POS code 12: Home.

The CMS definition

Location, other than a hospital or other facility, where the patient receives care in a private residence.

That is the description CMS publishes for POS 12, Home, in the Place of Service Code Set and in chapter 26 of the Medicare Claims Processing Manual. In the manual’s table it carries the Non-facility rate (NF) designation for payment under the Physician Fee Schedule.

What it means in plain terms

POS 12 is for in-person care at the patient's own residence. The distinction people miss is delivery mode: if the clinician is not physically with the patient and the visit is by telecommunication, Medicare telehealth billing uses POS 02 or POS 10 instead.

When it is used

• A clinician goes to the patient's private residence and provides in-person care.
• A hospice patient seen at home where the home is not operated by the hospice: CMS says the practitioner assigns the code for that setting, POS 12.
• A person staying in a facility is not at "home" for this code. CMS has separate codes for assisted living (13), group home (14), temporary lodging (16), custodial care (33) and nursing facility (32).

Billing implications (Medicare)

The manual marks POS 12 NF, so Medicare physician fee schedule services are paid at the non-facility rate.

For Medicare telehealth, CMS says the only valid POS codes in CY 2024 are 02 and 10 and must be paired with modifier 93 (audio-only) or 95 (audio/video). POS 10 is non-facility and POS 02 is facility. Using 12 for a telehealth visit is a coding mismatch, not a shortcut.

Durable medical equipment has its own wrinkle: CMS notes a homeless shelter is considered the beneficiary's home for DME, and contractors may crosswalk code 04 to 12.

The general rule in section 10.6 of the manual is that the POS code “generally” reflects the actual setting where the beneficiary receives the face-to-face service, with two exceptions: a registered hospital inpatient or outpatient is reported with the hospital code regardless of where the encounter happens. The code goes in item 24B of the paper Form CMS-1500 or the matching field of the 837P.

Look-alike codes

• POS 10: Telehealth provided in patient's home. Video or audio visit; non-facility rate.
• POS 02: Telehealth provided other than in patient's home. Facility rate.
• POS 13: Assisted living facility.
• POS 14: Group home.
• POS 11: Office.

For every code in one list, with the 02 vs 10 vs 11 telehealth verdict, see the place of service code lookup.

Sources

• CMS: Place of Service Code Set — official code list and descriptions, page database updated May 2, 2024 (retrieved 2026-11-02)
• CMS: Medicare Claims Processing Manual, Chapter 26 (Rev. 12779, issued 08-09-24) — sections 10.5 and 10.6, facility and non-facility designations and special considerations (retrieved 2026-11-02)

Every definition and rule above was read from these CMS pages on November 2, 2026. Payers revise code lists, contracts and policies, so confirm anything that affects a claim with the payer. CMS itself tells billers to check each payer (Medicare, Medicaid, private plans) for how it reimburses each code.