Telehealth billing fails for one simple reason: the claim says “telehealth,” but the POS tells the payer a different story. Revenue teams feel it as denials, underpayments, recoupments, and rework. The global telehealth market reached USD 186.41B in 2025 and is projected to reach USD 1,272.81B by 2034, so POS accuracy has become a direct payment driver.
CMS created POS 10 and updated POS 02 to separate telehealth in the patient’s home from telehealth in every other location. This guide explains the difference, shows how payers use it for reimbursement logic, and gives documentation and workflow rules that reduce denials.
Consequences of Error in Documentation of POS Codes
POS errors create predictable outcomes in adjudication systems:
- Claim denials from POS mismatch edits
- Delayed payments from manual review or documentation requests
- Underpayments when the wrong facility/non-facility rate triggers
- Revenue loss from write-offs and missed timely filing windows
- Administrative burden from corrected claims and appeals
- Audit exposure when the medical record location conflicts with the claim
- Recoupment demands when post-pay review finds location inaccuracies
- CMS explicitly notes that POS data is used to pay claims correctly.
What is POS 10?
CMS definition: POS 10 reports telehealth when the patient is located in their home (a private residence, not a hospital or facility).
Effective: POS 10 is effective January 1, 2022, and became available to Medicare on April 1, 2022.
Key Components of POS 10?
The main elements of POS 10 are;
- Telehealth service delivered through telecommunications technology
- Patient location = home/private residence
- Provider and patient are located in different places
- Professional claim uses POS to drive correct payment logic
When to Use POS 10?
- The encounter occurs via real-time video or audio-only telehealth (when allowed)
- The medical record confirms the patient’s location = home
- Scheduling/intake captures the home location, and the note matches the claim
POS 10 examples (patient location)
- Patient’s house or apartment
- Patient’s private residence where care is received (not an institutional facility)
What is POS 02?
CMS definition: POS 02 reports telehealth when the patient is not located in their home during the encounter.
Effective: POS 02 is effective January 1, 2017, with a description change effective January 1, 2022 (and Medicare applicability beginning April 1, 2022).
Key Components of POS 02
The main elements of POS 02 are:
- Telehealth delivered through telecommunications technology
- Patient location ≠ home
- Documentation must identify the patient location category clearly
Where to Use POS 02?
Use POS 02 when a telehealth service is provided and the patient is not at home. This code is used to show that the patient was located in a non-home setting, which helps payers process the claim correctly.
POS 02 will be applicable when the patient is in:
- Workplace, school, or public location
- Temporary lodging (hotel/shelter)
- Hospital or clinic
- Nursing facility or long-term care setting
POS 10 vs POS 02 Documentation Rules
Payers deny telehealth claims when the note does not prove location and modality. CMS telehealth guidance for professional billing emphasizes using POS 02 vs POS 10 based on patient location.
Minimum Documentation Checklist (use for every telehealth visit)
Document these items every time:
- Mode of communication: secure video platform, phone-based audio-only, or other approved method
- Patient location at time of service: home vs non-home (drives POS 10 vs POS 02)
- Provider location: facility/office/hospital (helps defend audits)
- Patient consent for telehealth: include audio-only consent when used
- Start time, end time, total duration: record time elements when time-based rules apply
- Medical necessity: clinical reasoning and plan, not only symptoms
- Technology note: the reason the video was not used during audio-only visits
POS 10 Documentation Requirement
- Record a clear statement such as, “Patient located at home during the telehealth encounter.”
- Keep the location statement consistent across scheduling, intake, and the clinician note.
POS 02 Documentation Requirement
- Record a clear statement such as, “Patient located at [work/school/hospital/nursing facility] during the telehealth encounter.”
- Capture the location category so a reviewer can confirm “not home” without guessing.
Reimbursement Rates of POS 10 vs POS 02
According to CMS (Centers for Medicare and Medicaid Services), cases under POS 10 are paid at a non-facility rate, and POS 02 cases are at a facility rate. The non-facility rate is usually higher because the provider bears practice overhead. So, POS 02 reimbursement rates are lower than POS 10.
How to Use POS Codes with Modifiers?
Modifiers are extensions used with the original CPT and POS codes to cover more details about the procedure and services provided in a visit. The following are modifiers for POS codes:
- Modifier 93: For audio-only services.
- Modifier 95: For real-time audio and video telehealth services.
- Modifier GT: Some companies used to indicate telehealth services
Key Difference Between POS 10 and POS 02
| Feature | POS 10 | POS 02 |
| Patient Location | Residence | Other than Home |
| Billing Type | Non-Facility Billing | Facility Based Billing |
| Reimbursement Impact | Paid at the non-facility rate | Paid at Facility Rate |
| Common Location | Patient’s Home | Hospital, Clinic, or Workplace |
Practical Guide for POS 10 and POS 02 Billing:
Be careful while billing with POS 10 and POS 02 codes about these parameters:
Location Verification
Location confirmation is very important while using the POS codes. If the documentation fails to verify the patient location, then there is no chance for claim approval. So, at the very first, you should add the location of the patient during the telehealth session with proper proof.
Use Appropriate Modifier
Modifiers are helpful in describing the case more efficiently. That is why the chances of your claim’s instant approval increase when you use an appropriate modifier.
Follow CMS Guidelines
CMS regularly works on the quality and outcomes of the health care system, including health insurance. It updates the billing guidelines from time to time. Checking and following CMS guidelines will update your billing journey by enhancing your claim’s approval ratio.
Conclusion
Telehealth is rapidly growing in this era. With proper use of POS codes and smooth medical billing, you can gain it successfully. POS codes are the codes used to describe where telehealth is provided. POS 10 covers home-based telehealth, and such cases are paid at a non-facility rate. POS 02 visits are paid on the basis of the facility rate. Reimbursement rates for non-facility settings are higher. So, if you understand a clear difference between POS 10 and POS 2, you can get your claims instantly approved with higher rates. Always follow CMS guidelines during documentation to avail maximum returns.
FAQS
What is a POS modifier?
Modifiers are 2-character codes added with POS 10 or POS 02 for more elaboration of the procedure and service provided. Such as modifier 95 and modifier 93.
How to use modifier 95 for POS 10 code?
Yes! Modifier 95 with POS 10 describes audio-video telehealth services provided to a patient at home.
What is the difference between POS 10 and POS 02?
POS 10 describes telehealth services given to the patient at home, while POS 02 is used for telehealth services provided other than at home.
Does POS 10 code pay more than POS 02?
Yes! POS 10 usually pays more than cases of POS 02 because it is reimbursed at the non-facility rate.
Can POS 02 be used for a patient at home?
No, POS 02 should not be used if the patient is at home. POS 10 is applicable to the telehealth services provided at home.
