# Benefit Type Value Set - National Directory of Healthcare Providers & Services (NDH) Implementation Guide v2.0.0-current

* [**Table of Contents**](toc.md)
* [**Artifacts Summary**](artifacts.md)
* **Benefit Type Value Set**

## ValueSet: Benefit Type Value Set 

| | | |
| :--- | :--- | :--- |
| *Official URL*:http://hl7.org/fhir/us/ndh/ValueSet/BenefitTypeVS | *Version*:2.0.0-current | |
| * Standards status: *[Trial-use](http://hl7.org/fhir/R4/versions.html#std-process) | [Maturity Level](http://hl7.org/fhir/versions.html#maturity): 4 | *Computable Name*:BenefitTypeVS |

 
Codes for Insurance Benefit Type. 

 **References** 

* [NDH InsurancePlan Profile](StructureDefinition-ndh-InsurancePlan.md)

### Logical Definition (CLD)

 

### Expansion

-------

 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](http://hl7.org/fhir/R4/datatypes.html#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 |



## Resource Content

```json
{
  "resourceType" : "ValueSet",
  "id" : "BenefitTypeVS",
  "extension" : [{
    "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
    "valueCode" : "pa"
  },
  {
    "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
    "valueInteger" : 4,
    "_valueInteger" : {
      "extension" : [{
        "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
        "valueCanonical" : "http://hl7.org/fhir/us/ndh/ImplementationGuide/hl7.fhir.us.ndh"
      }]
    }
  },
  {
    "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
    "valueCode" : "trial-use",
    "_valueCode" : {
      "extension" : [{
        "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
        "valueCanonical" : "http://hl7.org/fhir/us/ndh/ImplementationGuide/hl7.fhir.us.ndh"
      }]
    }
  }],
  "url" : "http://hl7.org/fhir/us/ndh/ValueSet/BenefitTypeVS",
  "version" : "2.0.0-current",
  "name" : "BenefitTypeVS",
  "title" : "Benefit Type Value Set",
  "status" : "active",
  "experimental" : false,
  "date" : "2026-03-30T14:03:58+00:00",
  "publisher" : "HL7 International / Patient Administration",
  "contact" : [{
    "name" : "HL7 International / Patient Administration",
    "telecom" : [{
      "system" : "url",
      "value" : "http://www.hl7.org/Special/committees/pafm"
    },
    {
      "system" : "email",
      "value" : "pafm@lists.hl7.org"
    }]
  }],
  "description" : "Codes for Insurance Benefit Type.",
  "jurisdiction" : [{
    "coding" : [{
      "system" : "urn:iso:std:iso:3166",
      "code" : "US",
      "display" : "United States of America"
    }]
  }],
  "compose" : {
    "include" : [{
      "system" : "http://terminology.hl7.org/CodeSystem/insurance-benefit-type",
      "concept" : [{
        "code" : "pcpov",
        "display" : "Primary Care Visit to Treat an Injury or Illness"
      },
      {
        "code" : "specialistov",
        "display" : "Specialist Office Visit"
      },
      {
        "code" : "mlpov",
        "display" : "Other Practitioner Office Visit (Nurse, Physician Assistant) - Mid Level Professional"
      },
      {
        "code" : "outpatient",
        "display" : "Outpatient Facility Fee (e.g., Ambulatory Surgery Center)"
      },
      {
        "code" : "outpatstx",
        "display" : "Outpatient Surgery Physician/Surgical Services"
      },
      {
        "code" : "hospserv",
        "display" : "Hospice Services"
      },
      {
        "code" : "routinedental",
        "display" : "Routine Dental Services (Adult)"
      },
      {
        "code" : "infertilitytx",
        "display" : "Infertility Treatment"
      },
      {
        "code" : "ltnhc",
        "display" : "Long-Term/Custodial Nursing Home Care"
      },
      {
        "code" : "privatenurse",
        "display" : "Private-Duty Nursing"
      },
      {
        "code" : "routineeye",
        "display" : "Routine Eye Exam (Adult)"
      },
      {
        "code" : "ucservice",
        "display" : "Urgent Care Centers or Facilities"
      },
      {
        "code" : "homehealth",
        "display" : "Home Health"
      },
      {
        "code" : "erservice",
        "display" : "Emergency Room Services"
      },
      {
        "code" : "ambulance",
        "display" : "Emergency Room Services"
      },
      {
        "code" : "inpatienthospital",
        "display" : "Inpatient Hospital Services (e.g., Hospital Stay)"
      },
      {
        "code" : "inpatientprovider",
        "display" : "Inpatient Physician and Surgical Services"
      },
      {
        "code" : "bariatricsurg",
        "display" : "Bariatric Surgery"
      },
      {
        "code" : "cosmeticsurg",
        "display" : "Cosmetic Surgery"
      },
      {
        "code" : "skillednursing",
        "display" : "Skilled Nursing Facility"
      },
      {
        "code" : "ppnatalcare",
        "display" : "Prenatal and Postnatal Care"
      },
      {
        "code" : "maternitycare",
        "display" : "Delivery and All Inpatient Services for Maternity Care"
      },
      {
        "code" : "menthlthoutp",
        "display" : "Mental/Behavioral Health Outpatient Services"
      },
      {
        "code" : "menthlthinp",
        "display" : "Mental/Behavioral Health Inpatient Services"
      },
      {
        "code" : "sadoutp",
        "display" : "Substance Abuse Disorder Outpatient Services"
      },
      {
        "code" : "sadinp",
        "display" : "Substance Abuse Disorder Inpatient Services"
      },
      {
        "code" : "drggenric",
        "display" : "Generic Drugs"
      },
      {
        "code" : "drgbrand",
        "display" : "Preferred Brand Drugs"
      },
      {
        "code" : "drgnonpreferred",
        "display" : "Non-Preferred Brand Drugs"
      },
      {
        "code" : "drgspecialty",
        "display" : "Specialty Drugs"
      },
      {
        "code" : "rehaboutp",
        "display" : "Outpatient Rehabilitation Services"
      },
      {
        "code" : "servicehablitation",
        "display" : "Habilitation Services"
      },
      {
        "code" : "chiro",
        "display" : "Chiropractic Care"
      },
      {
        "code" : "dme",
        "display" : "Durable Medical Equipment"
      },
      {
        "code" : "hearingaids",
        "display" : "Hearing Aids"
      },
      {
        "code" : "imgctpetmri",
        "display" : "Imaging (CT/PET Scans, MRIs)"
      },
      {
        "code" : "prev",
        "display" : "Preventive Care/Screening/Immunization"
      },
      {
        "code" : "rtnpod",
        "display" : "Routine Foot Care"
      },
      {
        "code" : "acupuncture",
        "display" : "Acupuncture"
      },
      {
        "code" : "weightloss",
        "display" : "Weight Loss Programs"
      },
      {
        "code" : "rtneyechld",
        "display" : "Routine Eye Exam for Children"
      },
      {
        "code" : "glasseschld",
        "display" : "Eye Glasses for Children"
      },
      {
        "code" : "rtndntlchld",
        "display" : "Dental Check-Up for Children"
      },
      {
        "code" : "speachthpy",
        "display" : "Rehabilitative Speech Therapy"
      },
      {
        "code" : "rehaboccandpt",
        "display" : "Rehabilitative Occupational and Rehabilitative Physical Therapy"
      },
      {
        "code" : "wellbaby",
        "display" : "Well Baby Visits and Care"
      },
      {
        "code" : "laboutp",
        "display" : "Laboratory Outpatient and Professional Services"
      },
      {
        "code" : "imagingdx",
        "display" : "X-rays and Diagnostic Imaging"
      },
      {
        "code" : "dntlbaschld",
        "display" : "Basic Dental Care - Child"
      },
      {
        "code" : "orthochld",
        "display" : "Orthodontia - Child"
      },
      {
        "code" : "dntlmajchld",
        "display" : "Major Dental Care - Child"
      },
      {
        "code" : "dntlbasadlt",
        "display" : "Basic Dental Care - Adult"
      },
      {
        "code" : "orthodadlt",
        "display" : "Orthodontia - Adult"
      },
      {
        "code" : "dntlmajadlt",
        "display" : "Major Dental Care - Adult"
      },
      {
        "code" : "abortion",
        "display" : "Abortion for Which Public Funding is Prohibited"
      },
      {
        "code" : "transplant",
        "display" : "Transplant"
      },
      {
        "code" : "accdntl",
        "display" : "Accidental Dental"
      },
      {
        "code" : "dialysis",
        "display" : "Dialysis"
      },
      {
        "code" : "testallrgy",
        "display" : "Allergy Testing"
      },
      {
        "code" : "chemotherapy",
        "display" : "Chemotherapy"
      },
      {
        "code" : "radiation",
        "display" : "Radiation"
      },
      {
        "code" : "edudiab",
        "display" : "Diabetes Education"
      },
      {
        "code" : "prosthetic",
        "display" : "Prosthetic Devices"
      },
      {
        "code" : "infusiontx",
        "display" : "Infusion Therapy"
      },
      {
        "code" : "tmjtx",
        "display" : "Treatment for Temporomandibular Joint Disorders"
      },
      {
        "code" : "nutrition",
        "display" : "Nutritional Counseling"
      },
      {
        "code" : "reconsurg",
        "display" : "Reconstructive Surgery"
      }]
    }]
  }
}

```
