This page is part of the Validated Healthcare Directory FHIR IG (v0.2.0: STU 1 Ballot 2) based on FHIR v3.5.0. . For a full list of available versions, see the Directory of published versions 
XML Format: ValueSet-valueset-benefit-type
Raw xml
<ValueSet xmlns="http://hl7.org/fhir"> <id value="valueset-benefit-type"/> <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml"><h2>VhDir Benefit Type</h2><div><p>This value set defines a set of codes that indicate the type of benefit in a product/plan.</p> </div><p>This value set includes codes from the following code systems:</p><ul><li>Include these codes as defined in <a href="CodeSystem-codesystem-payercharacteristics.html"><code>http://hl7.org/fhir/uv/vhdir/CodeSystem/codesystem-payercharacteristics</code></a><table class="none"><tr><td style="white-space:nowrap"><b>Code</b></td><td><b>Display</b></td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-pcpov">pcpov</a></td><td>Primary Care Visit to Treat an Injury or Illness</td><td>Benefit plan covers services rendered by a primary care physician during an office visit with the purpose to treat injury or illness, except for preventive care services.</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-specialistov">specialistov</a></td><td>Specialist Office Visit</td><td>Covered healthcare service rendered to a patient by a specialty provider.</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-mlpov">mlpov</a></td><td>Other Practitioner Office Visit (Nurse, Physician Assistant) - Mid Level Professional</td><td>Benefit plan covers covered health related services rendered by a practioner other than MD or DO and referred to as other practitioner.</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-outpatient">outpatient</a></td><td>Outpatient Facility Fee (e.g., Ambulatory Surgery Center)</td><td>Benefit plan covers health related services rendered to patient at an outpatient facility, outside of a facility that requires a patient admission.</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-outpatstx">outpatstx</a></td><td>Outpatient Surgery Physician/Surgical Services</td><td>Benefit plan covers surgical services rendered to patient outside of a facility admission, referred to as outpatient.</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-hospserv">hospserv</a></td><td>Hospice Services</td><td>Benefit plan covers hospice services.</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-routinedental">routinedental</a></td><td>Routine Dental Services (Adult)</td><td>Benefit plan covers routine dental services.</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-infertilitytx">infertilitytx</a></td><td>Infertility Treatment</td><td>Benefit plan covers eligible infertility treatment services.</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-ltnhc">ltnhc</a></td><td>Long-Term/Custodial Nursing Home Care</td><td>Long-Term/Custodial Nursing Home Care.</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-privatenurse">privatenurse</a></td><td>Private-Duty Nursing</td><td>Private-Duty Nursing.</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-routineeye">routineeye</a></td><td>Routine Eye Exam (Adult)</td><td>Routine Eye Exam (Adult).</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-ucservice">ucservice</a></td><td>Urgent Care Centers or Facilities</td><td>Urgent Care Centers or Facilities.</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-homehealth">homehealth</a></td><td>Home Health</td><td>Home health services insurance coverage.</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-erservice">erservice</a></td><td>Emergency Room Services</td><td>Emergency Room Services.</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-ambulance">ambulance</a></td><td>Emergency Room Services</td><td>Emergency Room Services.</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-inpatienthospital">inpatienthospital</a></td><td>Inpatient Hospital Services (e.g., Hospital Stay)</td><td>A person who is hospitalized for at least one night to receive treatment or participate in a study.</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-inpatientprovider">inpatientprovider</a></td><td>Inpatient Physician and Surgical Services</td><td>A healthcare provider who is delivering healthcare services in a hospital environment.</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-bariatricsurg">bariatricsurg</a></td><td>Bariatric Surgery</td><td>Bariatric surgery service Skilled nursing service (qualifier value).</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-cosmeticsurg">cosmeticsurg</a></td><td>Cosmetic Surgery</td><td>Cosmetic surgery service Skilled nursing service (qualifier value).</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-skillednursing">skillednursing</a></td><td>Skilled Nursing Facility</td><td>Skilled nursing service (qualifier value).</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-ppnatalcare">ppnatalcare</a></td><td>Prenatal and Postnatal Care</td><td>Prenatal and Postnatal services.</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-maternitycare">maternitycare</a></td><td>Delivery and All Inpatient Services for Maternity Care</td><td>All maternity care services.</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-menthlthoutp">menthlthoutp</a></td><td>Mental/Behavioral Health Outpatient Services</td><td>Mental health service delivered in an outpatient setting.</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-menthlthinp">menthlthinp</a></td><td>Mental/Behavioral Health Inpatient Services</td><td>Mental health service delivered in an hospital or inpatient facility setting.</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-sadoutp">sadoutp</a></td><td>Substance Abuse Disorder Outpatient Services</td><td>Substance abuse related services delivered in a outpatient setting.</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-sadinp">sadinp</a></td><td>Substance Abuse Disorder Inpatient Services</td><td>Substance abuse related services delivered in a inpatient setting.</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-drggenric">drggenric</a></td><td>Generic Drugs</td><td>Generic drugs eligible benefits.</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-drgbrand">drgbrand</a></td><td>Preferred Brand Drugs</td><td>Preferred brand drugs eligible benefits.</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-drgnonpreferred">drgnonpreferred</a></td><td>Non-Preferred Brand Drugs</td><td>Non-Preferred drugs brands eligible benefits.</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-drgspecialty">drgspecialty</a></td><td>Specialty Drugs</td><td>Benefit plan covers specialty drugs.</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-rehaboutp">rehaboutp</a></td><td>Outpatient Rehabilitation Services</td><td>Benefit plan covers outpatient rehabilitation services.</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-servicehablitation">servicehablitation</a></td><td>Habilitation Services</td><td>Habilitation Services.</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-chiro">chiro</a></td><td>Chiropractic Care</td><td>Benefit plan covers chiropractor eligible benefits.</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-dme">dme</a></td><td>Durable Medical Equipment</td><td>Benefit plan covers Durable medical equipment eligible benefits.</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-hearingaids">hearingaids</a></td><td>Hearing Aids</td><td>Benefit plan covers hearing aids.</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-imgctpetmri">imgctpetmri</a></td><td>Imaging (CT/PET Scans, MRIs)</td><td>Benefit plan covers advances imaging techniques services (CT/PET Scans, MRIs) eligible services.</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-prev">prev</a></td><td>Preventive Care/Screening/Immunization</td><td>Routine healthcare services to prevent health related problems eligible benefits.</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-rtnpod">rtnpod</a></td><td>Routine Foot Care</td><td>Routine Foot Care.</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-acupuncture">acupuncture</a></td><td>Acupuncture</td><td>Benefit plan covers acupuncture treatment.</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-weightloss">weightloss</a></td><td>Weight Loss Programs</td><td>Benefit plan covers weight loss services eligible benefits.</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-rtneyechld">rtneyechld</a></td><td>Routine Eye Exam for Children</td><td>Routine eye exam for children eligible benefits.</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-glasseschld">glasseschld</a></td><td>Eye Glasses for Children</td><td>Eye glasses children eligible benefits.</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-rtndntlchld">rtndntlchld</a></td><td>Dental Check-Up for Children</td><td>Dental Check-Up for Children.</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-speachthpy">speachthpy</a></td><td>Rehabilitative Speech Therapy</td><td>Benefit plan covers rehabilitative speech therapy eligible benefits.</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-rehaboccandpt">rehaboccandpt</a></td><td>Rehabilitative Occupational and Rehabilitative Physical Therapy</td><td>Benefit plan covers rehabilitative occupational and rehabilitative physical eligible benefits.</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-wellbaby">wellbaby</a></td><td>Well Baby Visits and Care</td><td>Regularly scheduled, preventive care services, including immunizations, provided to children up to an age as specified by a health insurance company or mandated by a government agency.</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-laboutp">laboutp</a></td><td>Laboratory Outpatient and Professional Services</td><td>Benefit plan covers laboratory testing and related professional services received as outpatient.</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-imagingdx">imagingdx</a></td><td>X-rays and Diagnostic Imaging</td><td>Benefit plan covers diagnostic imaging procedures that produce images of internal structures of the human body and uses radiation to diagnose and treat diseases.</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-dntlbaschld">dntlbaschld</a></td><td>Basic Dental Care – Child</td><td>Benefit plan covers diagnostic basic dental care.</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-orthochld">orthochld</a></td><td>Orthodontia – Child</td><td>Benefit plan covers orthodontia for children.</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-dntlmajchld">dntlmajchld</a></td><td>Major Dental Care – Child</td><td>Benefit plan covers major dental care for children.</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-dntlbasadlt">dntlbasadlt</a></td><td>Basic Dental Care – Adult</td><td>Benefit plan covers basic dental care for adults.</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-orthodadlt">orthodadlt</a></td><td>Orthodontia – Adult</td><td>Benefits plan covers services provided that are required for orthodontic purposes for an adult.</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-dntlmajadlt">dntlmajadlt</a></td><td>Major Dental Care – Adult</td><td>Benefit plan covers major dental care for adult.</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-abortion">abortion</a></td><td>Abortion for Which Public Funding is Prohibited</td><td>Benefit plan covers services for abortion for which public funding is prohibited.</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-transplant">transplant</a></td><td>Transplant</td><td>Benefit plan covers transplant related services.</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-accdntl">accdntl</a></td><td>Accidental Dental</td><td>Benefit plan covers dental care services related to an accident.</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-dialysis">dialysis</a></td><td>Dialysis</td><td>The plan benefit covers services used to treat end stage renal disease.</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-testallrgy">testallrgy</a></td><td>Allergy Testing</td><td>The plan benefits covers services for diagnostic procedures ordered or performed to evaluate whether a sensitivity to a substance is present. This test may be associated with specimen collection and/or substance administration challenge activities.</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-chemotherapy">chemotherapy</a></td><td>Chemotherapy</td><td>The plan benefits cover services the use of drugs and approved chemicals to treat disease.</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-radiation">radiation</a></td><td>Radiation</td><td>The plan benefits cover services the use radiation to treat disease.</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-edudiab">edudiab</a></td><td>Diabetes Education</td><td>The plan benefits cover services related to instruction or training that encourages behaviors most likely to optimize health potentials through information about diabetes; facilitates the prevention of diabetes.</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-prosthetic">prosthetic</a></td><td>Prosthetic Devices</td><td>Plan benefit covers services related to prosthesis devices.</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-infusiontx">infusiontx</a></td><td>Infusion Therapy</td><td>Plan benefit covers services related to infusion therapy.</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-tmjtx">tmjtx</a></td><td>Treatment for Temporomandibular Joint Disorders</td><td>Plan benefit covers services related to treatment of Temporomandibular Joint disorder.</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-nutrition">nutrition</a></td><td>Nutritional Counseling</td><td>Nutritional Counseling.</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-reconsurg">reconsurg</a></td><td>Reconstructive Surgery</td><td>Plan benefit covers services related to reconstructive surgery.</td></tr></table></li></ul></div> </text> <url value="http://hl7.org/fhir/uv/vhdir/ValueSet/valueset-benefit-type"/> <version value="0.2.0"/> <name value="VhDirBenefitType"/> <title value="VhDir Benefit Type"/> <status value="active"/> <date value="2018-02-21"/> <publisher value="HL7 International"/> <contact> <telecom> <system value="other"/> <value value="http://hl7.org/fhir"/> </telecom> </contact> <description value="This value set defines a set of codes that indicate the type of benefit in a product/plan."/> <compose> <include> <system value="http://hl7.org/fhir/uv/vhdir/CodeSystem/codesystem-payercharacteristics"/> <concept> <code value="pcpov"/> </concept> <concept> <code value="specialistov"/> </concept> <concept> <code value="mlpov"/> </concept> <concept> <code value="outpatient"/> </concept> <concept> <code value="outpatstx"/> </concept> <concept> <code value="hospserv"/> </concept> <concept> <code value="routinedental"/> </concept> <concept> <code value="infertilitytx"/> </concept> <concept> <code value="ltnhc"/> </concept> <concept> <code value="privatenurse"/> </concept> <concept> <code value="routineeye"/> </concept> <concept> <code value="ucservice"/> </concept> <concept> <code value="homehealth"/> </concept> <concept> <code value="erservice"/> </concept> <concept> <code value="ambulance"/> </concept> <concept> <code value="inpatienthospital"/> </concept> <concept> <code value="inpatientprovider"/> </concept> <concept> <code value="bariatricsurg"/> </concept> <concept> <code value="cosmeticsurg"/> </concept> <concept> <code value="skillednursing"/> </concept> <concept> <code value="ppnatalcare"/> </concept> <concept> <code value="maternitycare"/> </concept> <concept> <code value="menthlthoutp"/> </concept> <concept> <code value="menthlthinp"/> </concept> <concept> <code value="sadoutp"/> </concept> <concept> <code value="sadinp"/> </concept> <concept> <code value="drggenric"/> </concept> <concept> <code value="drgbrand"/> </concept> <concept> <code value="drgnonpreferred"/> </concept> <concept> <code value="drgspecialty"/> </concept> <concept> <code value="rehaboutp"/> </concept> <concept> <code value="servicehablitation"/> </concept> <concept> <code value="chiro"/> </concept> <concept> <code value="dme"/> </concept> <concept> <code value="hearingaids"/> </concept> <concept> <code value="imgctpetmri"/> </concept> <concept> <code value="prev"/> </concept> <concept> <code value="rtnpod"/> </concept> <concept> <code value="acupuncture"/> </concept> <concept> <code value="weightloss"/> </concept> <concept> <code value="rtneyechld"/> </concept> <concept> <code value="glasseschld"/> </concept> <concept> <code value="rtndntlchld"/> </concept> <concept> <code value="speachthpy"/> </concept> <concept> <code value="rehaboccandpt"/> </concept> <concept> <code value="wellbaby"/> </concept> <concept> <code value="laboutp"/> </concept> <concept> <code value="imagingdx"/> </concept> <concept> <code value="dntlbaschld"/> </concept> <concept> <code value="orthochld"/> </concept> <concept> <code value="dntlmajchld"/> </concept> <concept> <code value="dntlbasadlt"/> </concept> <concept> <code value="orthodadlt"/> </concept> <concept> <code value="dntlmajadlt"/> </concept> <concept> <code value="abortion"/> </concept> <concept> <code value="transplant"/> </concept> <concept> <code value="accdntl"/> </concept> <concept> <code value="dialysis"/> </concept> <concept> <code value="testallrgy"/> </concept> <concept> <code value="chemotherapy"/> </concept> <concept> <code value="radiation"/> </concept> <concept> <code value="edudiab"/> </concept> <concept> <code value="prosthetic"/> </concept> <concept> <code value="infusiontx"/> </concept> <concept> <code value="tmjtx"/> </concept> <concept> <code value="nutrition"/> </concept> <concept> <code value="reconsurg"/> </concept> </include> </compose> </ValueSet>
