Place of Service Code Description Conversion
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1 Place of Conversion CMS Place of Code Place of Name The place of service field indicates where the services were performed Possible values include: Code Description Inpatient Outpatient Office Home 5 Independent Lab Extended Care /Skilled Nursing 9 Ambulance 0 Other (Pharmacy, HME Suppliers, etc.) The following is a complete list of the CMS (Centers for Medicare and Medicaid s; formerly Health Care Financing Administration or HCFA) codes, and the Wellmark conversion codes. Place of Description Map to Wellmark -digit Code 0 School A facility whose primary purpose is education. 0 Homeless Shelter 05 Indian Health Free-standing 06 Indian Health Provider-based 07 Tribal 6 Freestanding A facility or location whose primary purpose is to provide temporary housing to homeless individuals (e.g., emergency shelters, individual or family shelters). A facility or location, owned and operated by the Indian Health, which provides diagnostic, therapeutic (surgical and non-surgical), and rehabilitation services to American Indians and Alaska Natives who do not require hospitalization. A facility or location, owned and operated by the Indian Health, which provides diagnostic, therapeutic (surgical and non-surgical), and rehabilitation services rendered by, or under the supervision of, physicians to American Indians and Alaska Natives admitted as inpatients or outpatients. A facility or location owned and operated by a federally recognized American Indian or Alaska Native tribe or tribal organization under a 6 agreement, which provides diagnostic, therapeutic (surgical and non-surgical), and rehabilitation services to tribal members who do not require Actuarial s/as 0//007
2 hospitalization. 0 Tribal 6 Provider-based A facility or location owned and operated by a federally recognized American Indian or Alaska Native tribe or tribal organization under a 6 agreement, which provides diagnostic, therapeutic (surgical and non-surgical), and rehabilitation services to tribal members admitted as inpatients or outpatients. Office Location, other than a hospital or other facility, where the patient receives care in a private residence. Home Location, other than a hospital orother facility, where the patient receives care in a private residence. Assisted Living Congregate residential facility with self-contained living units providing assessment of each resident s needs and on-site support hours a day, 7 days a week, with the capacity to deliver or arrange for services including some health care and other services. Group Home Congregate residential foster care setting for children and adolescents in state custody that provides some social, health care, and educational support services and that promotes rehabilitation and reintegration of residents into the community. 5 Mobile Unit A facility/unit that moves from place-to-place equipped to provide preventive, screening, 0 Urgent Care Inpatient Hospital Outpatient Hospital Emergency Room Hospital Ambulatory Surgical Center diagnostic, and/or treatment services. Location, distinct from a hospital emergency room, an office, or a clinic, whose purpose is to diagnose and treat illness or injury for unscheduled, ambulatory patients seeking immediate medical attention. A facility, other than psychiatric, which primarily provides diagnostic, therapeutic (both surgical and non-surgical), and rehabilitation services by, or under, the supervision of physicians to patients admitted for a variety of medical conditions. A portion of a hospital which provides diagnostic, therapeutic (both surgical and non-surgical), and rehabilitation services to sick or injured persons who do not require hospitalization or institutionalization. A portion of a hospital where emergency diagnosis and treatment of illness or injury is provided. A freestanding facility, other than a physician s office, where surgical and diagnostic services are provided on an ambulatory basis. 5 Birthing Center A facility, other than a hospital s maternity facilities Actuarial s/as 0//007
3 6 Military Skilled Nursing or a physician s office, which provides a setting for labor, delivery, and immediate postpartum care as well as immediate care of newborn infants. A medical facility operated by one or more of the Uniformed s. Military (MTF) also refers to certain former U.S. Public Health (USPHS) facilities now designated as Uniformed Facilities (USTF). A facility which primarily provides inpatient skilled nursing care and related services to patients who require medical, nursing, or rehabilitative services but does not provide the level of care or treatment available in a hospital. Nursing A facility which primarily provides to residents skilled nursing care and related services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care services above the level of custodial care to other than mentally retarded individuals. Custodial Care A facility which provides room, board and other personal assistance services, generally on a long term basis which does not include a medical component. Hospice A facility, other than a patient s home, in which palliative and supportive care for terminally ill patients and their families are provided. Ambulance Land Ambulance Air or Water 9 Independent 50 Federally Qualified Health Center 5 Inpatient Psychiatric 5 Psychiatric Partial A land vehicle specifically designed, equipped and staffed for lifesaving and transporting the sick or injured. An air or water vehicle specifically designed, equipped and staffed for lifesaving and transporting the sick or injured. A location, not part of a hospital and not described by any other Place of code, that is organized and operated to provide preventive, diagnostic, therapeutic, rehabilitative, or palliative services to outpatients only. A facility located in a medically underserved area that provides Medicare beneficiaries preventive primary medical care under the general direction of a A facility that provides inpatient psychiatric services for the diagnosis and treatment of mental illness on a -hour basis, by or under the supervision of a A facility for the diagnosis and treatment of mental illness that provides a planned therapeutic program Actuarial s/as 0//007
4 Hospitalization 5 Intermediate Care /Mentally Retarded 55 Residential Substance Abuse 57 Non-residential Substance Abuse 6 Comprehensive Inpatient Rehabilitation 6 Comprehensive Outpatient Rehabilitation 65 End-Stage Renal Disease 7 Public Health 7 Rural Health Independent Laboratory for patients who do not require full time hospitalization, but who need broader programs than are possible from outpatient visits to a hospital-based or hospital-affiliated facility. A facility which primarily provides health-related care and services above the level of custodial care to mentally retarded individuals but does not provide the level of care or treatment available in a hospital of SNF. A facility which provides treatment for substance (alcohol and drug) abuse to live-in residents who do not require acute medical care. s include individual and group therapy and counseling, family counseling, laboratory tests, drugs and supplies, psychological testing, and room and board. A location which provides treatment for substance (alcohol and drug) abuse on an ambulatory basis. s include individual and group therapy and counseling, family counseling, laboratory tests, drugs and supplies, and psychological testing. A facility that provides comprehensive rehabilitation services under the supervision of a physician to inpatients with physical disabilities. s include physical therapy, occupation therapy, speech pathology, social or psychological services, and orthotics and prosthetics services. A facility that provides comprehensive rehabilitation services under the supervision of a physician to outpatients with physical disabilities. s include physical therapy, occupational therapy, and speech pathology services. A facility other than a hospital, which provides dialysis treatment, maintenance, and/or training to patients or caregivers on ambulatory or home-care basis. A facility maintained by either State or local health departments that provides ambulatory primary medical care under the general direction of a A certified facility which is located in a rural medically underserved area that provides ambulatory primary medical care under the general direction of a A laboratory certified to perform diagnostic and/or clinical tests independent of an institution or a physician s office. 5 Actuarial s/as 0//007
5 99 Other Place of Other place of service not identified. 0 Actuarial s/as 0//007 5
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