For Dates of Service Before January 1, 2018

Procedures Reimbursable Only as Inpatient Hospital Services

Certain surgical procedures may be reimbursed only when performed in an inpatient hospital, indicated by POS code 21 (Inpatient Hospital).

Providers billing these services on professional claims (i.e., the 837P transaction or the 1500 Health Insurance Claim Form) are affected by this policy.

The following table lists services that may be reimbursed only when performed in an inpatient hospital. This list may be periodically updated.