POS 13 is the two-digit Place of Service code for an assisted living facility.
The Centers for Medicare and Medicaid Services (CMS) defines POS 13 as a “congregate residential facility with self-contained living units providing assessment of each resident’s needs and on-site support 24 hours a day, 7 days a week, with the capacity to deliver or arrange for services including some health care and other services.”
POS code 13 for assisted living facilities has been part of the national CMS Place of Service code set since October 1, 2003, and distinguishes assisted living from home visits, physician office visits, skilled nursing facilities, and nursing facilities for accurate medical billing and Medicare reimbursement.
Assisted living sits between independent living and a nursing home. Residents live in their own units. They get help with daily tasks such as bathing, dressing, and medication reminders. They do not need full-time skilled nursing care. POS 13 marks that setting on a claim
This guide covers what POS 13 code means, when to use it, how it changes payment, and which mistakes cost practices money.
When Should You Use POS 13?
POS 13 is used when a provider treats a patient inside an assisted living facility. The code follows the patient’s location at the moment of the visit, not the provider’s office address. Pick it for routine checkups, follow-up visits, and other in-person services delivered at the facility.
The visit codes changed in 2023. On January 1, 2023, the American Medical Association deleted the old domiciliary and rest home E/M codes (99324 through 99328 and 99334 through 99337).
Providers now report assisted living visits with the Home or Residence Services E/M codes. New patients use 99341 through 99345. Established patients use 99347 through 99350. CMS confirmed this change in MLN Matters article MM13004. The CPT codes moved, but the place of service stayed POS 13.
One practical effect is that the E/M code set is shared with home visits, but the POS code still distinguishes between the two settings. A home visit uses POS 12. An assisted living visit uses POS 13. Same E/M codes, different place of service.
Is POS 13 a Facility or Non-Facility Setting?
POS 13 is a non-facility setting under Medicare. CMS lists the settings paid at the facility rate in the Medicare Claims Processing Manual, Chapter 12. Assisted living facilities are not on that list, so Medicare applies the non-facility rate to physician services billed with POS 13.
The split matters for payment. Under the Medicare Physician Fee Schedule, many services carry two rates: a facility rate and a non-facility rate.
For the same code, the non-facility rate is usually higher. The reason is overhead. In a non-facility setting, the provider brings the staff, gear, and supplies. So Medicare pays more for practice expenses. In a hospital, the facility bills its own overhead on a separate claim. So the physician rate drops.
POS 13 is non-facility. So a provider who visits an assisted living resident gets paid at the higher non-facility rate. This is the same rate an office visit (POS 11) earns for the same code.
Which Services Are Typically Billed Under POS 13?
Providers most often bill evaluation and management (E/M) visits under POS 13. These are the office-equivalent visits a clinician performs at the resident’s bedside or in a common area. Since January 1, 2023, these visits use the Home or Residence Services codes (99341 through 99350). Common services billed with POS 13 include:
- New and established patient E/M visits
- Behavioral health and psychiatric visits, including medication management
- Chronic care management for residents with ongoing conditions
- Wound care, podiatry, and other mobile specialty visits
- Lab draws and point-of-care testing are performed on-site
For 2026, CMS expanded the add-on code G2211 (visit complexity). It can now be attached to E/M visits in home and residential settings, including POS 13. Confirm the current rule with your Medicare Administrative Contractor before you append it. Add-on policy changes each year.
Which Providers Commonly Bill With POS 13?
Primary care physicians, nurse practitioners, and physician assistants bill POS 13 most often. They run the routine visits that assisted living residents need. Many build house-call or facility-rounding practices around this work.
Other providers use POS 13 too. Psychiatrists and behavioral health clinicians treat residents with depression, anxiety, or dementia. Podiatrists, wound care specialists, and other mobile specialists also bill POS 13 when they travel to the facility. The link across all of them is simple. The clinician comes to the resident, and the visit happens inside the assisted living facility.
When Is POS 13 the Wrong Place of Service Code?
POS 13 is wrong any time the patient is not inside an assisted living facility during the face-to-face service. The code reports the actual service location, so a different setting needs a different code. Use a different POS code in these cases:
- The patient came to the provider’s office. Use POS 11 (Office).
- The provider visited the patient’s private home. Use POS 12 (Home).
- The patient is in a skilled nursing facility under a Medicare Part A stay. Use POS 31 (Skilled Nursing Facility).
- The patient is in a nursing facility or has used up the Part A stay. Use POS 32 (Nursing Facility).
- The visit happened by video or phone. Use POS 02 or POS 10, depending on where the patient was.
If you reframe a setting in your head to make POS 13 fit, stop. That urge is the signal to pick the code that matches the documented location.
How Does POS 13 Compare to Similar Place of Service Codes?
POS 13 differs from nearby residential codes mainly in the type of facility and the payment rate. The table below lines up the codes that billers confuse most. All definitions come from the CMS Place of Service code set.
| POS code | Setting | Short CMS description | Facility status |
| POS 11 | Office | Provider’s office where care is given on an ambulatory basis | Non-facility |
| POS 12 | Home | Private residence, not a hospital or other facility | Non-facility |
| POS 13 | Assisted Living Facility | Congregate residence with self-contained units and 24/7 on-site support | Non-facility |
| POS 14 | Group Home | Shared-living residence with supervision and minimal services | Non-facility |
| POS 31 | Skilled Nursing Facility | Inpatient skilled nursing care below the hospital level | Facility |
| POS 32 | Nursing Facility | Skilled or health-related care above custodial level | Non-facility |
What Are the Most Common POS 13 Billing Mistakes?
The most common POS 13 mistake is reporting the wrong location because of a default setting or a copy-forward error. The code must match the place documented in the note for every single visit. Watch for these frequent errors:
- Using POS 12 for assisted living visits: The home and assisted living E/M codes are the same, so billers forget to switch the place of service to 13.
- Using POS 11 (office) out of habit: This creates a mismatch between the claim and the clinical note that auditors look for.
- Using the old domiciliary or rest home E/M codes (99324 through 99337): The AMA deleted these on January 1, 2023.
- Confusing POS 13 with POS 32: An assisted living resident is not a nursing facility resident, and the codes are paid through different rules.
- Entering the wrong service address in the location field: For POS 13, the field should hold the assisted living facility’s name and address, not the provider’s office.
- Skipping a coverage check on mixed-care buildings: A patient who transfers to a skilled or nursing setting needs a new POS code.
Best Practices for Billing POS 13 Correctly
The best practice for POS 13 is simple. Confirm the patient’s actual setting before each claim, then match the code to the note. Accurate location reporting prevents denials, protects the correct payment, and lowers audit risk. Build these steps into your workflow:
- Verify the facility type and license. Confirm the building is an assisted living facility, not a group home, nursing facility, or skilled nursing facility.
- Check the patient’s status on mixed-care campuses. A resident’s setting can change, so confirm it per patient, per date of service.
- Use the current E/M codes (99341 through 99350) with POS 13, not the deleted domiciliary codes.
- Enter the facility’s name and address in the service location field so the claim matches the place of service.
- Keep documentation that supports the location: the visit note, the facility address, and proof the building qualifies as assisted living.
- Train staff on payer differences. Some Medicare Advantage and commercial payers were slow to adopt the 2023 changes, so track their rules and appeal patterns.
When the code, the note, and the service address all agree, the claim is clean and pays without follow-up.
Final Words
POS 13 reports care given inside an assisted living facility. CMS treats it as a non-facility setting, so it pays the higher non-facility rate. Since January 1, 2023, these visits use the Home or Residence Services E/M codes, and the place of service remains 13. The codes that cause the most trouble are the neighbors. POS 12 is the private home. POS 14 is a group home. POS 31 and POS 32 are nursing settings. Confirm the patient’s actual location, match the code to the note, and check payer-specific rules. Your assisted living claims will then pay cleanly. For any rate question or edge case, your Medicare Administrative Contractor is the authority of record.
