What POS 10 in Medical Billing Means
POS 10 in medical billing is the two-digit place of service code that tells Medicare, Medicaid, and commercial payers the patient was physically located in their home when the telehealth service happened.
CMS gives it the official name ‘Telehealth Provided in Patient’s Home.’ The code joined the national place of service set on January 1, 2022, and Medicare started recognizing it on April 1, 2022. The CMS Place of Service Code Set carries the change. Before POS 10 existed, every telehealth claim used POS 02, no matter where the patient sat.
Here’s the part that hits revenue. POS 10 triggers the non-facility payment rate under the Medicare Physician Fee Schedule. POS 02 triggers the facility rate, which runs lower. The POS code sets the rate, not the modifier. That gap shows up on every claim.
POS 10 lives in Box 24B of the CMS-1500 form. It applies to professional claims, not institutional UB-04 claims. A facility billing its originating-site fee under HCPCS Q3014 doesn’t use POS 10 for that fee.
Practices that catch the right POS at scheduling instead of at the claim stage cut their rework. That’s the quiet value of dialed-in medical billing services.
Per the CMS Place of Service Code Set, last modified February 17, 2026, POS 10 is defined only as ‘Telehealth Provided in Patient’s Home.’ It doesn’t cover emergency room visits, skilled nursing facilities, clinics, or any institutional setting.
The Patient Home Rule: Exactly When POS 10 Applies
Where the Patient Must Be for POS 10
CMS reads ‘home’ broadly for POS 10. It covers a private residence the patient owns or rents, an apartment, temporary lodging like a hotel room or short-term rental where they’re staying, and any non-institutional living space.
Picture a follow-up visit where the patient joins from the living room couch. Or a behavioral health session where they connect from a hotel while traveling for work. Both are POS 10.
Where POS 10 Doesn’t Apply
POS 10 drops out the moment the patient sits in an institutional setting during the call, even one they call home. Skilled nursing facilities, assisted living centers, hospitals, inpatient rehab, clinics, and outpatient centers all fall outside it. Patient in any of those during the visit, the code is POS 02.
POS 10 doesn’t apply to hospital-based emergency room visits under any payer’s current rules. The CMS Place of Service Code Set, updated February 17, 2026, confirms POS 10 marks home-based telehealth and nothing else.
How POS 10 Differs From POS 12
POS 12 is the in-person home visit, where the provider drives to the patient’s residence. POS 10 is telehealth to a patient at home, with the provider somewhere else. Patient at home plus telecommunication technology means POS 10, not POS 12.
Mixing up these two is one of the most common errors for practices that recently bolted telehealth onto their service mix.
Confirm patient location at the start of the visit. Document it in the clinical note. Match that documentation to the POS code on the claim.
POS 10 vs. POS 02: The Rate Difference That Drives Revenue
Billing POS 02 when the patient is at home costs the practice money on every claim. POS 10 triggers the non-facility rate under the Medicare Physician Fee Schedule. POS 02 triggers the facility rate, which sits lower.
Use POS 10 or POS 02: The Decision That Determines Your Rate
- Use POS 10 when the patient connects from their private residence, including a house, apartment, or temporary lodging that’s their current living space.
- Use POS 02 when the patient connects from somewhere other than home, including a clinic, hospital, workplace, school, skilled nursing facility, or any other institutional or non-residential setting.
- Don’t use POS 10 when the patient is in any healthcare facility during the call, even one they call home.
| Attribute | POS 10 | POS 02 | POS 11 |
|---|---|---|---|
| Patient location | Home | Non-home location | Provider office (in-person) |
| Payment rate | Non-facility (higher) | Facility (lower) | Non-facility (same as POS 10) |
| Most common scenario | Home telehealth | Clinic or facility telehealth | In-person office visit |
| Modifier required | 95 (commercial) | 95 (commercial) | None |
| Claim form | CMS-1500 | CMS-1500 | CMS-1500 |
POS 10 is a non-facility code that pays at the higher non-facility rate under the Medicare Physician Fee Schedule.
Here’s the insight most guides skip. POS 11 (in-person office) and POS 10 (home telehealth) both pay the non-facility rate. The rate matches because in both cases the provider carries the practice overhead.
POS 02 pays the facility rate because the facility carries that overhead. That’s the core of POS 10 in medical billing: the place of service sets the rate, not the modifier.
Per CMS Change Request R12671CP, for dates of service on or after January 1, 2024, covered Medicare telehealth claims billed with POS 10 pay at the Medicare Physician Fee Schedule non-facility rate. POS 02 pays at the facility rate. The POS code sets the rate, not the modifier.
Modifier 95 and POS 10: The Payer Rule Every Biller Gets Wrong
Modifier rules are where POS 10 in medical billing trips up even experienced billers.
Medicare Fee-for-Service doesn’t require modifier 95 for audio-video telehealth visits billed with POS 10. Most commercial payers do. The AAFP telehealth coding guidance and CMS Claims Processing Manual Chapter 12 both back the Medicare-only exception. Best practice: append modifier 95 unless the payer’s published policy carves it out.
The Three Modifiers That Pair With POS 10
| Modifier | Full name | When to use with POS 10 | Medicare required | Commercial required |
|---|---|---|---|---|
| 95 | Synchronous telehealth, audio/video | All audio-video visits from the patient’s home | No (recommended) | Yes (most payers) |
| 93 | Audio-only | Video available but the patient can’t or won’t use it; behavioral health permanent | Yes (when applicable) | Yes (most payers) |
| GT | Via interactive audio/video | Critical Access Hospital Method II billing only | CAH-specific | Largely obsolete |
Modifier 93 flags audio-only delivery. For non-behavioral health services, the note has to show video was available and the patient couldn’t or wouldn’t use it. State the reason: no device, poor connection, or patient declined. Skip that documentation, and the audio-only claim turns into a denial target.
Modifier GT is mostly obsolete in 2026. Medicare dropped it for standard telehealth claims years back. The one live exception is Critical Access Hospitals billing under Method II. A practice with no CAH tie can pull modifier GT out of the telehealth workflow.
Commercial payer rules for modifier 95 with POS 10 aren’t uniform. Some want modifier 95 on every POS 10 claim. Some take POS 10 with no modifier when the EHR flags the location as telehealth. Check the payer’s current telehealth policy before submitting.
Per Humana’s guidance effective February 3, 2026, synchronous telemedicine billed with POS 10 shouldn’t carry modifier 93. That rule differs from CMS, one more reason per-payer policy beats a blanket rule.
For Medicare Fee-for-Service, modifier 95 isn’t strictly required for audio-video telehealth billed with POS 10. For most commercial payers and most Medicaid programs, modifier 95 is required to avoid denial. The modifier describes the delivery method. It doesn’t change the payment rate.
Entering POS 10 on the CMS-1500: Box 24B and the Electronic Claim
POS 10 in medical billing only pays right when it lands in the correct box on the correct form. POS 10 belongs on the CMS-1500, the professional claim form physicians, outpatient clinics, and non-institutional providers use. It doesn’t show up on the UB-04, the institutional form for hospitals and facilities.
The CMS-1500 Boxes That Work With POS 10
| CMS-1500 box | What goes there | POS 10 context |
|---|---|---|
| Box 24B | Place of service code | Enter “10” for telehealth at the patient’s home |
| Box 24D | CPT/HCPCS code plus modifier | E/M code (99202-99215) plus modifier 95 or 93 |
| Box 32 | Facility/service location name and address | Leave blank or enter the provider’s enrolled practice address, not the patient’s home |
| Box 33 | Billing provider name, NPI, and address | Provider’s enrolled practice location |
Box 24B is where the facility versus non-facility decision gets made. The CMS Claims Processing Manual Chapter 26 ties the place of service to the payment rate.
Through the applicable policy period, providers sending Medicare POS 10 claims from their own residence can use their enrolled practice location in Box 33 instead of their home address. CMS confirms this to protect providers’ residential privacy.
On the HIPAA 837P electronic transaction, POS 10 maps to Loop 2300, CLM05-1. When you set up clearinghouse or practice management software for telehealth, confirm the system drops “10” into CLM05-1 for home visits. A dropdown that defaults to “02” for all telehealth quietly underbills every home telehealth claim.
POS 10 claims ride the CMS-1500 professional claim form, an outpatient-equivalent context. POS 10 doesn’t appear on inpatient institutional claims. So if the question is inpatient or outpatient, POS 10 sits on the outpatient side.
Which CPT Codes Belong With POS 10 (And the AMA Code Error to Avoid)
POS 10 in medical billing pairs with a specific set of CPT codes, and one wrong range triggers automatic denials. For Medicare Fee-for-Service telehealth billed with POS 10, the right codes are the standard in-person evaluation and management codes: 99202 through 99215.
The AMA rolled out a dedicated telehealth E/M range, 98000 through 98016, in 2025. CMS declined to reimburse most of them, calling them duplicative of existing E/M codes with modifiers. Bill a 98000-98015 code on a Medicare POS 10 claim, and it denies. The denial comes back as RARC N776, not a covered telehealth service.
CPT Codes That Work With POS 10 for Medicare
| CPT code | Service type | Correct for Medicare POS 10 | Notes |
|---|---|---|---|
| 99202-99215 | Office/outpatient E/M, new and established | Yes | Standard E/M codes plus modifier 95 |
| 99421-99423 | E-visits (patient-initiated) | Yes | Asynchronous; no audio/video needed |
| 98016 | Brief virtual check-in | Yes | Replaces G2012 for Medicare in 2026 |
| 98000-98015 | AMA dedicated telehealth E/M codes (2025) | No (Medicare) | CMS declined; commercial payers may accept |
| G2025 | FQHC/RHC telehealth | FQHC/RHC only | Through December 31, 2026 |
Yes. CPT 99214 is an established-patient E/M code in the 99202-99215 range, and CMS confirms it for Medicare telehealth billed with POS 10. Pair it with modifier 95 for audio-video visits. The complexity and time documentation match an in-person 99214. Our CPT 99215 billing guide walks the complexity thresholds.
Every CPT code billed with POS 10 for Medicare has to appear on the CMS Telehealth Services List CY 2026. CMS updated the 2026 list on March 4, 2026. A service that’s not on the list is non-covered under Medicare telehealth, whatever the POS code or modifier says.
Per CMS guidance, telehealth billed to Medicare with POS 10 has to use standard E/M CPT codes, 99202 through 99215. Pulling codes from the 98000-98015 AMA telehealth range for Medicare claims ends in denial.
Medicare POS 10 Rules for 2026: What Extended, What Changed, What Expires
On February 3, 2026, Congress signed a budget package that reset the near-term rules for POS 10 in medical billing, extending the major Medicare telehealth flexibilities through December 31, 2027.
Under that extension, Medicare beneficiaries can get non-behavioral health telehealth from home, billed with POS 10, with no geographic restrictions through December 31, 2027. The CMS Telehealth FAQ (February 2026) lays out the dates.
The 2027 Extension: What It Covers and What Providers Must Plan For
| Medicare POS 10 rule | Status in 2026 | Expires |
|---|---|---|
| Non-BH home telehealth (POS 10), no geographic restrictions | Active | December 31, 2027 |
| Audio-only for non-behavioral health services | Active | December 31, 2027 |
| Behavioral health home telehealth (POS 10), no geographic restrictions | Permanent | No expiration |
| Behavioral health audio-only | Permanent | No expiration |
| In-person BH visit requirement (6-month initial, annual after) | Waived | December 31, 2027 |
| BH grandfathering: patients who started before January 1, 2028 | Established, no 6-month requirement | Ongoing after 2027 |
Starting January 1, 2028, unless Congress acts again, Medicare non-behavioral health telehealth reverts to requiring the patient to be in a qualifying medical facility in a rural area. The home stays valid for behavioral health permanently. Non-BH practices billing heavy POS 10 volume need a contingency plan before the 2027 deadline.
For practices billing through Novitas Solutions, the MAC for Texas, the extension applies to all Medicare Fee-for-Service claims Novitas processes. TMHP, which runs Texas Medicaid, keeps separate telehealth rules, including its own prior authorization requirements for home telehealth. Check TMHP’s current policy on its own before submitting Medicaid POS 10 claims in Texas.
Medicare Advantage plans write their own telehealth rules apart from Fee-for-Service. Some extend POS 10 coverage past what FFS requires. Others add stricter prior authorization. Verify each MA plan’s current telehealth benefit before submitting home telehealth claims.
The spread across Medicare Advantage plans for POS 10 coverage is one reason practices working with an experienced revenue cycle management services partner keep payer-specific rules outside the EHR.
POS 10 Claim Denials: The Six Codes That Stop Payment and How to Fix Each One
POS 10 claims fail in predictable ways. Each failure has a specific CARC code, a root cause, and a fix. The matrix below covers the six codes behind most POS 10 failures. Practices running heavy telehealth volume lean on our denial management services to catch these before the claim leaves the system.
POS 10 Denial Code Matrix: Root Cause and Resolution
| Denial code | What it means | Root cause for POS 10 claims | Resolution |
|---|---|---|---|
| CO-16 | Missing or insufficient information | Patient location not in the note; consent not on file | Document patient location at home in every note, keep the consent form; see our CO-16 denial code guide |
| CO-96 | Non-covered charge | CPT billed with POS 10 isn’t on the CMS Telehealth Services List for the year | Cross-check the list before billing; RARC N776 confirms it; see our CO-96 denial guide |
| CO-197 | Pre-authorization required | Commercial payer required prior auth, not obtained before the visit | Verify telehealth prior auth per payer before scheduling; see our CO-197 prior auth denial guide |
| CO-B7 | Provider not certified or eligible | Provider’s credentials not accepted by the payer for telehealth | Confirm the provider is enrolled and credentialed for telehealth with that payer |
| CO-4 | Service inconsistent with modifier | POS 10 sent with modifier GT, which the payer won’t take for home telehealth | Swap GT for modifier 95 on audio-video; verify modifier acceptance per payer |
| RARC N776 | Not a covered telehealth service | CPT isn’t on Medicare’s covered list; POS 10 sent but the code is ineligible | Remove POS 10; bill under non-telehealth rules if the service fits another channel |
POS 10 Pre-Submission Checklist (10 Items)
- Confirm patient location at home before the visit starts. Note it.
- Verify the CPT code is on the CMS Telehealth Services List CY 2026.
- Confirm POS 10 fits, with the patient at home and not at a facility.
- Pair the right modifier: 95 for audio-video, 93 for documented audio-only.
- Verify the prior authorization requirement for this service with this payer.
- Enter POS code “10” in Box 24B of the CMS-1500.
- Confirm the CPT range is 99202-99215 for Medicare. Skip 98000-98015.
- Document patient consent for telehealth in the note.
- Record the technology platform used, whether HIPAA-compliant video or phone.
- Run a pre-submission scrub for POS and modifier mismatch.
POS 10 accuracy rides on documentation that agrees across three records: the clinical note, the authorization, and the claim form. A mismatch between any two of the three is the most common trigger for the denials in the table above.
Audio-Only Telehealth and Modifier 93 With POS 10: What the 2026 Rules Allow
Audio-only telehealth at home (POS 10 with modifier 93) runs on two different rule sets depending on the patient’s condition. For behavioral and mental health, audio-only is permanently allowed under CMS policy. For everything else, audio-only with POS 10 is extended through December 31, 2027, under the February 2026 Congressional extension. The HHS telehealth provider guidance spells out the split.
When Modifier 93 Is Correct With POS 10
Modifier 93 with POS 10 needs three things in the clinical note:
- The service ran on audio-only technology.
- Real-time audio-video was available on the provider’s end.
- The patient couldn’t or wouldn’t use video, with the reason stated: no device, poor connection, declined by preference, or a disability that ruled out video.
Miss any of the three, and the audio-only claim becomes a CO-16 target for missing information.
For behavioral health patients who started home mental health telehealth on or before December 31, 2027, CMS treats them as established. They skip the six-month in-person visit requirement when in-person rules return in January 2028. The annual in-person visit applies after that, but the initial six-month threshold doesn’t.
Federally Qualified Health Centers and Rural Health Clinics billing audio-only with POS 10 use modifier FQ instead of modifier 93 in certain contexts. Verify the applicable modifier with the payer and your clearinghouse setup.
Seven POS 10 Questions Billing Teams Ask (And the Answers That Prevent Denials)
What is POS 10 in medical billing?
POS 10 is the two-digit place of service code for a telehealth service delivered to a patient at home. CMS names it ‘Telehealth Provided in Patient’s Home.’
Is POS 10 required for home telehealth, or can I still use POS 02?
POS 02 isn’t correct for home telehealth anymore. CMS added POS 10 in January 2022 to separate home telehealth from telehealth in other settings. Use POS 02 for a patient at home, and the claim pays the facility rate, lower than the non-facility rate POS 10 brings.
What modifier goes with POS 10?
Modifier 95 for audio-video. Modifier 93 for audio-only, when video was available and the patient couldn’t or wouldn’t use it. Medicare FFS doesn’t require modifier 95, but most commercial payers do. Append modifier 95 unless the payer’s policy carves it out. For E/M complexity across the 99202-99215 range, our CPT 99213 billing guide breaks it down.
Does POS 10 pay more than POS 02?
Yes. POS 10 triggers the Medicare Physician Fee Schedule non-facility rate. POS 02 triggers the facility rate. CMS sets both rates each year. The non-facility rate runs higher because the provider carries the practice overhead when the patient is at home.
Can I bill Medicare for telehealth from the patient’s home in 2026?
Yes. Congress extended Medicare home telehealth flexibilities through December 31, 2027, in a budget package signed February 3, 2026. Beneficiaries can get non-behavioral health telehealth from home under POS 10 with no geographic restrictions through that date. Behavioral health home telehealth has no expiration under permanent CMS policy.
What happens if I use the wrong POS code for telehealth?
Use POS 02 for a patient at home, and every claim pays the facility rate instead of the non-facility rate. That’s lost revenue on every home telehealth visit. Use POS 10 for a patient who isn’t at home, and you misstate the service location and invite an audit.
What is the difference between POS 10 and POS 12 for home visits?
POS 12 is the in-person home visit, provider traveling to the residence. POS 10 is the telehealth home visit, provider elsewhere, using communication technology. Audio or video, the code is POS 10. Provider physically at the home, the code is POS 12.
POS Code Quick-Reference: Which Code, Which Rate, Which Modifier
POS Code Decision Table for Telehealth and In-Person Billing
| POS code | Service setting | Payment rate | Modifier needed (Medicare) | Claim form |
|---|---|---|---|---|
| POS 10 | Telehealth, patient at home | Non-facility rate (higher) | 95 (recommended), 93 for audio-only | CMS-1500 |
| POS 02 | Telehealth, patient not at home | Facility rate (lower) | 95 (recommended), 93 for audio-only | CMS-1500 |
| POS 11 | In-person, provider’s office | Non-facility rate (same as POS 10) | None | CMS-1500 |
| POS 12 | In-person, patient’s home | Non-facility rate | None | CMS-1500 |
| POS 21 | Inpatient hospital | Facility rate | Varies | UB-04 |
| POS 22 | On-campus outpatient hospital | Facility rate | Varies | UB-04 |
POS 10 and POS 11 pay the same non-facility rate. The practical gap: POS 10 needs a telehealth modifier (95 or 93), and POS 11 needs none. POS 02 pays the facility rate, lower, for the same services.
Accurate POS 10 in medical billing is the most controllable variable in telehealth revenue. The patient-location question takes fifteen seconds at the start of a visit. The documentation takes one sentence in the note. Get both right, and every home telehealth claim clears at the correct non-facility rate with no rework.
One O Seven RCM works with Texas and multi-state practices to keep POS 10 billing clean across Medicare, Medicaid, and commercial payers. Reach out for telehealth billing support.
