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PAP224 - Place of Service - Added POS rules for outpatient.
Blue Cross of Idaho·ID·Medical Policy
Effective date
Mar 1, 2026
We identified it
Jun 19, 2026
Summary
Blue Cross of Idaho updated their Place of Service policy to add specific POS rules for outpatient services. The policy clarifies that hospital-owned clinics should still be billed as POS 11 (office), while services in hospital outpatient departments must use POS 22 (outpatient hospital) or POS 23 (emergency room).
Action Required
Immediately: Billing team must review and update Place of Service codes for all outpatient claims. Ensure hospital-owned clinic services use POS 11 (office), hospital outpatient department services use POS 22 (outpatient hospital), and emergency services use POS 23 (emergency room). Update billing software edits to prevent claim denials for incorrect POS codes, as the clinical editing software will deny claims with invalid or inconsistent place of service codes.