• Include these codes as defined in http://terminology.hl7.org/CodeSystem/v3-ActCode version 8.0.0

  Code	Display	Definition
  COIN	coinsurance	That portion of the eligible charges which a covered party must pay for each service and/or product. It is a percentage of the eligible amount for the service/product that is typically charged after the covered party has met the policy deductible. This amount represents the covered party's coinsurance that is applied to a particular adjudication result. It is expressed as a negative dollar amount in adjudication results.
  COPAYMENT	patient co-pay	That portion of the eligible charges which a covered party must pay for each service and/or product. It is a defined amount per service/product of the eligible amount for the service/product. This amount represents the covered party's copayment that is applied to a particular adjudication result. It is expressed as a negative dollar amount in adjudication results.
  DEDUCTIBLE	deductible	That portion of the eligible charges which a covered party must pay in a particular period (e.g. annual) before the benefits are payable by the adjudicator. This amount represents the covered party's deductible that is applied to a particular adjudication result. It is expressed as a negative dollar amount in adjudication results.
  PAY	payment	The guarantor, who may be the patient, pays the entire charge for a service. Reasons for such action may include: there is no insurance coverage for the service (e.g. cosmetic surgery); the patient wishes to self-pay for the service; or the insurer denies payment for the service due to contractual provisions such as the need for prior authorization.
  SPEND	spend down	That total amount of the eligible charges which a covered party must periodically pay for services and/or products prior to the Medicaid program providing any coverage. This amount represents the covered party's spend down that is applied to a particular adjudication result. It is expressed as a negative dollar amount in adjudication results
  COINS	co-insurance	The covered party pays a percentage of the cost of covered services.
  AFTHRS	non-normal hours	Premium paid on service fees in compensation for practicing outside of normal working hours.
  ISOL	isolation allowance	Premium paid on service fees in compensation for practicing in a remote location.
  OOO	out of office	Premium paid on service fees in compensation for practicing at a location other than normal working location.
  CANCAPT	cancelled appointment	A charge to compensate the provider when a patient cancels an appointment with insufficient time for the provider to make another appointment with another patient.
  DSC	discount	A reduction in the amount charged as a percentage of the amount. For example a 5% discount for volume purchase.
  ESA	extraordinary service assessment	A premium on a service fee is requested because, due to extenuating circumstances, the service took an extraordinary amount of time or supplies.
  FFSTOP	fee for service top off	Under agreement between the parties (payor and provider), a guaranteed level of income is established for the provider over a specific, pre-determined period of time. The normal course of business for the provider is submission of fee-for-service claims. Should the fee-for-service income during the specified period of time be less than the agreed to amount, a top-up amount is paid to the provider equal to the difference between the fee-for-service total and the guaranteed income amount for that period of time. The details of the agreement may specify (or not) a requirement for repayment to the payor in the event that the fee-for-service income exceeds the guaranteed amount.
  FNLFEE	final fee	Anticipated or actual final fee associated with treating a patient.
  FRSTFEE	first fee	Anticipated or actual initial fee associated with treating a patient.
  MARKUP	markup or up-charge	An increase in the amount charged as a percentage of the amount. For example, 12% markup on product cost.
  MISSAPT	missed appointment	A charge to compensate the provider when a patient does not show for an appointment.
  PERFEE	periodic fee	Anticipated or actual periodic fee associated with treating a patient. For example, expected billing cycle such as monthly, quarterly. The actual period (e.g. monthly, quarterly) is specified in the unit quantity of the Invoice Element.
  PERMBNS	performance bonus	The amount for a performance bonus that is being requested from a payor for the performance of certain services (childhood immunizations, influenza immunizations, mammograms, pap smears) on a sliding scale. That is, for 90% of childhood immunizations to a maximum of $2200/yr. An invoice is created at the end of the service period (one year) and a code is submitted indicating the percentage achieved and the dollar amount claimed.
  RESTOCK	restocking fee	A charge is requested because the patient failed to pick up the item and it took an amount of time to return it to stock for future use.
  TRAVEL	travel	A charge to cover the cost of travel time and/or cost in conjuction with providing a service or product. It may be charged per kilometer or per hour based on the effective agreement.
  URGENT	urgent	Premium paid on service fees in compensation for providing an expedited response to an urgent situation.
  FST	federal sales tax	Federal tax on transactions such as the Goods and Services Tax (GST)
  HST	harmonized sales Tax	Joint Federal/Provincial Sales Tax
  PST	provincial/state sales tax	Tax levied by the provincial or state jurisdiction such as Provincial Sales Tax

This value set expansion contains 25 concepts.