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: ActCoverageLimitCode

Official URL: http://terminology.hl7.org/ValueSet/v3-ActCoverageLimitCode Version: 3.0.0
Active as of 2014-03-26 Responsible: Health Level Seven International Computable Name: ActCoverageLimitCode
Other Identifiers: urn:ietf:rfc:3986#Uniform Resource Identifier (URI)#urn:oid:2.16.840.1.113883.1.11.17496

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

Criteria that are applicable to the authorized coverage.


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)

This value set includes codes based on the following rules:

This value set excludes codes based on the following rules:



Expansion based on codesystem ActCode v9.0.0 (CodeSystem)

This value set contains 10 concepts.


Maximum amount paid or maximum number of services/products covered; or maximum amount or number covered during a specified time period under the policy or program.

  COVPRDhttp://terminology.hl7.org/CodeSystem/v3-ActCodecoverage period

Codes representing the time period during which coverage is available; or financial participation requirements are in effect.

  LFEMXhttp://terminology.hl7.org/CodeSystem/v3-ActCodelife time maximum

Definition: Maximum amount paid by payer or covered party; or maximum number of services or products covered under the policy or program during a covered party's lifetime.

  NETAMThttp://terminology.hl7.org/CodeSystem/v3-ActCodeNet Amount

Maximum net amount that will be covered for the product or service specified.

  PRDMXhttp://terminology.hl7.org/CodeSystem/v3-ActCodeperiod maximum

Definition: Maximum amount paid by payer or covered party; or maximum number of services/products covered under the policy or program by time period specified by the effective time on the act.

  UNITPRICEhttp://terminology.hl7.org/CodeSystem/v3-ActCodeUnit Price

Maximum unit price that will be covered for the authorized product or service.

  UNITQTYhttp://terminology.hl7.org/CodeSystem/v3-ActCodeUnit Quantity

Maximum number of items that will be covered of the product or service specified.

  COVMXhttp://terminology.hl7.org/CodeSystem/v3-ActCodecoverage maximum

Definition: Codes representing the maximum coverate or financial participation requirements.


Codes representing the types of covered parties that may receive covered benefits under a policy or program.


Codes representing the level of coverage provided under the policy or program in terms of the types of entities that may play covered parties based on their personal relationships or employment status.

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


2023-11-14reviseMarc DuteauTSMGAdd standard copyright and contact to internal content; up-476
2022-10-18reviseMarc DuteauTSMGFixing missing metadata; up-349
2020-05-06reviseTed KleinVocabulary WGMigrated to the UTG maintenance environment and publishing tooling.
2014-03-26reviseVocabulary (Woody Beeler) (no record of original request)2014T1_2014-03-26_001283 (RIM release ID)Lock all vaue sets untouched since 2014-03-26 to trackingId 2014T1_2014_03_26