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CMS Process for Requesting New Codes or Modification of Existing Codes

Guidance for applying for a new or modified place of service code.

Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: February 11, 2020

To apply for a new or modified place of service code, you should submit a request that responds to the questions listed below. Each request should be limited to one code or modification and should include any additional descriptive material that you think would be helpful in furthering our understanding of the benefit of the code or modification being requested.

After we receive your request, it is placed on the agenda for an upcoming meeting of the CMS Place of Service Workgroup. The Workgroup, comprised of representatives of several components of the Centers for Medicare & Medicaid Services (formerly known as the Health Care Financing Administration), meets to analyze the appropriateness of, and business need for, the requested code; its effect on existing POS codes and descriptions; and the impact of the proposed coding change on health care payers.

If you have questions regarding the process for reviewing place of service code recommendations and associated issues, please feel free to direct them to the POS Coordinator, via e-mail at posrequest@cms.hhs.gov. 

NOTE:  Please direct questions related to billing place of service codes to your Medicare Administrative Contractor (MAC) for assistance.

Place of Service New Code/Modification Request Instructions

  1. Please sign and date each request. Be certain to provide the name, mailing address, telephone number, fax number, and e-mail address of the person to be contacted regarding this request.
  2. Please provide all information necessary to support your request.
  3. Please note: All necessary information must be supplied before your request for a new code or modification to the POS coding set can be considered. Incomplete submittals will be returned for clarification or additional information.
  4. Submit this information to:  Sara Harshman, POS Coordinator
    Centers for Medicare & Medicaid Services
    Disabled & Elderly Health Programs Group, Division of Benefits & Coverage
    Mail Stop S2-14-26
    7500 Security Blvd.
    Baltimore, MD  21244
    E-mail:  Sara.Harshman@cms.hhs.gov

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DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.