HCFA-1500 Box 24b - Place of Service

On the HCFA-1500 form, Box 24B is used to report the place of service (POS) code for each line item. This two-digit code indicates where the service was rendered, such as in a physician’s office, hospital, or other healthcare setting.

Tip: Always use the correct two-digit POS code as defined by CMS and payers. The most common code is 11, which represents a physician’s office.

In our example below, the provider reported a place of service code of 11 (Office) for a single service line.

In the X12 837P 5010 transaction, Box 24B data is captured in two places:

• CLM05-1 – The overall claim-level place of service (2300 Claim Information Loop). This is the typical spot for POS.
• SV105 – The service line–level place of service (2400 Service Line Loop) only when the line’s POS differs from CLM05-1.

Sample 837P (5010) – Box 24B Mapping

Segment Breakdown:

• CLM05-1: Claim-level Place of Service (e.g., 11 = Office)
• SV105: Line-level Place of Service, used only when different from CLM05-1

Note: Populate SV105 only when a specific service line occurred in a different setting than the claim-level POS in CLM05-1. If they are the same, omit SV105.

For additional information on the X12 837 standard, please refer to the official implementation guides published by X12.

HCFA-1500 Form Box Locations

• HCFA-1500 Box 0 - Carrier Block
• HCFA-1500 Box 1 - Insurance Type
• HCFA-1500 Box 1a - Insured's ID Number
• HCFA-1500 Box 2 - Patient's Name
• HCFA-1500 Box 3 - Patient's Birth Date and Sex
• HCFA-1500 Box 4 - Insured's Name
• HCFA-1500 Box 5 - Patient's Address
• HCFA-1500 Box 6 - Patient Relationship to Insured
• HCFA-1500 Box 7 - Insured's Address
• HCFA-1500 Box 8 - Reserved For NUCC Use
• HCFA-1500 Box 9 - Other Insured's Name
• HCFA-1500 Box 9a - Other Insured's Policy or Group Number
• HCFA-1500 Box 9b - Reserved For NUCC Use
• HCFA-1500 Box 9c - Reserved For NUCC Use
• HCFA-1500 Box 9d - Insurance Plan Name or Program Name
• HCFA-1500 Box 10 - Is Patient's Condition Related To
• HCFA-1500 Box 10d - Claim Codes
• HCFA-1500 Box 11 - Insured's Policy Group or FECA Number
• HCFA-1500 Box 11a - Insured's Date of Birth and Sex
• HCFA-1500 Box 11b - Other Claim ID
• HCFA-1500 Box 11c - Insurance Plan Name or Program Name
• HCFA-1500 Box 11d - Is There Another Health Plan
• HCFA-1500 Box 12 - Patient's or Authorized Person's Signature
• HCFA-1500 Box 13 - Insured's or Authorized Person's Signature
• HCFA-1500 Box 14 - Date of Current Illness, Injury, Pregnancy (LMP)
• HCFA-1500 Box 15 - Other Date
• HCFA-1500 Box 16 - Dates Patient Unable to Work in Current Occupation
• HCFA-1500 Box 17 - Name of Referring Provider or Other Source
• HCFA-1500 Box 17a - Other ID
• HCFA-1500 Box 17b - NPI
• HCFA-1500 Box 18 - Hospitalization Dates Related to Current Services
• HCFA-1500 Box 19 - Additional Claim Information
• HCFA-1500 Box 20 - Outside Lab Charges
• HCFA-1500 Box 21 - Diagnosis or Nature of Illness or Injury
• HCFA-1500 Box 22 - Resubmission Code and Original Reference Number
• HCFA-1500 Box 23 - Prior Authorization Number
• HCFA-1500 Box 24a - Date(s) of Service
• HCFA-1500 Box 24b - Place of Service [You are Here]
• HCFA-1500 Box 24c - EMG
• HCFA-1500 Box 24d - Procedures, Services, or Supplies
• HCFA-1500 Box 24e - Diagnosis Pointer
• HCFA-1500 Box 24f - Charges
• HCFA-1500 Box 24g - Days or Units
• HCFA-1500 Box 24h - EPSDT/Family Plan
• HCFA-1500 Box 24i - Rendering Provider ID Qualifier
• HCFA-1500 Box 24j - Rendering Provider ID
• HCFA-1500 Box 25 - Federal Tax ID Number
• HCFA-1500 Box 26 - Patient's Account No.
• HCFA-1500 Box 27 - Accept Assignment
• HCFA-1500 Box 28 - Total Charge
• HCFA-1500 Box 29 - Amount Paid
• HCFA-1500 Box 30 - Rsvd for NUCC Use
• HCFA-1500 Box 31 - Signature of Physician or Supplier Including Degrees or Credentials
• HCFA-1500 Box 32 - Service Facility Location Information

Grab a sample of the HCFA-1500 claim form here - HCFA 02/12 Claim Form