Place of Service Crosswalk

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Place of Service Crosswalk

Below is a table that shows how Place of Service codes have been crosswalked for PROMISe™ billing purposes. For provider specific place of service codes, please refer to the appropriate PROMISe Provider Handbooks and Billing Guides.

CMS-1500 PROMISe™ Place of Service Codes	837 P (Professional) PROMISe™ Place of Service Codes	837 D (Dental) PROMISe™ Place of Service Codes	ADA-2012 PROMISe™ Place of Service Codes
11 = Office	11 = Office	11 = Office	11 = Office, Block 38
62 = Comprehensive Outpatient Rehabilitation Facility	62 = Comprehensive Outpatient Rehabilitation Facility	N/A	N/A
12 = Patient's Home	12 = Patient's Home	12 = Patient's Home	12 = Home, Block 38
56 = Psychiatric Residential Treatment Facility	56 = Psychiatric Residential Treatment Facility	N/A	N/A
21 = Inpatient Hospital	21 = Inpatient Hospital	21 = Inpatient Hospital	21 = Inpatient Hospital, Block 38
65 = End Stage Renal Disease Treatment Facility	65 = End Stage Renal Disease Treatment Facility	N/A	N/A
22 = Outpatient Hospital	22 = Outpatient Hospital	22 = Outpatient Hospital	22 = Outpatient Hospital , Block 38
81 = Independent Laboratory	81 = Independent Laboratory	N/A	N/A
99 = Other Unlisted Facility (Hospital Special Treatment Room)	99 = Other Unlisted Facility (Hospital Special Treatment Room)	N/A	N/A
32 = Nursing Facility	32 = Nursing Facility	32 = Nursing Facility	32 = Nursing Facility, Block 38, Show Remarks
25 = Birthing Center	25 = Birthing Center	N/A	N/A
49 = Independent Clinic	49 = Independent Clinic	N/A	N/A
50 = Federally Qualified Health Center	50 = Federally Qualified Health Center	N/A	N/A
57 = Non-residential Substance Abuse Treatment Facility	57 = Non-residential Substance Abuse Treatment Facility	N/A	N/A
72 = Rural Health Clinic	72 = Rural Health Clinic	N/A	N/A
52 = Psychiatric Facility Partial Hospitalization	52 = Psychiatric Facility Partial Hospitalization	N/A	N/A
99 = Other Unlisted Facility (Community)	99 = Other Unlisted Facility (Community)	99 = Community	99 = Community, Block 38
24 = Ambulatory Surgical Center	24 = Ambulatory Surgical Center	24 = Ambulatory Surgical Center	24 = Ambulatory Surgical Center, Block 38, Show Remarks
23 = Emergency Room	23 = Emergency Room	23 = Emergency Room	23 = Emergency Room, Block 38, Show Remarks
54 = Intermediate Care Facility/Mentally Retarded	54 = Intermediate Care Facility/Mentally Retarded	31 = Nursing Facility	31 = Nursing Facility, Block 38, Show Remarks
34 = Hospice	34 = Hospice	N/A	N/A

​Place of Service Crosswalk

Place of Service Crosswalk