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| Patient Administration Work Group | Maturity Level: N/A | Standards Status: Informative |
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Definition for Code SystemEligibility
@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdf: <http://www.w3.org/1999/02/22-rdf-syntax-ns#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .
# - resource -------------------------------------------------------------------
<http://hl7.org/fhir/CodeSystem/eligibility> a fhir:CodeSystem ;
fhir:nodeRole fhir:treeRoot ;
fhir:id [ fhir:v "eligibility"] ; #
fhir:meta [
fhir:lastUpdated [ fhir:v "2025-10-20T13:04:42.141+00:00"^^xsd:dateTime ] ;
fhir:profile ( [
fhir:v "http://hl7.org/fhir/StructureDefinition/shareablecodesystem"^^xsd:anyURI ;
fhir:link <http://hl7.org/fhir/StructureDefinition/shareablecodesystem>
] )
] ; #
fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: CodeSystem eligibility</b></p><a name=\"eligibility\"> </a><a name=\"hceligibility\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"shareablecodesystem.html\">Shareable CodeSystem</a></p></div><p>This case-sensitive code system <code>http://hl7.org/fhir/eligibility</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\">veterans<a name=\"eligibility-veterans\"> </a></td><td>Veterans</td><td>Only Veterans are eligible to receive services associated with this code</td></tr><tr><td style=\"white-space:nowrap\">pediatric-patients<a name=\"eligibility-pediatric-patients\"> </a></td><td>Pediatric patients</td><td>Pediatric Patients</td></tr><tr><td style=\"white-space:nowrap\">existing-patients<a name=\"eligibility-existing-patients\"> </a></td><td>Existing Patients</td><td>Existing Patients</td></tr><tr><td style=\"white-space:nowrap\">new-patients<a name=\"eligibility-new-patients\"> </a></td><td>New patients</td><td>New patients</td></tr><tr><td style=\"white-space:nowrap\">low-income-patients<a name=\"eligibility-low-income-patients\"> </a></td><td>Low-income patients</td><td>Low-income patients</td></tr><tr><td style=\"white-space:nowrap\">uninsured-patients<a name=\"eligibility-uninsured-patients\"> </a></td><td>Uninsured patients</td><td>Uninsured patients</td></tr><tr><td style=\"white-space:nowrap\">renal-patients<a name=\"eligibility-renal-patients\"> </a></td><td>Renal patients</td><td>Renal patients (e.g., for dialysis services)</td></tr><tr><td style=\"white-space:nowrap\">specialist-referral-required<a name=\"eligibility-specialist-referral-required\"> </a></td><td>Specialist referral required</td><td>A specific specialist referral is required to receive services associated with this code</td></tr><tr><td style=\"white-space:nowrap\">assessment-required<a name=\"eligibility-assessment-required\"> </a></td><td>Assessment required</td><td>An assessment is required to receive services associated with this code</td></tr></table></div>"^^rdf:XMLLiteral
] ; #
fhir:extension ( [
fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg"^^xsd:anyURI ] ;
fhir:value [
a fhir:code ;
fhir:v "pa"
]
] ) ; #
fhir:url [ fhir:v "http://hl7.org/fhir/eligibility"^^xsd:anyURI] ; #
fhir:version [ fhir:v "6.0.0-ballot3"] ; #
fhir:name [ fhir:v "Eligibility"] ; #
fhir:title [ fhir:v "Eligibility Characteristics"] ; #
fhir:status [ fhir:v "active"] ; #
fhir:experimental [ fhir:v false] ; #
fhir:publisher [ fhir:v "HL7 International"] ; #
fhir:description [ fhir:v "Example set of HealthcareService eligibility codes"] ; #
fhir:jurisdiction ( [
fhir:coding ( [
fhir:system [ fhir:v "http://unstats.un.org/unsd/methods/m49/m49.htm"^^xsd:anyURI ] ;
fhir:code [ fhir:v "001" ] ;
fhir:display [ fhir:v "World" ]
] )
] ) ; #
fhir:caseSensitive [ fhir:v true] ; #
fhir:hierarchyMeaning [] ; #
fhir:content [ fhir:v "complete"] ; #
fhir:concept ( [
fhir:code [ fhir:v "veterans" ] ;
fhir:display [ fhir:v "Veterans" ] ;
fhir:definition [ fhir:v "Only Veterans are eligible to receive services associated with this code" ]
] [
fhir:code [ fhir:v "pediatric-patients" ] ;
fhir:display [ fhir:v "Pediatric patients" ] ;
fhir:definition [ fhir:v "Pediatric Patients" ]
] [
fhir:code [ fhir:v "existing-patients" ] ;
fhir:display [ fhir:v "Existing Patients" ] ;
fhir:definition [ fhir:v "Existing Patients" ]
] [
fhir:code [ fhir:v "new-patients" ] ;
fhir:display [ fhir:v "New patients" ] ;
fhir:definition [ fhir:v "New patients" ]
] [
fhir:code [ fhir:v "low-income-patients" ] ;
fhir:display [ fhir:v "Low-income patients" ] ;
fhir:definition [ fhir:v "Low-income patients" ]
] [
fhir:code [ fhir:v "uninsured-patients" ] ;
fhir:display [ fhir:v "Uninsured patients" ] ;
fhir:definition [ fhir:v "Uninsured patients" ]
] [
fhir:code [ fhir:v "renal-patients" ] ;
fhir:display [ fhir:v "Renal patients" ] ;
fhir:definition [ fhir:v "Renal patients (e.g., for dialysis services)" ]
] [
fhir:code [ fhir:v "specialist-referral-required" ] ;
fhir:display [ fhir:v "Specialist referral required" ] ;
fhir:definition [ fhir:v "A specific specialist referral is required to receive services associated with this code" ]
] [
fhir:code [ fhir:v "assessment-required" ] ;
fhir:display [ fhir:v "Assessment required" ] ;
fhir:definition [ fhir:v "An assessment is required to receive services associated with this code" ]
] ) . #
# -------------------------------------------------------------------------------------
Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.
FHIR ®© HL7.org 2011+. FHIR R6 hl7.fhir.core#6.0.0-ballot3 generated on Mon, Oct 20, 2025 13:07+0000.
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