COT.002.123

PLACE-OF-SERVICE

Data Element

DE Number

COT123

System DE Number

COT.002.123

File Name

COT - CLAIM OTHER

File Segment Number

COT00002

File Segment Name

CLAIM-HEADER-RECORD-OT

Last updated

Overview Valid Values Related Rules Related DQ Measures Other Instances

Definition	A pass-through data element meaning that the state should report the field in T-MSIS as reported by the provider on the claim form (i.e., 837P or 837D - Place of Service is only captured at the line level of the CMS-1500). If the claim is submitted on the 837p electronic claims form and the Facility Code Qualifier is reported with any value other than 'B', then the PLACE-OF-SERVICE value should be blank or space-filled. If the claim is submitted on the CMS-1450 (UB-04) institutional claims form, the PLACE-OF-SERVICE field should be blank or space-filled. Otherwise, if the claim is submitted with the place of service populated with any value other than the valid values listed in T-MSIS Data Guide for PLACE-OF-SERVICE values, that value should still be reported in the PLACE-OF-SERVICE data element. If the claim is submitted by a provider with the place of service fields blank, then the PLACE-OF-SERVICE on the T-MSIS OT claims file should be blank or space-filled.
Size	X(2)
FLF Start Position	772
FLF Stop Position	773
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value must be 2 characters 2. Value must be in Place of Service Code List (VVL) 3. Conditional 4. If value is populated, then Type of Bill must not be populated

Valid Value Code Set	Valid Value Code	Valid Value Name	Valid Value Description	Effective Start Date	Effective End Date

RULE ID	RULE Definition
RULE-1559	If the place of service is populated on a non-denied claim from an OT file, then the place of service value reported must be in the list of valid values for place of service.
RULE-1560	If the type of service is for a a HMO, HIO, PACE, PCCM, or PHP capitation payment or for a premium payment on a non-denied claim line from an OT file, then the place of service value must not be populated.
RULE-7034	If a claim is a non-denied claim from an OT file, then the place of service value reported must be compatible with specified T-MSIS picture format: X(2).
RULE-7351	If a non-denied claim from an OT file has the type of claim equal to '1','3','A','C', then the claim type of bill or place of service must be populated.
RULE-7746	If a non-denied claim from an OT file has the type of claim Medicaid or Medicaid-expansion CHIP Managed Care Encounter or Separate CHIP Encounter, then the claim type of bill or place of service must be populated.
RULE-7812	If a non-denied claim from an OT file has the type of claim Medicaid or Medicaid-expansion CHIP Managed Care Fee-for-service or Separate CHIP Fee-for-service, then the claim type of bill or place of service must be populated.

Measure ID	Measure Name
ALL-13-004-6	% of MSIS IDs with alien restricted benefits code status (RESTRICTED-BENEFITS-CODE = 2) with services that are not emergency room or pregnancy-related
MCR-14-007-9	% of claim lines with ER Place of Service
MCR-14-008-19	% of claim lines with office Place of Service
MCR-14-009-18	% of claim lines with missing Place of Service
MCR-15-002-2	% of claim lines with TYPE-OF-SERVICE = 12, 2, 61 with ER Place of Service (Medicaid Paid Amount > $0)
MCR-15-003-4	% of claim lines with office Place of Service (Medicaid Paid Amount > $0)
MCR-15-004-3	% of claim lines with missing Place of Service (Medicaid Paid Amount > $0)
MIS-6-025-25	% missing: PLACE-OF-SERVICE (COT00002)
ALL-13-004-4	% of MSIS IDs with alien restricted benefits code status (RESTRICTED-BENEFITS-CODE = 2) with non-emergency room services
MCR-11-004-4	% of claim lines with missing Place of Service (Medicaid Paid Amount > $0)
ALL-15-001-1	% of claim lines with non-missing Place of Service that have missing Procedure Code
ALL-15-002-2	% of claim lines with both Type of Bill and Place of Service non-missing
ALL-15-003-3	% of claim lines missing Type of Bill and Place of Service
MIS-25-026-26	% missing: PLACE-OF-SERVICE (COT00002)
MIS-83-026-26	% missing: PLACE-OF-SERVICE (COT00002)
RULE-7349	% of claim lines with non-missing Place of Service that have missing Procedure Code
RULE-7351	% of claim lines missing Type of Bill and Place of Service
FFS-9-007-9	% of claim lines with ER Place of Service
FFS-10-003-84	% of claim lines with office Place of Service (Medicaid Paid Amount > $0)
FFS-10-004-4	% of claim lines with missing Place of Service (Medicaid Paid Amount > $0)
FFS-11-007-9	% of claim lines with ER Place of Service
FFS-11-008-19	% of claim lines with office Place of Service
FFS-11-009-18	% of claim lines with missing Place of Service
FFS-12-003-2	% of claim lines with TYPE-OF-SERVICE = 12, 2, 61 with ER Place of Service (Medicaid Paid Amount > $0)
FFS-12-004-4	% of claim lines with office Place of Service (Medicaid Paid Amount > $0)
FFS-12-005-3	% of claim lines with missing Place of Service (Medicaid Paid Amount > $0)
FFS-10-002-3	% of claim lines with TYPE-OF-SERVICE = 12, 2, 61 with ER Place of Service (Medicaid Paid Amount > $0)
FFS-9-008-98	% of claim lines with office Place of Service
FFS-9-009-18	% of claim lines with missing Place of Service
MCR-10-007-9	% of claim lines with ER Place of Service
MCR-10-008-19	% of claim lines with office Place of Service
MCR-10-009-18	% of claim lines with missing Place of Service
MCR-11-002-3	% of claim lines with TYPE-OF-SERVICE = 12, 2, 61 with ER Place of Service (Medicaid Paid Amount > $0)
MCR-11-003-5	% of claim lines with office Place of Service (Medicaid Paid Amount > $0)

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
COT264	COT.003.264	PLACE-OF-SERVICE	COT00003	CLAIM-LINE-RECORD-OT

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
06/05/2025	4.0.10	COT.002.123	UPDATE	Definition	A pass-through data element meaning that the state should report the field in T-MSIS as reported by the provider on the claim form (i.e., 837P or 837D - Place of Service is only captured at the line level of the CMS-1500). If the claim is submitted on the 837p electronic claims form and the Facility Code Qualifier is reported with any value other than �B�, then the PLACE-OF-SERVICE value should be blank or space-filled. If the claim is submitted on the CMS-1450 (UB-04) institutional claims form, the PLACE-OF-SERVICE field should be blank or space-filled. Otherwise, if the claim is submitted with the place of service populated with any value other than the valid values listed in T-MSIS Data Guide for PLACE-OF-SERVICE values, that value should still be reported in the PLACE-OF-SERVICE data element. If the claim is submitted by a provider with the place of service fields blank, then the PLACE-OF-SERVICE on the T-MSIS OT claims file should be blank or space-filled.	A pass-through data element meaning that the state should report the field in T-MSIS as reported by the provider on the claim form (i.e., 837P or 837D - Place of Service is only captured at the line level of the CMS-1500). If the claim is submitted on the 837p electronic claims form and the Facility Code Qualifier is reported with any value other than 'B', then the PLACE-OF-SERVICE value should be blank or space-filled. If the claim is submitted on the CMS-1450 (UB-04) institutional claims form, the PLACE-OF-SERVICE field should be blank or space-filled. Otherwise, if the claim is submitted with the place of service populated with any value other than the valid values listed in T-MSIS Data Guide for PLACE-OF-SERVICE values, that value should still be reported in the PLACE-OF-SERVICE data element. If the claim is submitted by a provider with the place of service fields blank, then the PLACE-OF-SERVICE on the T-MSIS OT claims file should be blank or space-filled.
05/29/2025	4.0.9	COT.002.123	UPDATE	Definition	A pass-through data element meaning that the state should report the field in T-MSIS as reported by the provider on the claim form (i.e., 837P or 837D - Place of Service is only captured at the line level of the CMS-1500). If the claim is submitted on the 837p electronic claims form and the Facility Code Qualifier is reported with any value other than â€œBâ€, then the PLACE-OF-SERVICE value should be blank or space-filled. If the claim is submitted on the CMS-1450 (UB-04) institutional claims form, the PLACE-OF-SERVICE field should be blank or space-filled. Otherwise, if the claim is submitted with the place of service populated with any value other than the valid values listed in T-MSIS Data Guide for PLACE-OF-SERVICE values, that value should still be reported in the PLACE-OF-SERVICE data element. If the claim is submitted by a provider with the place of service fields blank, then the PLACE-OF-SERVICE on the T-MSIS OT claims file should be blank or space-filled.	A pass-through data element meaning that the state should report the field in T-MSIS as reported by the provider on the claim form (i.e., 837P or 837D - Place of Service is only captured at the line level of the CMS-1500). If the claim is submitted on the 837p electronic claims form and the Facility Code Qualifier is reported with any value other than �B�, then the PLACE-OF-SERVICE value should be blank or space-filled. If the claim is submitted on the CMS-1450 (UB-04) institutional claims form, the PLACE-OF-SERVICE field should be blank or space-filled. Otherwise, if the claim is submitted with the place of service populated with any value other than the valid values listed in T-MSIS Data Guide for PLACE-OF-SERVICE values, that value should still be reported in the PLACE-OF-SERVICE data element. If the claim is submitted by a provider with the place of service fields blank, then the PLACE-OF-SERVICE on the T-MSIS OT claims file should be blank or space-filled.
01/16/2025	4.0.2	COT.002.123	UPDATE	Definition	A pass-through data element meaning that the state should report the field in T-MSIS as reported by the provider on the claim form (i.e., 837P or 837D - Place of Service is only captured at the line level of the CMS-1500). If the claim is submitted on the 837p electronic claims form and the Facility Code Qualifier is reported with any value other than â€śBâ€ť, then the PLACE-OF-SERVICE value should be blank or space-filled. If the claim is submitted on the CMS-1450 (UB-04) institutional claims form, the PLACE-OF-SERVICE field should be blank or space-filled. Otherwise, if the claim is submitted with the place of service populated with any value other than the valid values listed in T-MSIS Data Guide for PLACE-OF-SERVICE values, that value should still be reported in the PLACE-OF-SERVICE data element. If the claim is submitted by a provider with the place of service fields blank, then the PLACE-OF-SERVICE on the T-MSIS OT claims file should be blank or space-filled.	A pass-through data element meaning that the state should report the field in T-MSIS as reported by the provider on the claim form (i.e., 837P or 837D - Place of Service is only captured at the line level of the CMS-1500). If the claim is submitted on the 837p electronic claims form and the Facility Code Qualifier is reported with any value other than â€œBâ€, then the PLACE-OF-SERVICE value should be blank or space-filled. If the claim is submitted on the CMS-1450 (UB-04) institutional claims form, the PLACE-OF-SERVICE field should be blank or space-filled. Otherwise, if the claim is submitted with the place of service populated with any value other than the valid values listed in T-MSIS Data Guide for PLACE-OF-SERVICE values, that value should still be reported in the PLACE-OF-SERVICE data element. If the claim is submitted by a provider with the place of service fields blank, then the PLACE-OF-SERVICE on the T-MSIS OT claims file should be blank or space-filled.
12/19/2024	4.0.1	COT.002.123	UPDATE	Definition	A data element corresponding with line 24b on the CMS-1500 that indicates where the services took place. This is a pass-through data element that should not be modified or derived when missing unless otherwise specified.	A pass-through data element meaning that the state should report the field in T-MSIS as reported by the provider on the claim form (i.e., 837P or 837D - Place of Service is only captured at the line level of the CMS-1500). If the claim is submitted on the 837p electronic claims form and the Facility Code Qualifier is reported with any value other than â€śBâ€ť, then the PLACE-OF-SERVICE value should be blank or space-filled. If the claim is submitted on the CMS-1450 (UB-04) institutional claims form, the PLACE-OF-SERVICE field should be blank or space-filled. Otherwise, if the claim is submitted with the place of service populated with any value other than the valid values listed in T-MSIS Data Guide for PLACE-OF-SERVICE values, that value should still be reported in the PLACE-OF-SERVICE data element. If the claim is submitted by a provider with the place of service fields blank, then the PLACE-OF-SERVICE on the T-MSIS OT claims file should be blank or space-filled.
09/16/2024	4.0.0	COT.002.123	UPDATE	File segment	None	35
09/16/2024	4.0.0	COT.002.123	ADD	N/A		Created