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Welcome  » April 29, 2024 2:24 AM
Program Name: BadgerCare Plus and Medicaid Handbook Area: Dental
04/29/2024  

Covered and Noncovered Services : Codes

Topic #2814

Information is available for DOS before October 1, 2023.

Place of Service Codes

The following table lists the allowable POS codes for dental services.

POS Code Description
03 School
05 Indian Health Service Free-Standing Facility
06 Indian Health Service Provider-Based Facility
07 Tribal 638 Free-Standing Facility
08 Tribal 638 Provider-Based Facility
11 Office
12 Home
15 Mobile Unit
19 Off Campus—Outpatient Hospital
21 Inpatient Hospital
22 On Campus—Outpatient Hospital
23 Emergency Room—Hospital
24 Ambulatory Surgical Center
27 Outreach Site/Street
31 Skilled Nursing Facility
32 Nursing Facility
50 Federally Qualified Health Center
51 Inpatient Psychiatric Facility
71 Public Health Clinic
72 Rural Health Clinic

Providers should refer to the maximum allowable fee schedule for the most up-to-date POS information. Providers are reminded that the POS code must accurately represent the location where the service was rendered.

 
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