HL7 Terminology (THO)
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HL7 Terminology (THO), published by HL7 International - Vocabulary Work Group. This guide is not an authorized publication; it is the continuous build for version 5.5.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/UTG/ and changes regularly. See the Directory of published versions

ValueSet: Benefit Type Codes

Official URL: http://terminology.hl7.org/ValueSet/benefit-type Version: 1.0.0
Draft as of 2020-02-24 Maturity Level: 1 Responsible: Health Level Seven International Computable Name: BenefitTypeCodes
Other Identifiers: urn:ietf:rfc:3986#Uniform Resource Identifier (URI)#urn:oid:2.16.840.1.113883.4.642.3.606

Copyright/Legal: This material derives from the HL7 Terminology THO. THO is copyright ©1989+ Health Level Seven International and is made available under the CC0 designation. For more licensing information see: https://terminology.hl7.org/license

This value set includes a smattering of Benefit type codes.


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)



Expansion based on codesystem Benefit Type Codes v1.0.0 (CodeSystem)

This value set contains 12 concepts.


Maximum benefit allowable.


Cost to be incurred before benefits are applied


Service visit


Type of room

  copayhttp://terminology.hl7.org/CodeSystem/benefit-typeCopayment per service

Copayment per service

  copay-percenthttp://terminology.hl7.org/CodeSystem/benefit-typeCopayment Percent per service

Copayment percentage per service

  copay-maximumhttp://terminology.hl7.org/CodeSystem/benefit-typeCopayment maximum per service

Copayment maximum per service

  vision-examhttp://terminology.hl7.org/CodeSystem/benefit-typeVision Exam

Vision Exam

  vision-glasseshttp://terminology.hl7.org/CodeSystem/benefit-typeVision Glasses

Frames and lenses

  vision-contactshttp://terminology.hl7.org/CodeSystem/benefit-typeVision Contacts Coverage

Contact Lenses

  medical-primarycarehttp://terminology.hl7.org/CodeSystem/benefit-typeMedical Primary Health Coverage

Medical Primary Health Coverage

  pharmacy-dispensehttp://terminology.hl7.org/CodeSystem/benefit-typePharmacy Dispense Coverage

Pharmacy Dispense Coverage

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
System 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


2023-11-14reviseTSMGMarc DuteauAdd standard copyright and contact to internal content; up-476
2020-10-14reviseVocabulary WGGrahame GrieveReset Version after migration to UTG
2020-05-06reviseVocabulary WGTed KleinMigrated to the UTG maintenance environment and publishing tooling.