| Code(s) | Place of Service Name |
| 01 | Pharmacy |
| 02 | Unassigned |
| 03 | School |
| 04 | Homeless Shelter |
| 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 |
| 09-10 | Prison/ Correctional Facility |
| 11 | Office Visit |
| 12 | Home Visit |
| 13 | Assisted Living Facility |
| 14 | Group Home * |
| 15 | Mobile Unit |
| 16 | Temporary Lodging |
| 17-19 | Unassigned |
| 20 | Urgent Care Facility |
| 21 | Inpatient Hospital Visit |
| 22 | Outpatient Hospital Visit |
| 23 | Emergency Room Hospital |
| 24 | Ambulatory Surgical Center |
| 25 | Birthing Center |
| 26 | Military Treatment Facility |
| 27-30 | Unassigned |
| 31 | Skilled Nursing Facility |
| 32 | Nursing Facility |
| 33 | Custodial Care Facility |
| 34 | Hospice |
| 35-40 | Unassigned |
| 41 | Ambulance - Land |
| 42 | Ambulance Air or Water |
| 43-48 | Unassigned |
| 49 | Independent Clinic |
| 50 | Federally Qualified Health Center |
| 51 | Inpatient Psychiatric Facility |
| 52 | Psychiatric Facility-Partial Hospitalization |
| 53 | Community Mental Health Center |
| 54 | Intermediate Care Facility/Mentally Retarded |
| 55 | Residential Substance Abuse Treatment Facility |
| 56 | Psychiatric Residential Treatment Center |
| 57 | Non-residential Substance Abuse Treatment Facility |
| 58-59 | Unassigned |
| 60 | Mass Immunization Center |
| 61 | Comprehensive Inpatient Rehabilitation Facility |
| 62 | Comprehensive Outpatient Rehabilitation Facility |
| 63-64 | Unassigned |
| 65 | End-Stage Renal Disease Treatment Facility |
| 66-70 | Unassigned |
| 71 | Public Health Clinic |
| 72 | Rural Health Clinic |
| 73-80 | Unassigned |
| 81 | Independent Laboratory |
| 82-98 | Unassigned |
| 99 | Other Place of Service |
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