TRICARE Manuals - Display Chap 2 Addendum F (Baseline, Dec 5, 2022)

TRICARE Encounter Data (TED)

Chapter 2

Addendum F

Data Requirements - Place Of Service/Type Of Service Allowable Relationships

Revision:

Figure 2.F-1 Place Of Service Codes
Place Of Service Code	Type Of Service Code(s) Allowed (Second Position Values)
This table is used in edit 2-275-01R.
01	B, M
02	1, 2, 3, 4, 5, 6, 8, 9, B, C, D, E, F, G, H, I, J, K, L, M
03	1, 2, 3, 4, 5, 7, 9, A, B, F, H, J, K, L
04	1, H
05	1, 2, 3, 4, 5, 6, 7, 8, 9, A, B, C, D, E, F, G, H, J, K, L
06	1, 2, 3, 4, 5, 6, 7, 8, 9, A, B, C, D, E, F, G, H, J, K, L
07	1, 2, 3, 4, 5, 6, 7, 8, 9, A, B, C, D, E, F, G, H, J, K, L
08	1, 2, 3, 4, 5, 6, 7, 8, 9, A, B, C, D, E, F, G, H, J, K, L
09	1, 2, 3, 4, 5, 6, 7, 8, 9, A, B, C, D, E, F, G, H, I, J, K, L, M
11	1, 2, 3, 4, 5, 6, 7, 9, A, C, E, F, G, H, J, K, L
12	1, 2, 3, 4, 5, 6, 7, 8, 9, A, D, F, H, J, K, L
13	1, 2, 9, A, H, I, K
14	1, 2, 9, H, I, K
15	1, 2, 3, 4, 5, 6, 7, 9, A, C, E, F, G, H, J, K, L
16	1, 3, 9, A, B, D, H, J, K, L
17	1, 4, 5, 9, B
18	1, 3, 9, A, B, F, H, J, K, L, M
19	1, 2, 3, 4, 5, 6, 7, 8, 9, A, B, C, E, F, G, H, I, J, K, L, M
20	1, 2, 3, 4, 5, 6, 7, 9, A, C, E, F, G, H, J, K, L
21	1, 2, 3, 4, 5, 6, 7, 8, 9, E, F, G, H, K, L
22	1, 2, 3, 4, 5, 6, 7, 8, 9, A, C, E, F, G, H, I, J, K, L
23	1, 2, 3, 4, 5, 6, 7, 8, 9, A, C, E, F, G, H, I, J, K, L
24	1, 2, 3, 4, 5, 6, 7, 8, 9, A, C, F, G, H, K
25	1, 2, 3, 4, 5, 7, 9, F
26	1, 2, 3, 4, 5, 6, 7, 8, 9, A, C, E, F, G, H, I, J, K, L
31	1, 2, 3, 4, 5, 9, A, E, H, J, K, L
32	1, 2, 3, 4, 5, 6, 9, A, E, H, J, K, L
33	1, 2, 3, 4, 5, 9, A, E, H, J, K, L
34	1, 2, 3, 9, A, D
41	1, 9, A, F, I, J
42	1, 9, A, I
49	1, 2, 3, 4, 5, 6, 7, 9, A, C, D, E, F, G, H, J, K, L
50	1, 2, 3, 4, 5, 9, F, H
51	1, 2, 3, 4, 5, 7, 9, H, K, L
52	1, 3, 4, 5, 9, H, J, K, L
53	1, 3, 4, 5, 9, H, K, L
54	1, 2, 3, 4, 5, 9, A, H, J, K, L
55	1, 3, 4,5, 9, H, J, K, L
56	1, 3, 9, H, K, L
57	1, 3, 5, 9, H
60	1, 9, B
61	1, 2, 3, 4, 5, 9, A, B, H, J, K, L
62	1, 2, 3, 4, 5, 9, A, H, J, K, L
65	1, 2, 3, 4, 5, 6, 9, A, E, J
71	1, 2, 3, 4, 5, 6, 7, 8, 9, E, F, G, H, J, K, L
72	1, 2, 3, 4, 5, 6, 7, 8, 9, E, F, G, H, J, K, L
81	1, 2, 4, 5, 9, F
99	1, 2, 3, 4, 5, 6, 7, 8, 9, A, B, C, D, E, F, G, H, J, K, L

Figure 2.F-2 Place Of Service Values
Place Of Service Value	description
01	Pharmacy
02	Telehealth
03	School
04	Homeless Schedule
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	Prison-Correctional Facility
11	Office
12	Home
13	Assisted Living Facility
14	Group Home
15	Mobile Unit
16	Temporary Lodging
17	Walk-in Retail Health Clinic
18	Place of Employment Work-site
19	Pharmacy (Terminated 12/31/2015)
19	Off Campus-Outpatient Hospital
20	Urgent Care Facility
21	Inpatient Hospital
22	On Campus-Outpatient Hospital
23	Emergency Room - Hospital
24	Ambulatory Surgical Center
25	Birthing Center
26	Military Treatment Facility
31	Skilled Nursing Facility
32	Nursing Facility
33	Custodial Care Facility
34	Hospice
41	Ambulance - Land
42	Ambulance - Air or Water
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
60	Mass Immunization Center
61	Comprehensive Inpatient Rehabilitation Facility
62	Comprehensive Outpatient Rehabilitation Facility
65	End Stage Renal Disease Treatment Facility
71	Public Health Clinic
72	Rural Health Clinic
81	Independent Laboratory
99	Other Unlisted Facility

Figure 2.F-3 Type Of Service Second Position Values
Type Of Service Second Position Value	description
1	Medical Care
2	Surgery
3	Consultation
4	Diagnostic/Therapeutic X-Ray
5	Diagnostic Laboratory
6	Radiation Therapy
7	Anesthesia
8	Assistance at Surgery
9	Other Medical Service & Supplies
A	DME Rental/Purchase
B	Retail Drugs, Supplies, Prescription Authorizations, and Reviews
C	Ambulatory Surgery
D	Hospice
E	Second Opinion on Elective Surgery
F	Maternity
G	Dental
H	Mental Health Care
I	Ambulance
J	Persons with Disabilities
K	Physical/Occupational Therapy
L	Speech Therapy
M	Mail Order Pharmacy (MOP) Drugs, Supplies, Prescription Authorizations, and Reviews

- END -

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