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 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

• Narrative Content
• XML
• JSON
• TTL

: Cost Tier Code System - XML Representation

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<CodeSystem xmlns="http://hl7.org/fhir">
  <id value="cost-tier"/>
  <text>
    <status value="generated"/>
    <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>
  </text>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
    <valueCode value="claims"/>
  </extension>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
    <valueCode value="informative">
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom">
        <valueCanonical
                        value="http://hl7.org/fhir/us/insurance-card/ImplementationGuide/hl7.fhir.us.insurance-card"/>
      </extension>
    </valueCode>
  </extension>
  <url value="http://hl7.org/fhir/us/insurance-card/CodeSystem/cost-tier"/>
  <version value="2.0.0"/>
  <name value="CostTierCS"/>
  <title value="Cost Tier Code System"/>
  <status value="draft"/>
  <experimental value="true"/>
  <date value="2026-06-25T21:16:04+00:00"/>
  <publisher
             value="HL7 International / Payer/Provider Information Exchange Work Group"/>
  <contact>
    <name
          value="HL7 International / Payer/Provider Information Exchange Work Group"/>
    <telecom>
      <system value="url"/>
      <value value="http://www.hl7.org/Special/committees/claims"/>
    </telecom>
    <telecom>
      <system value="email"/>
      <value value="pie@lists.HL7.org"/>
    </telecom>
  </contact>
  <description
               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"/>
  <jurisdiction>
    <coding>
      <system value="urn:iso:std:iso:3166"/>
      <code value="US"/>
    </coding>
  </jurisdiction>
  <caseSensitive value="true"/>
  <content value="complete"/>
  <count value="3"/>
  <concept>
    <code value="value-choice"/>
    <display value="Value Choice Provider"/>
    <definition
                value="Cost sharing that applies when the service is delivered by a provider the plan has designated in its value or preferred-value tier"/>
  </concept>
  <concept>
    <code value="standard"/>
    <display value="Standard Provider"/>
    <definition
                value="Cost sharing that applies when the service is delivered by an in-network provider without a special designation"/>
  </concept>
  <concept>
    <code value="virtual"/>
    <display value="Virtual Visit"/>
    <definition
                value="Cost sharing that applies when the service is delivered virtually (telehealth modality) rather than in person"/>
  </concept>
</CodeSystem>