Place of Service

The place of service for DMEPOS claims is considered the location where a beneficiary will primarily use the DMEPOS item. Coverage for DMEPOS items is considered when the place of service is:

  • 01 - Pharmacy
  • 04 - Homeless Shelter
  • 09 - Prison/Correctional Facility
  • 12 - Home
  • 13 - Assisted Living Facility
  • 14 - Group Home
  • 33 - Custodial Care Facility
  • 54 - Intermediate Care Facility/Mentally Retarded
  • 55 - Residential Substance Abuse Treatment Facility
  • 56 - Psychiatric Residential Treatment Center
  • 65 - End Stage Renal Disease (ESRD) Treatment Facility (valid POS for Parenteral Nutritional Therapy)

For a list of place of service codes, see the CMS Place of Service Codes.

Coverage consideration for DMEPOS items in a Skilled Nursing Facility (31), unless a beneficiary is in a covered Part A stay or in a Nursing Facility (32) is limited to the following:

  • Prosthetics, orthotics and related supplies
  • Urinary incontinence supplies
  • Ostomy supplies
  • Surgical dressings
  • Oral anticancer drugs
  • Oral antiemetic drugs
  • Therapeutic shoes for diabetics
  • Parenteral/enteral nutrition (including E0776BA, the IV pole used to administer parenteral/enteral nutrition)
  • ESRD - dialysis supplies only
  • Immunosuppressive drugs

This list does not apply to situations where a beneficiary is in a Part A covered Skilled Nursing Facility (SNF) stay. See the Consolidated Billing webpage for information on this.

 

Last Updated Wed, 05 Feb 2020 16:10:43 +0000