CARIN Digital Insurance Card
2.0.0-ballot - STU 2 Ballot United States of America flag

CARIN Digital Insurance Card, published by HL7 International / Payer/Provider Information Exchange Work Group. This guide is not an authorized publication; it is the continuous build for version 2.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/carin-digital-insurance-card/ and changes regularly. See the Directory of published versions

: Cost Tier Code System - TTL Representation

Page standards status: Informative

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@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

# - resource -------------------------------------------------------------------

<http://hl7.org/fhir/CodeSystem/cost-tier> a fhir:CodeSystem ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:Resource.id [ fhir:value "cost-tier"] ;
  fhir:DomainResource.text [
     fhir:Narrative.status [ fhir:value "generated" ] ;
     fhir:Narrative.div "<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>"
  ] ;
  fhir:DomainResource.extension [
     fhir:index 0 ;
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg" ] ;
     fhir:Extension.valueCode [ fhir:value "claims" ]
  ], [
     fhir:index 1 ;
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status" ] ;
     fhir:Extension.valueCode [
       fhir:value "informative" ;
       fhir:Element.extension [
         fhir:index 0 ;
         fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom" ] ;
         fhir:Extension.valueCanonical [
           fhir:value "http://hl7.org/fhir/us/insurance-card/ImplementationGuide/hl7.fhir.us.insurance-card" ;
           fhir:link <http://hl7.org/fhir/us/insurance-card/ImplementationGuide/hl7.fhir.us.insurance-card>
         ]
       ]
     ]
  ] ;
  fhir:CodeSystem.url [ fhir:value "http://hl7.org/fhir/us/insurance-card/CodeSystem/cost-tier"] ;
  fhir:CodeSystem.identifier [
     fhir:index 0 ;
     fhir:Identifier.system [ fhir:value "urn:ietf:rfc:3986" ] ;
     fhir:Identifier.value [ fhir:value "urn:oid:2.16.840.1.113883.4.642.40.9.16.7" ]
  ] ;
  fhir:CodeSystem.version [ fhir:value "2.0.0-ballot"] ;
  fhir:CodeSystem.name [ fhir:value "CostTierCS"] ;
  fhir:CodeSystem.title [ fhir:value "Cost Tier Code System"] ;
  fhir:CodeSystem.status [ fhir:value "draft"] ;
  fhir:CodeSystem.experimental [ fhir:value "true"^^xsd:boolean] ;
  fhir:CodeSystem.date [ fhir:value "2026-08-12T14:42:03+00:00"^^xsd:dateTime] ;
  fhir:CodeSystem.publisher [ fhir:value "HL7 International / Payer/Provider Information Exchange Work Group"] ;
  fhir:CodeSystem.contact [
     fhir:index 0 ;
     fhir:ContactDetail.name [ fhir:value "HL7 International / Payer/Provider Information Exchange Work Group" ] ;
     fhir:ContactDetail.telecom [
       fhir:index 0 ;
       fhir:ContactPoint.system [ fhir:value "url" ] ;
       fhir:ContactPoint.value [ fhir:value "http://www.hl7.org/Special/committees/claims" ]
     ], [
       fhir:index 1 ;
       fhir:ContactPoint.system [ fhir:value "email" ] ;
       fhir:ContactPoint.value [ fhir:value "pie@lists.HL7.org" ]
     ]
  ] ;
  fhir:CodeSystem.description [ fhir: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"] ;
  fhir:CodeSystem.jurisdiction [
     fhir:index 0 ;
     fhir:CodeableConcept.coding [
       fhir:index 0 ;
       fhir:Coding.system [ fhir:value "urn:iso:std:iso:3166" ] ;
       fhir:Coding.code [ fhir:value "US" ]
     ]
  ] ;
  fhir:CodeSystem.caseSensitive [ fhir:value "true"^^xsd:boolean] ;
  fhir:CodeSystem.content [ fhir:value "complete"] ;
  fhir:CodeSystem.count [ fhir:value "3"^^xsd:nonNegativeInteger] ;
  fhir:CodeSystem.concept [
     fhir:index 0 ;
     fhir:CodeSystem.concept.code [ fhir:value "value-choice" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "Value Choice Provider" ] ;
     fhir:CodeSystem.concept.definition [ fhir:value "Cost sharing that applies when the service is delivered by a provider the plan has designated in its value or preferred-value tier" ]
  ], [
     fhir:index 1 ;
     fhir:CodeSystem.concept.code [ fhir:value "standard" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "Standard Provider" ] ;
     fhir:CodeSystem.concept.definition [ fhir:value "Cost sharing that applies when the service is delivered by an in-network provider without a special designation" ]
  ], [
     fhir:index 2 ;
     fhir:CodeSystem.concept.code [ fhir:value "virtual" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "Virtual Visit" ] ;
     fhir:CodeSystem.concept.definition [ fhir:value "Cost sharing that applies when the service is delivered virtually (telehealth modality) rather than in person" ]
  ] .

# - ontology header ------------------------------------------------------------

<http://hl7.org/fhir/CodeSystem/cost-tier.ttl> a owl:Ontology ;
  owl:imports fhir:fhir.ttl ;
  owl:versionIRI <http://build.fhir.org/CodeSystem/cost-tier.ttl> .