Summary of Benefits and Coverage (SBC) FHIR Implementation Guide
0.1.0 - ci-build
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
| Official URL: http://flexpa.com/fhir/sbc/ValueSet/sbc-benefit-category | Version: 0.1.0 | |||
| Draft as of 2025-11-10 | Computable Name: SBCBenefitCategory | |||
Value set containing all 27 benefit categories required in Summary of Benefits and Coverage (SBC) documents
References
http://flexpa.com/fhir/sbc/CodeSystem/sbc-benefit-category version 📦0.1.0
Expansion performed internally based on codesystem SBC Benefit Category Code System v0.1.0 (CodeSystem)
This value set contains 29 concepts
| System | Code | Display (en) | JSON | XML |
http://flexpa.com/fhir/sbc/CodeSystem/sbc-benefit-category | preventive-care | Preventive Care/Screening/Immunization | ||
http://flexpa.com/fhir/sbc/CodeSystem/sbc-benefit-category | primary-care-visit | Primary Care Visit | ||
http://flexpa.com/fhir/sbc/CodeSystem/sbc-benefit-category | specialist-visit | Specialist Visit | ||
http://flexpa.com/fhir/sbc/CodeSystem/sbc-benefit-category | diagnostic-test | Diagnostic Test | ||
http://flexpa.com/fhir/sbc/CodeSystem/sbc-benefit-category | imaging | Imaging (CT/PET/MRI) | ||
http://flexpa.com/fhir/sbc/CodeSystem/sbc-benefit-category | generic-drugs | Generic Drugs | ||
http://flexpa.com/fhir/sbc/CodeSystem/sbc-benefit-category | preferred-brand-drugs | Preferred Brand Drugs | ||
http://flexpa.com/fhir/sbc/CodeSystem/sbc-benefit-category | non-preferred-brand-drugs | Non-Preferred Brand Drugs | ||
http://flexpa.com/fhir/sbc/CodeSystem/sbc-benefit-category | specialty-drugs | Specialty Drugs | ||
http://flexpa.com/fhir/sbc/CodeSystem/sbc-benefit-category | facility-fee | Facility Fee | ||
http://flexpa.com/fhir/sbc/CodeSystem/sbc-benefit-category | physician-surgeon-fee | Physician/Surgeon Fees | ||
http://flexpa.com/fhir/sbc/CodeSystem/sbc-benefit-category | emergency-room-care | Emergency Room Care | ||
http://flexpa.com/fhir/sbc/CodeSystem/sbc-benefit-category | emergency-medical-transport | Emergency Medical Transportation | ||
http://flexpa.com/fhir/sbc/CodeSystem/sbc-benefit-category | urgent-care | Urgent Care | ||
http://flexpa.com/fhir/sbc/CodeSystem/sbc-benefit-category | hospital-outpatient | Hospital Outpatient Care | ||
http://flexpa.com/fhir/sbc/CodeSystem/sbc-benefit-category | hospital-inpatient | Hospital Inpatient Care | ||
http://flexpa.com/fhir/sbc/CodeSystem/sbc-benefit-category | mental-health-outpatient | Mental/Behavioral Health Outpatient Services | ||
http://flexpa.com/fhir/sbc/CodeSystem/sbc-benefit-category | mental-health-inpatient | Mental/Behavioral Health Inpatient Services | ||
http://flexpa.com/fhir/sbc/CodeSystem/sbc-benefit-category | pregnancy | Pregnancy Services | ||
http://flexpa.com/fhir/sbc/CodeSystem/sbc-benefit-category | pregnancy-delivery | Childbirth/Delivery Professional Services | ||
http://flexpa.com/fhir/sbc/CodeSystem/sbc-benefit-category | pregnancy-home-health | Pregnancy Home Health Care | ||
http://flexpa.com/fhir/sbc/CodeSystem/sbc-benefit-category | rehabilitation | Rehabilitation Services | ||
http://flexpa.com/fhir/sbc/CodeSystem/sbc-benefit-category | habilitation | Habilitation Services | ||
http://flexpa.com/fhir/sbc/CodeSystem/sbc-benefit-category | skilled-nursing | Skilled Nursing Care | ||
http://flexpa.com/fhir/sbc/CodeSystem/sbc-benefit-category | durable-medical-equipment | Durable Medical Equipment | ||
http://flexpa.com/fhir/sbc/CodeSystem/sbc-benefit-category | hospice | Hospice Services | ||
http://flexpa.com/fhir/sbc/CodeSystem/sbc-benefit-category | children-eye-exam | Children's Eye Exam | ||
http://flexpa.com/fhir/sbc/CodeSystem/sbc-benefit-category | children-glasses | Children's Glasses | ||
http://flexpa.com/fhir/sbc/CodeSystem/sbc-benefit-category | children-dental | Children's Dental Check-up |
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 |