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    PROMISe

    ​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 Codes837 D (Dental) PROMISe™ Place of Service CodesADA-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