In-Person Office Visit Billing: POS 11 and POS 12 for Mental Health Practices
An in-person office visit is reported with a place of service (POS) code for where the visit happened. POS 11 is the office. POS 12 is the patient’s home. In-person visits do not take telehealth modifiers 93 or 95. Current as of 9/30/26 — reconfirm with each payer before you bill.
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- ✓ POS 11 (office) defined
- ✓ POS 12 (home) defined
- ✓ No telehealth modifiers on in-person visits
- ✓ Facility vs non-facility explained
- ✓ A pre-bill checklist
What counts as an in-person office visit
An in-person office visit is a face-to-face service where patient and clinician are in the same physical location. The place of service tells the payer which location that was.
| POS | Definition | Typical use |
|---|---|---|
| POS 11 | Office: a location, other than a hospital, skilled nursing facility, military treatment facility, community health center, State or local public health clinic, or intermediate care facility, where the health professional routinely provides health examinations, diagnosis, and treatment of illness or injury on an ambulatory basis | Your practice’s office |
| POS 12 | Home: a location, other than a hospital or other facility, where the patient receives care in a private residence | Visits at the patient’s house |
Definitions are from the CMS Place of Service Code Set. See the full place of service code list for other in-person settings.
Does an in-person office visit use modifiers 93 or 95?
No. Modifiers 93 and 95 describe telemedicine delivery, so they do not belong on a visit where patient and clinician are in the same room. Use the POS that matches the location and add only modifiers the service needs.
Modifiers that can apply to in-person mental health visits include 25 (separate E/M on the same day as a procedure) and 59 or the X modifiers. See the CPT modifiers page. For telehealth, see the telehealth location page.
Facility vs non-facility: what POS does to payment
Medicare and many payers pay physician fee schedule services at a facility or non-facility rate, depending on POS. Non-facility rates generally include the practice’s overhead. Check each payer’s fee schedule for the rate that matches your POS.
| POS | Facility or non-facility | What to verify |
|---|---|---|
| POS 11 | Non-facility rate is the usual expectation for private offices | Confirm on your payer’s fee schedule |
| POS 12 | Depends on payer | Verify with the payer before billing home visits |
Psychiatrist home visits use different E/M codes; see the E/M and home-visit codes page.
Pre-bill checklist for an in-person office visit
A five-minute check on every in-person office visit catches most POS errors before the claim leaves.
- Was the in-person office visit held in your office (POS 11) or their home (POS 12)?
- Are telehealth modifiers 93 and 95 off the claim?
- Does the rendering provider’s address match the POS?
- Does the payer’s fee schedule show the rate for this POS?
- Does the note document the location?
In-person office visit billing: frequently asked questions
What is POS 11?
POS 11 is the Office place of service. It is the standard code for an in-person visit at your practice’s office.
What is POS 12?
POS 12 is Home. Use it when the clinician sees the patient in a private residence. Confirm coverage and payment with the payer first.
Do I add modifier 95 to an in-person visit?
No. Modifier 95 is only for real-time audio and video telemedicine visits.
Can I bill POS 11 if I work from home and the patient comes to my home office?
It depends on how the payer and CMS define the location. Check with the payer and a compliance officer or counsel before you choose a code.
Where this information comes from
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Related on this site: Medicaid HCPCS code guide, electronic claims submission, and denied and rejected claim follow-up.
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