Summary of Benefits and Coverage (SBC) FHIR Implementation Guide
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Summary of Benefits and Coverage (SBC) FHIR Implementation Guide, published by SBC FHIR Project. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/jdjkelly/fhir-sbc/ and changes regularly. See the Directory of published versions

Extension: Benefit Limitation Extension

Official URL: http://flexpa.com/fhir/sbc/StructureDefinition/benefit-limitation Version: 0.1.0
Draft as of 2025-11-10 Computable Name: BenefitLimitation

Extension for documenting limitations and exceptions that apply to specific benefits in the SBC

Context of Use

Usage info

Usages:

You can also check for usages in the FHIR IG Statistics

Formal Views of Extension Content

Description of Profiles, Differentials, Snapshots, and how the XML and JSON presentations work.

This structure is derived from Extension

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Extension 0..* Extension Benefit Limitation Extension
... extension 0..0 Extension
... url 1..1 uri "http://flexpa.com/fhir/sbc/StructureDefinition/benefit-limitation"
... value[x] 0..1 string Limitation or Exception

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Extension 0..* Extension Benefit Limitation Extension
... id 0..1 string Unique id for inter-element referencing
... extension 0..0 Extension
Slice: Unordered, Open by value:url
... url 1..1 uri "http://flexpa.com/fhir/sbc/StructureDefinition/benefit-limitation"

doco Documentation for this format

This structure is derived from Extension

Summary

Simple Extension with the type string: Extension for documenting limitations and exceptions that apply to specific benefits in the SBC

Differential View

This structure is derived from Extension

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Extension 0..* Extension Benefit Limitation Extension
... extension 0..0 Extension
... url 1..1 uri "http://flexpa.com/fhir/sbc/StructureDefinition/benefit-limitation"
... value[x] 0..1 string Limitation or Exception

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Extension 0..* Extension Benefit Limitation Extension
... id 0..1 string Unique id for inter-element referencing
... extension 0..0 Extension
Slice: Unordered, Open by value:url
... url 1..1 uri "http://flexpa.com/fhir/sbc/StructureDefinition/benefit-limitation"

doco Documentation for this format

This structure is derived from Extension

Summary

Simple Extension with the type string: Extension for documenting limitations and exceptions that apply to specific benefits in the SBC

 

Other representations of profile: CSV, Excel, Schematron

Constraints

Id Grade Path(s) Description Expression
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()