POS code 33: Custodial Care Facility.

The CMS definition

A facility which provides room, board and other personal assistance services, generally on a long term basis, and which does not include a medical component.

That is the description CMS publishes for POS 33, Custodial Care Facility, 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 33 is the code for a setting that provides living support rather than medical care. The CMS definition is explicit that it "does not include a medical component," which is what separates it from the nursing facility code 32.

When it is used

• A service is furnished at a facility whose purpose is room, board and personal assistance, generally on a long-term basis.
• CMS also mentions POS 33 in a homeless-shelter context: for durable medical equipment, local contractors may crosswalk Homeless Shelter (04) to Home (12) or Custodial Care Facility (33) so that DME is covered when other conditions are met.

Billing implications (Medicare)

The manual marks POS 33 NF, so Medicare physician fee schedule services are paid at the non-facility rate.

Whether a given service is covered in a custodial setting is a coverage question, not something the POS code decides. The code only tells the payer where the service was furnished; check the payer's coverage policy for the service itself.

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 32: Nursing facility. Includes skilled nursing or health-related care.
• POS 13: Assisted living facility. Self-contained living units with on-site support and some health care.
• POS 14: Group home. Shared residence with supervision and minimal services.
• POS 12: Home. Care in a private residence.

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.