Place of Service - JD DME
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
- 27 - Non-permanent location on the street or found environment, not described by any other POS code, where health professionals provide preventive, screening, diagnostic, and/or treatment services to unsheltered homeless individuals
- 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 Thu, 07 Sep 2023 19:57:01 +0000