Place of Service Codes 2026: POS 02 vs 10 (and the Full List)
One two-digit code on the claim tells the payer where care happened — and for telehealth it decides whether you're paid the facility or the non-facility rate. Since 2024 that math flipped, and practices still billing the old way are underpaid on every home visit.
POS 02 vs POS 10: the distinction that moves money
Before 2022, every telehealth claim used POS 02 regardless of where the patient sat. Then CMS created POS 10 — "Telehealth Provided in Patient's Home" (effective January 1, 2022, Medicare April 1, 2022) and narrowed POS 02 to "Telehealth Provided Other Than in Patient's Home." The two aren't interchangeable, and here's the part that hits revenue: per CMS Change Request effective for dates of service on or after January 1, 2024, POS 10 pays the Medicare Physician Fee Schedule non-facility rate — the higher one — while POS 02 pays the facility rate. The logic is that when the patient is at home, the provider still carries the practice overhead, so the non-facility rate applies.
Two consequences billers live with daily. First, the POS code sets the rate — not the modifier. Whether you append 93 (audio-only) or 95 (audio-video) doesn't change the payment; the location code does. Second, the most common and most expensive error is defaulting to POS 02 for a patient who was actually at home — since most telehealth patients connect from home, that quietly pays the facility rate on visit after visit. The mirror error, POS 10 for a patient in a clinic or SNF, misstates the location and invites an audit. Confirm patient location at scheduling, document it in the note, and match it to the claim.
The modifier pairing (and where GT still hides)
The POS code says where; the modifier says how. Modifier 95 = real-time audio-video. Modifier 93 = audio-only. A Medicare-specific quirk trips up experienced billers: Medicare fee-for-service does not require modifier 95 with POS 10, but most commercial payers do — so the safe default is to append 95 (or 93) unless a payer's published policy carves it out. Modifier GT is largely obsolete for 2026; the notable exception is Critical Access Hospitals billing under Method II, and a handful of commercial/Medicaid plans that still ask for it. Modifier FQ covers audio-only behavioral health for FQHCs and RHCs. The whole telehealth modifier set lives in our modifier reference table.
Don't confuse POS 10 with POS 12. POS 12 is an in-person home visit — the provider physically travels to the residence. POS 10 is telehealth to a patient who happens to be at home, with the provider elsewhere. Patient at home plus telecommunication technology means POS 10, every time.
The place-of-service codes billers reach for most
The "F/NF" column shows which Medicare Physician Fee Schedule rate the setting generally triggers — facility (lower, because the site carries overhead) or non-facility (higher). This drives the payment difference between, say, an office visit and the same service in a hospital clinic.
What's covered through 2027 — and what ends in 2028
Telehealth policy has lurched from deadline to deadline, so the current state is worth stating plainly. The Consolidated Appropriations Act of 2026 (H.R. 7148), signed February 3, 2026, extended most Medicare telehealth flexibilities through December 31, 2027 — retroactively covering the funding lapse before it. Through that date: Medicare patients can receive non-behavioral telehealth at home, with no geographic restriction; audio-only is covered for non-behavioral services; and the expanded list of eligible practitioners and distant-site FQHCs/RHCs continues.
Behavioral and mental health telehealth in the home is permanent — no expiration, no six-month in-person requirement. But mark one date: beginning January 1, 2028, physical therapists, occupational therapists, speech-language pathologists, and audiologists lose Medicare telehealth billing unless Congress extends again. If your practice bills those disciplines by telehealth, that's a revenue cliff to plan around now, not in late 2027.
The 98000-series trap (Medicare vs commercial)
CPT introduced a new telemedicine E/M family — 98000–98015 — for synchronous audio-video and audio-only visits. Here's the catch: Medicare determined these codes are duplicative and does not reimburse them. For Medicare patients, continue billing the standard office/outpatient E/M codes 99202–99215 with the telehealth POS (02 or 10) and modifier 95 or 93. The one new code Medicare does accept is 98016 (brief virtual check-in), which replaced the old G2012.
Some commercial payers do want the 98000-series. That means a practice with mixed payers needs two coding pathways — Medicare on 99202–99215 + POS, commercial per each payer's telehealth policy — mapped in the billing system so the right code goes out per payer. How each visit was selected (MDM or time) still follows the E/M coding rules, which apply to telehealth exactly as they do in person.
Telehealth denials or underpayments piling up?
POS mismatches and stale modifier rules are among the highest-error categories in billing. A quick audit shows whether your telehealth claims are coded for the rate you've actually earned.
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