Place of Service Code 31
- • Skilled Nursing Facility
- • 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.
Place of Service Code 32
- • Nursing Facility
- • 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 individuals with intellectual disabilities.
Use POS 31 when the patient is in a skilled nursing facility (SNF), which is a short-term care/rehabilitation facility.
Use POS 32 when the patient is in a long-term nursing care facility.
Keep in mind that one facility can provide BOTH types of care.
Since both types of care are available within the same facility, it is imperative to confirm with the staff whether the patient is a skilled nursing patient or a nursing facility patient. There are not separate wings or areas of the Nursing Facility that are designated as “skilled” or “nursing.”
Often physicians are confused when choosing the place of service between Place of Service 31 and Place of Service 32 whenever the treating and billing physician visits to a nursing home. As we know for place of 32 reimbursement is more than place of service 31, so we should be very careful when choosing to avoid fraudulent billing of the claim. This is unfortunately what has been leading to the audits that are being performed by CMS.
It is important to be aware that Place of Service Code 32 reimburses at a higher rate than Place of Service Code 31. It comes down to Facility Rate vs. Non-Facility rate. Place of Service Code 31 is classified as facility. Place of Service Code 32 is classified as Non-facility. Therefore, the reimbursement of Place of Service Code 32 is greater.
This is my opinion.
Michael G. Warshaw