Place of Service Codes in ABA Billing

Place of service (POS) codes are two-digit codes on CMS-1500 claims that indicate where a service was delivered. Using the wrong POS code is a common cause of ABA claim denials, particularly for telehealth services.

The Most Common ABA Place of Service Codes

POS 02 — Telehealth Provided Other Than in Patient's Home

Use when the client is receiving telehealth services from a location other than their home (e.g., a school, community center, or clinic).

POS 10 — Telehealth Provided in Patient's Home

Use when the client is receiving telehealth services from their home. This is the correct code for most ABA telehealth sessions.

POS 11 — Office

Use when services are delivered at the provider's office or clinic.

POS 12 — Home

Use when services are delivered in the client's home (in-person, not telehealth).

POS 03 — School

Use when services are delivered at a school. Note: some payors do not cover ABA services delivered at school — verify coverage before scheduling school-based services.

POS 99 — Other Place of Service

Use for services delivered in community settings (parks, grocery stores, etc.) that don't fit other categories.

The Telehealth POS Code Confusion

The most common POS code error in ABA billing is using POS 11 (office) for telehealth sessions. This creates a mismatch: the claim says the service was delivered in an office, but the telehealth modifier (95 or GT) indicates it was delivered remotely. Most payors will deny this claim.

Correct telehealth billing:

  • Client at home: POS 10 + modifier 95 (or GT)
  • Client at another location: POS 02 + modifier 95 (or GT)

    • Incorrect telehealth billing:

  • POS 11 + modifier 95 (office + telehealth modifier = contradiction)

    • Payor-Specific POS Requirements

    Most payors follow the standard CMS POS code definitions. However, some Medicaid programs have state-specific requirements:

  • Texas Medicaid: Requires POS 12 for home-based services (not POS 11)
  • Florida Medicaid: Requires EVV data for POS 12 claims
  • California DHCS: Accepts POS 02 for telehealth (does not use POS 10)

    • Always verify POS code requirements with the specific payor's provider manual.