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Billing Examples for Hospitals With Multiple Service Locations

CMS provided examples of how to report service facility addresses under different circumstances in MLN Matters (SE18002). Visit https://go.cms.gov/2VjMlVX.

No.Service FacilityBilling ProviderService Facility AddressModifier Used
1Billing provider (Main Campus) OnlyYesN/ANo “PO” or “PN” Modifier required on billing provider services.
2Billing Provider (Main Campus), Excepted Off-CampusYesN/ANo “PO” or “PN” Modifier required on Main Campus services. Modifier “PO” required on services with a HCPCS from Excepted Off-Campus.
3Billing Provider (Main Campus), Non-Excepted Off-CampusYesN/ANo “PO” or “PN” Modifier required on Main Campus services. Modifier “PN” required on services with a HCPCS from Non-Excepted Off-Campus.
4Billing Provider (Main Campus), Campus of Multi-Campus provider*YesN/ANo “PO” or “PN” Modifier required on billing provider services or other Campus services of a Multi-Campus.
5Campus of Multi-Campus provider*YesYes Campus Address*No “PO” or “PN” Modifier required on billing Campus services of a Multi-Campus.
6Billing Provider (Main Campus), Excepted Off-Campus, Non-Excepted Off-CampusYesN/ANo “PO” or “PN” Modifier required on Billing Provider services. Modifier “PO” required on services with a HCPCS from Excepted Off-Campus. Modifier “PN” required on services with a HCPCS from Non-Excepted Off-Campus.
7Billing Provider (Main Campus), Campus of Multi-Campus provider*, Excepted Off-Campus, Non-Excepted Off-CampusYesN/ANo “PO” or “PN” Modifier required on billing provider services or other Campus services of a Multi-Campus. Modifier “PO” required on services with a HCPCS from Excepted Off-Campus. Modifier “PN” required on services with a HCPCS from Non-Excepted Off-Campus.
8Campus of Multi-Campus provider*, Excepted Off-Campus, Non-Excepted Off-CampusYesYes Campus Address*No “PO” or “PN” Modifier required on billing Campus services of a Multi-Campus. Modifier “PO” required on services with a HCPCS from Excepted Off-Campus. Modifier “PN” required on services with a HCPCS from Non-Excepted Off-Campus.
9Excepted Off-CampusYesYesModifier “PO” required on all services with a HCPCS.
10Non-Excepted Off-CampusYesYesModifier “PN” required on all services with a HCPCS.
11Excepted Off-Campus, Non-Excepted Off-CampusYesYes First Registered EncounterModifier “PO” required on services with a HCPCS from Excepted Off-Campus. Modifier “PN” required on services with a HCPCS from Non-Excepted Off-Campus.
12Excepted Off-Campus, Excepted Off-CampusYesYes First Registered EncounterModifier “PO” required on all services with a HCPCS.
13Non-Excepted Off-Campus, Non-Excepted Off-CampusYesYes First Registered EncounterModifier “PN” required on all services with a HCPCS.
* Campus address is different from Billing Provider address; if the Campus address is the same as the Billing Provider address, follow the billing provider instructions.
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