Coverage Copay Type Codes - HL7 Terminology (THO) v7.5.0

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 7.5.0 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: Coverage Copay Type Codes

Official URL: http://terminology.hl7.org/ValueSet/coverage-copay-type		Version: 1.0.1	Highlight text changes?
Active as of 2024-04-24	Maturity Level: 2	Responsible: Health Level Seven International	Computable Name: CoverageCopayTypeCodes
Other Identifiers: OID:2.16.840.1.113883.4.642.3.527
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.html

This value set includes sample Coverage Copayment Type codes.

References

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)

Last updated: 2024-04-24 00:00:00+0000

Profile: Shareable ValueSet

Include all codes defined in http://terminology.hl7.org/CodeSystem/coverage-copay-type version 📦2.0.0

Expansion

Expansion performed internally based on codesystem Coverage Copay Type Codes v2.0.0 (CodeSystem)

This value set contains 27 concepts

Level	System	Code	Display (en)	Definition	JSON	XML
1	`http://terminology.hl7.org/CodeSystem/coverage-copay-type`	gpvisit	GP Office Visit	An office visit for a general practitioner of a discipline.
1	`http://terminology.hl7.org/CodeSystem/coverage-copay-type`	spvisit	Specialist Office Visit	An office visit for a specialist practitioner of a discipline
1	`http://terminology.hl7.org/CodeSystem/coverage-copay-type`	emergency	Emergency	An episode in an emergency department.
1	`http://terminology.hl7.org/CodeSystem/coverage-copay-type`	inpthosp	Inpatient Hospital	An episode of an Inpatient hospital stay.
1	`http://terminology.hl7.org/CodeSystem/coverage-copay-type`	televisit	Tele-visit	A visit held where the patient is remote relative to the practitioner, e.g. by phone, computer or video conference.
1	`http://terminology.hl7.org/CodeSystem/coverage-copay-type`	urgentcare	Urgent Care	A visit to an urgent care facility - typically a community care clinic.
1	`http://terminology.hl7.org/CodeSystem/coverage-copay-type`	rx	Prescription	Prescription drug and pharmacy-related services.
1	`http://terminology.hl7.org/CodeSystem/coverage-copay-type`	copaypct	Copay Percentage	A standard percentage applied to all classes or service or product not otherwise specified.
1	`http://terminology.hl7.org/CodeSystem/coverage-copay-type`	copay	Copay Amount	A standard fixed currency amount applied to all classes or service or product not otherwise specified.
1	`http://terminology.hl7.org/CodeSystem/coverage-copay-type`	deductible	Deductible	The accumulated amount of patient payment before the coverage begins to pay for services.
2	`http://terminology.hl7.org/CodeSystem/coverage-copay-type`	FamOutDed	Family Out of Network Deductible	The accumulated amount applied toward the family's out-of-network deductible before the coverage begins to pay for covered out-of-network services.
2	`http://terminology.hl7.org/CodeSystem/coverage-copay-type`	FamInDed	Family In Network Deductible	The accumulated amount applied toward the family's in-network deductible before the coverage begins to pay for covered in-network services.
2	`http://terminology.hl7.org/CodeSystem/coverage-copay-type`	FamRxOutDed	Family Pharmacy Out of Network Deductible	The accumulated amount applied toward the family's out-of-network pharmacy deductible before the coverage begins to pay for covered out-of-network pharmacy services.
2	`http://terminology.hl7.org/CodeSystem/coverage-copay-type`	FamRxInDed	Family Pharmacy In Network Deductible	The accumulated amount applied toward the family's in-network pharmacy deductible before the coverage begins to pay for covered in-network pharmacy services.
2	`http://terminology.hl7.org/CodeSystem/coverage-copay-type`	IndOutDed	Invidual Out of Network Deductible	The accumulated amount applied toward the individual's out-of-network deductible before the coverage begins to pay for covered out-of-network services.
2	`http://terminology.hl7.org/CodeSystem/coverage-copay-type`	IndInDed	Individual In Network Deductible	The accumulated amount applied toward the individual's in-network deductible before the coverage begins to pay for covered in-network services.
2	`http://terminology.hl7.org/CodeSystem/coverage-copay-type`	IndRxOutDed	Individual Pharmacy Out of Network Deductible	The accumulated amount applied toward the individual's out-of-network pharmacy deductible before the coverage begins to pay for covered out-of-network pharmacy services.
2	`http://terminology.hl7.org/CodeSystem/coverage-copay-type`	IndRxInDed	Individual Pharmacy In Network Deductible	The accumulated amount applied toward the individual's in-network pharmacy deductible before the coverage begins to pay for covered in-network pharmacy services.
1	`http://terminology.hl7.org/CodeSystem/coverage-copay-type`	maxoutofpocket	Maximum out of pocket	The maximum amout of payment for services which a patient, or family, is expected to incur - typically annually.
2	`http://terminology.hl7.org/CodeSystem/coverage-copay-type`	FamOutMax	Family Out of Network Out of Pocket Maximum	The maximum amount of out-of-pocket payment that a family is expected to incur for covered out-of-network services.
2	`http://terminology.hl7.org/CodeSystem/coverage-copay-type`	FamInMax	Family In Network Out of Pocket Maximum	The maximum amount of out-of-pocket payment that a family is expected to incur for covered in-network services.
2	`http://terminology.hl7.org/CodeSystem/coverage-copay-type`	FamRxOutMax	Family Pharmacy Out of Network Out of Pocket Maximum	The maximum amount of out-of-pocket payment that a family is expected to incur for covered out-of-network pharmacy services.
2	`http://terminology.hl7.org/CodeSystem/coverage-copay-type`	FamRxInMax	Family Pharmacy In Network Out of Pocket Maximum	The maximum amount of out-of-pocket payment that a family is expected to incur for covered in-network pharmacy services.
2	`http://terminology.hl7.org/CodeSystem/coverage-copay-type`	IndOutMax	Individual Out of Network Out of Pocket Maximum	The maximum amount of out-of-pocket payment that an individual is expected to incur for covered out-of-network services.
2	`http://terminology.hl7.org/CodeSystem/coverage-copay-type`	IndInMax	Individual In Network Out of Pocket Maximum	The maximum amount of out-of-pocket payment that an individual is expected to incur for covered in-network services.
2	`http://terminology.hl7.org/CodeSystem/coverage-copay-type`	IndRxOutMax	Individual Pharmacy Out of Network Out of Pocket Maximum	The maximum amount of out-of-pocket payment that an individual is expected to incur for covered out-of-network pharmacy services.
2	`http://terminology.hl7.org/CodeSystem/coverage-copay-type`	IndRxInMax	Individual Pharmacy In Network Out of Pocket Maximum	The maximum amount of out-of-pocket payment that an individual is expected to incur for covered in-network pharmacy services.