HL7 Terminology (THO)
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This page is part of the HL7 Terminology (v5.5.0: Release) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

: Coverage Copay Type Codes - XML Representation

Draft as of 2024-03-09 Maturity Level: 2

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<CodeSystem xmlns="http://hl7.org/fhir">
  <id value="coverage-copay-type"/>
  <meta>
    <lastUpdated value="2020-04-09T21:10:28.568+00:00"/>
    <profile
             value="http://hl7.org/fhir/StructureDefinition/shareablecodesystem"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p>This case-sensitive code system <code>http://terminology.hl7.org/CodeSystem/coverage-copay-type</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">gpvisit<a name="coverage-copay-type-gpvisit"> </a></td><td>GP Office Visit</td><td>An office visit for a general practitioner of a discipline.</td></tr><tr><td style="white-space:nowrap">spvisit<a name="coverage-copay-type-spvisit"> </a></td><td>Specialist Office Visit</td><td>An office visit for a specialist practitioner of a discipline</td></tr><tr><td style="white-space:nowrap">emergency<a name="coverage-copay-type-emergency"> </a></td><td>Emergency</td><td>An episode in an emergency department.</td></tr><tr><td style="white-space:nowrap">inpthosp<a name="coverage-copay-type-inpthosp"> </a></td><td>Inpatient Hospital</td><td>An episode of an Inpatient hospital stay.</td></tr><tr><td style="white-space:nowrap">televisit<a name="coverage-copay-type-televisit"> </a></td><td>Tele-visit</td><td>A visit held where the patient is remote relative to the practitioner, e.g. by phone, computer or video conference.</td></tr><tr><td style="white-space:nowrap">urgentcare<a name="coverage-copay-type-urgentcare"> </a></td><td>Urgent Care</td><td>A visit to an urgent care facility - typically a community care clinic.</td></tr><tr><td style="white-space:nowrap">copaypct<a name="coverage-copay-type-copaypct"> </a></td><td>Copay Percentage</td><td>A standard percentage applied to all classes or service or product not otherwise specified.</td></tr><tr><td style="white-space:nowrap">copay<a name="coverage-copay-type-copay"> </a></td><td>Copay Amount</td><td>A standard fixed currency amount applied to all classes or service or product not otherwise specified.</td></tr><tr><td style="white-space:nowrap">deductible<a name="coverage-copay-type-deductible"> </a></td><td>Deductible</td><td>The accumulated amount of patient payment before the coverage begins to pay for services.</td></tr><tr><td style="white-space:nowrap">maxoutofpocket<a name="coverage-copay-type-maxoutofpocket"> </a></td><td>Maximum out of pocket</td><td>The maximum amout of payment for services which a patient, or family, is expected to incur - typically annually.</td></tr></table></div>
  </text>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
    <valueCode value="fm"/>
  </extension>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm">
    <valueInteger value="2"/>
  </extension>
  <url value="http://terminology.hl7.org/CodeSystem/coverage-copay-type"/>
  <identifier>
    <system value="urn:ietf:rfc:3986"/>
    <value value="urn:oid:2.16.840.1.113883.4.642.1.1149"/>
  </identifier>
  <version value="1.0.0"/>
  <name value="CoverageCopayTypeCodes"/>
  <title value="Coverage Copay Type Codes"/>
  <status value="draft"/>
  <experimental value="false"/>
  <date value="2024-03-09T11:11:30-07:00"/>
  <publisher value="Health Level Seven International"/>
  <contact>
    <telecom>
      <system value="url"/>
      <value value="http://hl7.org"/>
    </telecom>
    <telecom>
      <system value="email"/>
      <value value="hq@HL7.org"/>
    </telecom>
  </contact>
  <description
               value="This value set includes sample Coverage Copayment Type codes."/>
  <copyright
             value="This material derives from the HL7 Terminology (THO). THO is copyright ©1989+ Health Level Seven International and is made available under the CC0 designation. For more licensing information see: https://terminology.hl7.org/license"/>
  <caseSensitive value="true"/>
  <valueSet value="http://terminology.hl7.org/ValueSet/coverage-copay-type"/>
  <content value="complete"/>
  <concept>
    <code value="gpvisit"/>
    <display value="GP Office Visit"/>
    <definition
                value="An office visit for a general practitioner of a discipline."/>
  </concept>
  <concept>
    <code value="spvisit"/>
    <display value="Specialist Office Visit"/>
    <definition
                value="An office visit for a specialist practitioner of a discipline"/>
  </concept>
  <concept>
    <code value="emergency"/>
    <display value="Emergency"/>
    <definition value="An episode in an emergency department."/>
  </concept>
  <concept>
    <code value="inpthosp"/>
    <display value="Inpatient Hospital"/>
    <definition value="An episode of an Inpatient hospital stay."/>
  </concept>
  <concept>
    <code value="televisit"/>
    <display value="Tele-visit"/>
    <definition
                value="A visit held where the patient is remote relative to the practitioner, e.g. by phone, computer or video conference."/>
  </concept>
  <concept>
    <code value="urgentcare"/>
    <display value="Urgent Care"/>
    <definition
                value="A visit to an urgent care facility - typically a community care clinic."/>
  </concept>
  <concept>
    <code value="copaypct"/>
    <display value="Copay Percentage"/>
    <definition
                value="A standard percentage applied to all classes or service or product not otherwise specified."/>
  </concept>
  <concept>
    <code value="copay"/>
    <display value="Copay Amount"/>
    <definition
                value="A standard fixed currency amount applied to all classes or service or product not otherwise specified."/>
  </concept>
  <concept>
    <code value="deductible"/>
    <display value="Deductible"/>
    <definition
                value="The accumulated amount of patient payment before the coverage begins to pay for services."/>
  </concept>
  <concept>
    <code value="maxoutofpocket"/>
    <display value="Maximum out of pocket"/>
    <definition
                value="The maximum amout of payment for services which a patient, or family, is expected to incur - typically annually."/>
  </concept>
</CodeSystem>