbursements, and keeps your practice in compliance.