![.](tbl_spacer.png) 0 Table of Contents |
![.](tbl_spacer.png) ![.](tbl_vjoin.png) 1 Patient Cost Transparency Implementation Guide Home Page |
![.](tbl_spacer.png) ![.](tbl_vjoin.png) 2 Use Case and Actors |
![.](tbl_spacer.png) ![.](tbl_vjoin.png) 3 Good Faith Estimate (GFE) Coordination Overview |
![.](tbl_spacer.png) ![.](tbl_vjoin.png) 4 Good Faith Estimate (GFE) Submission and AEOB Overview |
![.](tbl_spacer.png) ![.](tbl_vjoin.png) 5 Technical Background and Underlying Technologies |
![.](tbl_spacer.png) ![.](tbl_vjoin.png) 6 Formal Specification |
![.](tbl_spacer.png) ![.](tbl_vjoin.png) 7 Good Faith Estimate (GFE) Coordination Specification |
![.](tbl_spacer.png) ![.](tbl_vjoin.png) 8 Good Faith Estimate (GFE) Submission and AEOB Specification |
![.](tbl_spacer.png) ![.](tbl_vjoin.png) 9 Terminology Licensure |
![.](tbl_spacer.png) ![.](tbl_vjoin.png) 10 Security |
![.](tbl_spacer.png) ![.](tbl_vjoin.png) 11 Downloads |
![.](tbl_spacer.png) ![.](tbl_vjoin.png) 12 Change Log |
![.](tbl_spacer.png) ![.](tbl_vjoin_end-open.png) 13 Artifacts Summary |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.1 Patient Cost Transparency Implementation Guide Coordination Platform Capability Statement |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.2 Patient Cost Transparency Implementation Guide Coordination Requester Capability Statement |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.3 Patient Cost Transparency Implementation Guide GFE Contributor Capability Statement |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.4 Patient Cost Transparency Implementation Guide Payer Capability Statement |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.5 Retrieve GFE Collection Bundle |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.6 Submit a GFE resource for the creation of an AEOB |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.7 aeob-date-of-service |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.8 TaskReplaces |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.9 TaskRequestedPeriod |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.10 PCT Coverage |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.11 PCT Organization |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.12 PCT Practitioner |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.13 PCT GFE Bundle |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.14 PCT GFE Collection Bundle |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.15 PCT GFE Contributor Task |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.16 PCT GFE Coordination Bundle |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.17 PCT GFE Coordination Task |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.18 PCT GFE DeviceRequest |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.19 PCT GFE Information Bundle |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.20 PCT GFE MedicationRequest |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.21 PCT GFE Missing Bundle |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.22 PCT GFE ServiceRequest |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.23 PCT Good Faith Estimate Summary |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.24 PCT Good Faith Estimate Institutional |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.25 PCT Good Faith Estimate Professional |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.26 PCT Service Location |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.27 PCT Advanced EOB |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.28 PCT Advanced EOB Summary |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.29 PCT AEOB Adjudication Error |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.30 PCT AEOB Bundle |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.31 PCT AEOB Complete |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.32 PCT GFE Validation Error |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.33 Benefit Remaining |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.34 CountrySubdivisionCode |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.35 GFE Reference |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.36 GFEBillingProviderLineItemCtrlNum |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.37 GFEConsentForBalanceBilling |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.38 GFEDisclaimer |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.39 GFEServiceLinkingInfo |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.40 In Network Provider Options Link |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.41 PCTEndpoint |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.42 Planned Service Period |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.43 ProcessNote Class |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.44 ProviderEventMethodology |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.45 ProviderTaxonomy |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.46 ReferralNumber |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.47 Request Initiation Time |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.48 Self-Pay Declared |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.49 Service Description |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.50 Subject To Medical Management |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.51 Claim Medical Product or Service Value Set |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.52 GFE Coordination Task Status Codes |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.53 ICD-10 Procedure Codes |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.54 NUBC Point Of Origin |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.55 NUBC Priority (Type) of Admission or Visit |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.56 PCT Adjudication Value Set |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.57 PCT Adjustment Reason |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.58 PCT Advance Explanation of Benefit Type Value Set |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.59 PCT AEOB Process Note Types |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.60 PCT benefitBalance.category codes |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.61 PCT Care Team Role Value Set |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.62 PCT CMS HCPCS and AMA CPT Procedure Surgical Codes |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.63 PCT Diagnosis Type Value Set |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.64 PCT Financial Type Value Set |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.65 PCT GFE CMS Place of Service Value Set |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.66 PCT GFE Contributor Task Status Reason Codes ValueSet |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.67 PCT GFE Frequency Code Value Set |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.68 PCT GFE Item Adjudication Value Set |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.69 PCT GFE Item CPT - HCPCS Value Set |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.70 PCT GFE Item NDC Value Set |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.71 PCT GFE NUBC Revenue Value Set |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.72 PCT GFE NUBC Uniform Billing (UB-04) Type of Bill Value Set |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.73 PCT GFE Request Coordination Task Status Reason Codes ValueSet |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.74 PCT GFE Request Task Codes ValueSet |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.75 PCT ICD-10 Diagnostic Codes |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.76 PCT Organization Contact Purpose Value Set |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.77 PCT Organization Identifier Type Value Set |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.78 PCT Organization Type Value Set |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.79 PCT Payer Benefit Payment Status |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.80 PCT Payer Provider Network Status |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.81 PCT Procedure Type Value Set |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.82 PCT Subject-To-Medical-Management Reason Value Set |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.83 PCT Supporting Info Type Value Set |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.84 PCT Total Value Set |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.85 Provider GFE Contributor Task Status Codes |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.86 US Claim DRG Codes |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.87 PCT Adjudication Category CodeSystem |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.88 PCT Adjudication Code System |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.89 PCT AEOB Process Note Code System |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.90 PCT Care Team Role |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.91 PCT Diagnosis Type |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.92 PCT Estimate Type Code System |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.93 PCT Financial Type Code System |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.94 PCT GFE Frequency Code System |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.95 PCT GFE Request Task Codes Code System |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.96 PCT GFE Request Task Status Reason Code Code System |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.97 PCT GFE Supporting Info Type Code System |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.98 PCT Identifier Type |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.99 PCT Network Status |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.100 PCT Organization Contact Purpose Type Code System |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.101 PCT Organization Identifier Type Code System |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.102 PCT Procedure Type |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.103 PCT Subject-To-Medical-Management Reason Code System |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.104 contract1001 |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.105 coverage1001 |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.106 endpoint001 |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.107 org1001 |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.108 org1002 |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.109 patient1001 |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.110 PCT-AEOB-1 |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.111 PCT-AEOB-Adjudication-Error-Example-1 |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.112 PCT-AEOB-Bundle-1 |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.113 PCT-AEOB-Complete-Example-1 |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.114 PCT-AEOB-Summary-1 |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.115 PCT-DeviceRequest-1 |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.116 PCT-GFE-Bundle-Inst-1 |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.117 PCT-GFE-Bundle-Prof-1 |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.118 PCT-GFE-Collection-Bundle-1 |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.119 PCT-GFE-Collection-Bundle-2 |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.120 PCT-GFE-Contributor-Task-1 |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.121 PCT-GFE-Contributor-Task-2 |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.122 PCT-GFE-Coordination-Bundle-1 |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.123 PCT-GFE-Coordination-Task-1 |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.124 PCT-GFE-Information-Bundle-1 |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.125 PCT-GFE-Institutional-1 |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.126 PCT-GFE-Institutional-MRI |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.127 PCT-GFE-Missing-Bundle-1 |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.128 PCT-GFE-Professional-MRI |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.129 PCT-GFE-Summary-1 |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.130 PCT-GFE-Summary-MRI |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.131 PCT-GFE-Validation-Error-Example-1 |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.132 PCT-MedicationRequest-1 |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.133 PCT-ServiceLocation-1 |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.134 PCT-ServiceRequest-1 |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.135 prac001 |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.136 prac002 |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 13.137 Submitter-Org-1 |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin_end.png) 13.138 Submitter-Practitioner-1 |