Place of Service Crosswalk

Place of Service Crosswalk
Type of Bill	Type of Bill Position 1 (Type of Facility)	Type of Bill Position 2 (Bill Classification)	Place of Service*	Place of Service Description
11X	Hospital	Inpatient	21	Inpatient Hospital
12X	Hospital	Inpatient	21	Inpatient Hospital
13X	Hospital	Outpatient	22	Outpatient Hospital
14X	Hospital	Other	22	Outpatient Hospital
18X	Hospital	Swing Bed	21	Inpatient Hospital
21X	Skilled Nursing	Inpatient	31	Skilled Nursing Facility
22X	Skilled Nursing	Inpatient	31	Skilled Nursing Facility
23X	Skilled Nursing	Outpatient	32	Nursing Facility
28X	Skilled Nursing	Swing Bed	32	Nursing Facility
32X	Home Health	Inpatient	12	Home
33X	Home Health	Outpatient	12	Home
34X	Home Health	Other	12	Home
41X	Religious Nonmedical	Inpatient	21	Inpatient Hospital
42X	Religious Nonmedical	Inpatient	21	Inpatient Hospital
43X	Religious Nonmedical	Outpatient	22	Outpatient Hospital
65X	Intermediate Care	Intermediate Care—Level I	54	Intermediate Care Facility/Mentally Retarded
66X	Intermediate Care	Intermediate Care—Level II	54	Intermediate Care Facility/Mentally Retarded
71X	Clinic or Hospital Based Renal Dialysis Facility	Rural Health Clinic (RHC)	72	Rural Health Clinic
72X	Clinic or Hospital Based Renal Dialysis Facility	Hospital Based or Independent Renal Dialysis Facility	65	End-Stage Renal Disease Treatment Facility
73X	Clinic or Hospital Based Renal Dialysis Facility	Free Standing Provider-Based Federally Qualified Health Center (FQHC)	49	Independent Clinic
74X	Clinic or Hospital Based Renal Dialysis Facility	Outpatient Rehabilitation Facility (ORF)	49	Independent Clinic
75X	Clinic or Hospital Based Renal Dialysis Facility	Comprehensive Outpatient Rehabilitation Facility (CORF)	62	Comprehensive Outpatient Rehabilitation Facility
76X	Clinic or Hospital Based Renal Dialysis Facility	Community Mental Health Center (CMHC)	53	Community Mental Health Center
79X	Clinic or Hospital Based Renal Dialysis Facility	OTHER	49	Independent Clinic
81X	Special facility or hospital ASC surgery	Hospice (Nonhospital Based)	34	Hospice
82X	Special facility or hospital ASC surgery	Hospice (Hospital Based)	34	Hospice
83X	Special facility or hospital ASC surgery	Ambulatory Surgical Center Services to Hospital Outpatients	24	Ambulatory Surgical Center
84X	Special facility or hospital ASC surgery	Free Standing Birthing Center	25	Birthing Center
85X	Special facility or hospital ASC surgery	Critical Access Hospital	22	Outpatient Hospital