HL7 Terminology
2.0.0 - Publication

This page is part of the HL7 Terminology (v2.0.0: Release) based on FHIR R4. The current version which supercedes this version is 5.2.0. For a full list of available versions, see the Directory of published versions

ValueSet: ActInvoiceDetailGenericProviderCode


Defining URL:http://terminology.hl7.org/ValueSet/v3-ActInvoiceDetailGenericProviderCode
Status:Active as of 2014-03-26

The billable item codes to identify provider supplied charges or changes to the total billing of a claim.

OID:2.16.840.1.113883.1.11.19408 (for OID based terminology systems)
Source Resource:XML / JSON / Turtle


This value set is not used here; it may be used elsewhere (e.g. specifications and/or implementations that use this content)

Logical Definition (CLD)

This value set includes codes based on the following rules:

This value set excludes codes based on the following rules:



This value set contains 13 concepts

Expansion based on ActCode v2.1.0 (CodeSystem)

All codes from system http://terminology.hl7.org/CodeSystem/v3-ActCode

CANCAPTcancelled appointmentA charge to compensate the provider when a patient cancels an appointment with insufficient time for the provider to make another appointment with another patient.
DSCdiscountA reduction in the amount charged as a percentage of the amount. For example a 5% discount for volume purchase.
ESAextraordinary service assessmentA premium on a service fee is requested because, due to extenuating circumstances, the service took an extraordinary amount of time or supplies.
FFSTOPfee for service top offUnder 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.
FNLFEEfinal feeAnticipated or actual final fee associated with treating a patient.
FRSTFEEfirst feeAnticipated or actual initial fee associated with treating a patient.
MARKUPmarkup or up-chargeAn increase in the amount charged as a percentage of the amount. For example, 12% markup on product cost.
MISSAPTmissed appointmentA charge to compensate the provider when a patient does not show for an appointment.
PERFEEperiodic feeAnticipated 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.
PERMBNSperformance bonusThe 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.
RESTOCKrestocking feeA 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.
TRAVELtravelA 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.
URGENTurgentPremium paid on service fees in compensation for providing an expedited response to an urgent situation.

Explanation of the columns that may appear on this page:

Level A few code lists that FHIR defines are hierarchical - each code is assigned a level. In this scheme, some codes are under other codes, and imply that the code they are under also applies
Source The source of the definition of the code (when the value set draws in codes defined elsewhere)
Code The code (used as the code in the resource instance)
Display The display (used in the display element of a Coding). If there is no display, implementers should not simply display the code, but map the concept into their application
Definition An explanation of the meaning of the concept
Comments Additional notes about how to use the code


2020-05-06reviseTed KleinVocabulary WGMigrated to the UTG maintenance environment and publishing tooling.
2014-03-26reviseVocabulary (Woody Beeler) (no record of original request)2014T1_2014-03-26_001283 (RIM release ID)Lock all vaue sets untouched since 2014-03-26 to trackingId 2014T1_2014_03_26