POS 19: off-campus outpatient hospital.

What CMS says POS 19 means

A portion of an off-campus hospital provider based department which provides diagnostic, therapeutic (both surgical and nonsurgical), and rehabilitation services to sick or injured persons who do not require hospitalization or institutionalization.

Code name: Off Campus-Outpatient Hospital. CMS lists it as effective January 1, 2016. Source: CMS Place of Service Codes for Professional Claims, retrieved 2026-11-02.

POS 19 versus POS 22

POS 22, On Campus-Outpatient Hospital, is "a portion of a hospital's main campus" providing the same kinds of services, with a description change effective January 1, 2016. The line between the two is the hospital's campus. Federal rules define campus in 42 CFR 413.65(a)(2) as the physical area immediately adjacent to the provider's main buildings, other areas and structures not strictly contiguous but within 250 yards of the main buildings, and any other areas the CMS regional office determines to be part of the campus.

POS 19 versus POS 11

POS 11 is an office: a location other than a hospital where a health professional routinely provides ambulatory care. A physician practice that a hospital owns and operates as a provider-based department off its campus is a different setting from an independent office. Whether a site has provider-based status is decided under 42 CFR 413.65, not by the building's signage.

What to check before you submit

• Is the site a hospital department with provider-based status? If it is an independent practice, POS 19 is not the right code.
• Is it inside the hospital's campus as defined in 413.65, or away from it? Inside is POS 22, away is POS 19.
• Ask the practice's compliance contact or the hospital which code it bills. The code on the professional claim should agree with how the site is registered.
• CMS tells billers to check each payer for its reimbursement policy for each place of service. Payers may price the same service differently by setting, so a mismatch can produce an adjustment or denial.
• If the POS was wrong, correct it and resubmit as the payer directs. For Medicare, a party can ask for reopening within 1 year for any reason (42 CFR 405.980(c)).

Worked example (hypothetical)

A hospital opens a clinic 2 miles from its main buildings and registers it as a provider-based department. Professional claims from that clinic use POS 19. A clinic in a building within 250 yards of the main buildings that is part of the campus would be POS 22. A group practice across the street that the hospital does not own uses POS 11.

Sources

• CMS: Place of Service Codes for Professional Claims — code names and descriptions (retrieved 2026-11-02)
• eCFR: 42 CFR 413.65 (provider-based status) — regulation text as of the eCFR issue dated 2026-10-29, retrieved 2026-11-02
• eCFR: 42 CFR 405.980 — regulation text as of the eCFR issue dated 2026-10-29, retrieved 2026-11-02

Every code description and rule above was retrieved from these pages on November 2, 2026. X12 code text is copyrighted by X12 and quoted only for the codes explained here; the complete lists are at x12.org. Payers revise code lists, contracts and policies, so confirm anything that affects a claim or a deadline with the payer.