00.10.39q, Billing for Professional Office-Based Services Performed in an Outpatient Office-Based Setting Located within a Facility or on a Facility Campus

By 11/26/2025: Billing team must review Policy 00.10.39q in full to understand the specific billing requirements, modifiers, and place-of-service rules for office-based services performed within facility or campus locations. Update billing system logic, encounter forms, and provider documentation templates to ensure compliance with facility-based billing rules. Verify that all claims for services in these settings are coded and submitted according to the policy's guidance. Without proper implementation, claims may be denied or require rework due to incorrect billing methodology.