CARIN Digital Insurance Card
2.0.0 - STU 2.0

CARIN Digital Insurance Card, published by HL7 International / Payer/Provider Information Exchange Work Group. This guide is not an authorized publication; it is the continuous build for version 2.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/carin-digital-insurance-card/ and changes regularly. See the Directory of published versions

## ValueSet: SBC Benefit Category Value Set (Experimental)

Official URL: http://hl7.org/fhir/us/insurance-card/ValueSet/sbc-benefit-category | Version: 2.0.0
Standards status: Informative | Computable Name: SBCBenefitCategoryVS

Value set containing all 27 benefit categories required in Summary of Benefits and Coverage (SBC) documents

References

- SBC Insurance Plan Profile
- SBC Insurance Plan Profile

### Logical Definition (CLD)

- Include all codes defined in `http://hl7.org/fhir/us/insurance-card/CodeSystem/sbc-benefit-category` version 📦2.0.0

### Expansion

Expansion performed internally based on codesystem SBC Benefit Category Code System v2.0.0 (CodeSystem)

This value set contains 29 concepts

System | Code | Display (en) | Definition | JSON | XML
`http://hl7.org/fhir/us/insurance-card/CodeSystem/sbc-benefit-category` | preventive-care | Preventive Care/Screening/Immunization | Preventive care services, health screenings, and immunizations |  |
`http://hl7.org/fhir/us/insurance-card/CodeSystem/sbc-benefit-category` | primary-care-visit | Primary Care Visit | Visits to primary care physicians to treat illness or injury |  |
`http://hl7.org/fhir/us/insurance-card/CodeSystem/sbc-benefit-category` | specialist-visit | Specialist Visit | Visits to specialist physicians |  |
`http://hl7.org/fhir/us/insurance-card/CodeSystem/sbc-benefit-category` | diagnostic-test | Diagnostic Test | X-rays and diagnostic imaging other than CT/PET/MRI |  |
`http://hl7.org/fhir/us/insurance-card/CodeSystem/sbc-benefit-category` | imaging | Imaging (CT/PET/MRI) | Advanced imaging services including CT scans, PET scans, and MRIs |  |
`http://hl7.org/fhir/us/insurance-card/CodeSystem/sbc-benefit-category` | generic-drugs | Generic Drugs | Generic prescription medications |  |
`http://hl7.org/fhir/us/insurance-card/CodeSystem/sbc-benefit-category` | preferred-brand-drugs | Preferred Brand Drugs | Brand-name prescription medications on the preferred drug list |  |
`http://hl7.org/fhir/us/insurance-card/CodeSystem/sbc-benefit-category` | non-preferred-brand-drugs | Non-Preferred Brand Drugs | Brand-name prescription medications not on the preferred drug list |  |
`http://hl7.org/fhir/us/insurance-card/CodeSystem/sbc-benefit-category` | specialty-drugs | Specialty Drugs | High-cost or specialty prescription medications |  |
`http://hl7.org/fhir/us/insurance-card/CodeSystem/sbc-benefit-category` | facility-fee | Facility Fee | Hospital or facility charges for services |  |
`http://hl7.org/fhir/us/insurance-card/CodeSystem/sbc-benefit-category` | physician-surgeon-fee | Physician/Surgeon Fees | Professional fees for physicians and surgeons |  |
`http://hl7.org/fhir/us/insurance-card/CodeSystem/sbc-benefit-category` | emergency-room-care | Emergency Room Care | Emergency department services |  |
`http://hl7.org/fhir/us/insurance-card/CodeSystem/sbc-benefit-category` | emergency-medical-transport | Emergency Medical Transportation | Ambulance and emergency medical transport services |  |
`http://hl7.org/fhir/us/insurance-card/CodeSystem/sbc-benefit-category` | urgent-care | Urgent Care | Urgent care facility services |  |
`http://hl7.org/fhir/us/insurance-card/CodeSystem/sbc-benefit-category` | hospital-outpatient | Hospital Outpatient Care | Outpatient hospital services and surgeries |  |
`http://hl7.org/fhir/us/insurance-card/CodeSystem/sbc-benefit-category` | hospital-inpatient | Hospital Inpatient Care | Inpatient hospital stays and services |  |
`http://hl7.org/fhir/us/insurance-card/CodeSystem/sbc-benefit-category` | mental-health-outpatient | Mental/Behavioral Health Outpatient Services | Outpatient mental health and substance abuse services |  |
`http://hl7.org/fhir/us/insurance-card/CodeSystem/sbc-benefit-category` | mental-health-inpatient | Mental/Behavioral Health Inpatient Services | Inpatient mental health and substance abuse services |  |
`http://hl7.org/fhir/us/insurance-card/CodeSystem/sbc-benefit-category` | pregnancy | Pregnancy Services | Prenatal and postnatal office visits |  |
`http://hl7.org/fhir/us/insurance-card/CodeSystem/sbc-benefit-category` | pregnancy-delivery | Childbirth/Delivery Professional Services | Professional services for childbirth and delivery |  |
`http://hl7.org/fhir/us/insurance-card/CodeSystem/sbc-benefit-category` | pregnancy-home-health | Pregnancy Home Health Care | Home health care services related to pregnancy |  |
`http://hl7.org/fhir/us/insurance-card/CodeSystem/sbc-benefit-category` | rehabilitation | Rehabilitation Services | Outpatient physical, occupational, and speech therapy |  |
`http://hl7.org/fhir/us/insurance-card/CodeSystem/sbc-benefit-category` | habilitation | Habilitation Services | Health care services that help develop or maintain daily living skills |  |
`http://hl7.org/fhir/us/insurance-card/CodeSystem/sbc-benefit-category` | skilled-nursing | Skilled Nursing Care | Skilled nursing facility services |  |
`http://hl7.org/fhir/us/insurance-card/CodeSystem/sbc-benefit-category` | durable-medical-equipment | Durable Medical Equipment | Medical equipment for home use such as wheelchairs, oxygen equipment |  |
`http://hl7.org/fhir/us/insurance-card/CodeSystem/sbc-benefit-category` | hospice | Hospice Services | End-of-life care services |  |
`http://hl7.org/fhir/us/insurance-card/CodeSystem/sbc-benefit-category` | children-eye-exam | Children's Eye Exam | Eye examinations for children |  |
`http://hl7.org/fhir/us/insurance-card/CodeSystem/sbc-benefit-category` | children-glasses | Children's Glasses | Eyeglasses for children |  |
`http://hl7.org/fhir/us/insurance-card/CodeSystem/sbc-benefit-category` | children-dental | Children's Dental Check-up | Routine dental care for children |  |

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