POS 12: Home
POS 12 is the place of service code for services delivered in person in the patient's private residence, typically with home visit codes 99341-99350. It pays the Medicare non-facility rate. POS 12 means the provider physically went to the home; a video visit with the patient at home is POS 10 instead.
- Setting
- Patient's private residence, provider on site
- Rate type
- Non-facility (higher payment)
- Common pairing
- Home visit E/M 99341-99350
- Watch out for
- Assisted living is POS 13, not 12; telehealth at home is POS 10
What does POS 12 mean?
POS 12 identifies the patient's home: per CMS, a location other than a hospital or other facility where the patient receives care in a private residence. It is the house-call code, used when the provider is physically present in the patient's living space.
POS 12 predates telehealth by decades and has nothing to do with virtual care. When CMS created POS 10 in 2022 for telehealth in the home, plenty of billers mixed the two up, and payer edit systems have been sorting out the wreckage ever since. The full code list is in our Place of Service reference.
When do you use POS 12?
Use POS 12 when a physician, NP, or PA renders an in-person service at the patient's private residence. Typical users are house-call practices, home-based primary care programs, palliative care groups, and mobile podiatry or wound care providers.
- New patient home visits: 99341-99345 with POS 12.
- Established patient home visits: 99347-99350 with POS 12.
- Home INR checks, in-home injections, or wound debridement performed at the residence.
Do not use POS 12 for assisted living (POS 13), group homes or custodial facilities (POS 33), nursing facilities (POS 32), or hospice residences. The building type controls the code, and E/M code families change with it.
How does POS 12 affect payment?
POS 12 pays the Medicare non-facility rate, the higher Physician Fee Schedule rate that includes practice expense. The direction is the same as an office visit: you bear the costs of supplies and staff, so you get the full rate rather than the stripped-down facility rate a hospital-based provider receives.
What POS 12 does not do is add travel money. Windshield time between homes is unbillable, so the payment math of a home-visit program lives or dies on scheduling geography. Price your home visit code mix at the non-facility rate with the Medicare fee calculator and build routes so a provider sees six to eight patients within a tight radius rather than four scattered across a county.
What are the common POS 12 errors and denials?
The dominant errors are code-family mismatches and residence-type mismatches:
- CARC 5 (procedure inconsistent with POS): office E/M 99202-99215 billed with POS 12, or home codes 99341-99350 billed with POS 11. Decode remits fast with the denial code lookup.
- Wrong residential setting: assisted living visits billed as POS 12. Pays initially, recoups later when the payer matches the address to a licensed facility.
- Telehealth confusion: video visits coded POS 12 because "the patient was home." That belongs on POS 10 with modifier 95.
- Address gaps: claims missing the actual service address in item 32, a frequent front-end rejection for home-based providers.
Frequently asked questions
Both involve the patient being at home, but POS 12 means the provider traveled there and rendered care in person, while POS 10 means the encounter happened by telehealth. They also pair with different CPT ranges: in-person home visits use 99341-99350 with POS 12, while telehealth visits use office E/M or psychotherapy codes with POS 10 and modifier 95.
No. Assisted living facilities, group homes, and custodial care settings map to POS 13 or POS 33, and domiciliary/rest home E/M coding rules apply. POS 12 is reserved for a private residence: house, apartment, or the relative's home where the patient lives. Billing 99341-99350 with the wrong residential POS is a common edit and a frequent postpay recoupment in house-call practices.
Home visit codes 99341-99350 generally carry higher work RVUs than comparable office visits because of travel and complexity, and POS 12 keeps them at the non-facility rate. But Medicare does not pay separately for travel time or mileage. The visit code itself is the entire payment, which is why house-call economics depend on route density.
Medicare no longer requires the patient to be confined to the home for physician home visits, but the medical record should support why the service was rendered there and meet the E/M level billed. Home-visit-heavy practices are a known program integrity focus, so document the clinical reason and the actual address of service on every encounter.
Sources & further reading
Reviewed by the ImmediCare Solutions RCM team
Certified billers and coders handling claims across 50+ specialties nationwide. This entry is reviewed against current payer policy and CMS rules. Last review: Jul 5, 2026.
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