provider place of service
prvdr_pos_cdDefinition
ISO-11179 Definition
A two-digit code on a professional claim identifying the setting where a healthcare service was delivered to a patient, using the CMS Place of Service code set. Common place of service codes include 11 for office, 21 for inpatient hospital, 22 for outpatient hospital, 23 for emergency room, 24 for ambulatory surgical center, 31 for skilled nursing facility, and 02 for telehealth. Place of service affects reimbursement rates because the same procedure code may have different allowed amounts depending on the site of care — facility rates apply when services are delivered in a hospital outpatient department while non-facility rates apply for office-based services.
Healthcare data teams use prvdr_pos_cd in claims adjudication to apply correct fee schedule rates, in utilization analytics to track care setting shifts from inpatient to outpatient settings, and in telehealth analytics to measure virtual care adoption.
Standard Abbreviation
prvdr_pos_cd
Category
Production DDL — DIM_PROVIDER
CREATE OR REPLACE TABLE DIM_PROVIDER (
prvdr_key INTEGER NOT NULL -- surrogate key,
prvdr_npi VARCHAR(10) -- NPI number,
prvdr_tin VARCHAR(10) -- tax ID number,
prvdr_first_nm VARCHAR(100) -- first name,
prvdr_last_nm VARCHAR(100) -- last name,
prvdr_org_nm VARCHAR(255) -- organization name,
prvdr_typ_cd VARCHAR(20) -- provider type code,
prvdr_spclty_cd VARCHAR(10) -- specialty code,
prvdr_tax VARCHAR(10) -- taxonomy code,
prvdr_state_cd CHAR(2) -- state code,
prvdr_zip_cd VARCHAR(10) -- zip code,
prvdr_ntwk_sts VARCHAR(10) -- network status,
prvdr_accpt_pt_ind CHAR(1) -- accepting patients,
prvdr_excl_ind CHAR(1) -- exclusion indicator,
load_dt TIMESTAMP_NTZ NOT NULL -- load timestamp
);
Standard Snowflake DDL for the canonical provider table. Convert to BigQuery or Databricks →
Why This Term Matters
Provider data management is one of the most operationally complex data domains in healthcare because providers move, merge, and update their credentials continuously. A data engineer who understands provider terminology can build NPI validation, credentialing, and network adequacy pipelines that keep provider directories accurate and prevent claim rejections. Stale or incorrect provider data is a leading cause of prior authorization delays and CMS compliance findings.
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