CARIN Digital Insurance Card
2.0.0-ballot - STU 2 Ballot

CARIN Digital Insurance Card - Downloaded Version 2.0.0-ballot See the Directory of published versions

## : Cost Tier Code System - XML Representation

Page standards status: Informative

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    <CodeSystem xmlns="http://hl7.org/fhir">
      <id value="cost-tier"/>
      <text>
        <status value="generated"/>
        <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: CodeSystem cost-tier</b></p><a name="cost-tier"> </a><a name="hccost-tier"> </a><p>This case-sensitive code system <code>http://hl7.org/fhir/us/insurance-card/CodeSystem/cost-tier</code> defines the following codes:</p><table class="codes"><tr><td style="white-space:nowrap"><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td style="white-space:nowrap">value-choice<a name="cost-tier-value-choice"> </a></td><td>Value Choice Provider</td><td>Cost sharing that applies when the service is delivered by a provider the plan has designated in its value or preferred-value tier</td></tr><tr><td style="white-space:nowrap">standard<a name="cost-tier-standard"> </a></td><td>Standard Provider</td><td>Cost sharing that applies when the service is delivered by an in-network provider without a special designation</td></tr><tr><td style="white-space:nowrap">virtual<a name="cost-tier-virtual"> </a></td><td>Virtual Visit</td><td>Cost sharing that applies when the service is delivered virtually (telehealth modality) rather than in person</td></tr></table></div>
      </text>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
        <valueCode value="claims"/>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
        <valueCode value="informative">
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom">
            <valueCanonical
                            value="http://hl7.org/fhir/us/insurance-card/ImplementationGuide/hl7.fhir.us.insurance-card"/>
          </extension>
        </valueCode>
      </extension>
      <url value="http://hl7.org/fhir/us/insurance-card/CodeSystem/cost-tier"/>
      <identifier>
        <system value="urn:ietf:rfc:3986"/>
        <value value="urn:oid:2.16.840.1.113883.4.642.40.9.16.7"/>
      </identifier>
      <version value="2.0.0-ballot"/>
      <name value="CostTierCS"/>
      <title value="Cost Tier Code System"/>
      <status value="draft"/>
      <experimental value="true"/>
      <date value="2026-08-13T02:29:19+10:00"/>
      <publisher
                 value="HL7 International / Payer/Provider Information Exchange Work Group"/>
      <contact>
        <name
              value="HL7 International / Payer/Provider Information Exchange Work Group"/>
        <telecom>
          <system value="url"/>
          <value value="http://www.hl7.org/Special/committees/claims"/>
        </telecom>
        <telecom>
          <system value="email"/>
          <value value="pie@lists.HL7.org"/>
        </telecom>
      </contact>
      <description
                   value="Code system for cost-sharing tiers that distinguish multiple cost amounts for the same benefit and network status, based on provider designation or modality of care"/>
      <jurisdiction>
        <coding>
          <system value="urn:iso:std:iso:3166"/>
          <code value="US"/>
        </coding>
      </jurisdiction>
      <caseSensitive value="true"/>
      <content value="complete"/>
      <count value="3"/>
      <concept>
        <code value="value-choice"/>
        <display value="Value Choice Provider"/>
        <definition
                    value="Cost sharing that applies when the service is delivered by a provider the plan has designated in its value or preferred-value tier"/>
      </concept>
      <concept>
        <code value="standard"/>
        <display value="Standard Provider"/>
        <definition
                    value="Cost sharing that applies when the service is delivered by an in-network provider without a special designation"/>
      </concept>
      <concept>
        <code value="virtual"/>
        <display value="Virtual Visit"/>
        <definition
                    value="Cost sharing that applies when the service is delivered virtually (telehealth modality) rather than in person"/>
      </concept>
    </CodeSystem>