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Packagehl7.fhir.uv.xver-r4b.r4.r4b
Resource TypeCodeSystem
IdCodeSystem-coverage-copay-type.json
FHIR VersionR4B

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Narrative

Note: links and images are rebased to the (stated) source

This code system http://terminology.hl7.org/CodeSystem/coverage-copay-type defines the following codes:

Code Display Definition
gpvisit GP Office Visit An office visit for a general practitioner of a discipline.
spvisit Specialist Office Visit An office visit for a specialist practitioner of a discipline
emergency Emergency An episode in an emergency department.
inpthosp Inpatient Hospital An episode of an Inpatient hospital stay.
televisit Tele-visit A visit held where the patient is remote relative to the practitioner, e.g. by phone, computer or video conference.
urgentcare Urgent Care A visit to an urgent care facility - typically a community care clinic.
copaypct Copay Percentage A standard percentage applied to all classes or service or product not otherwise specified.
copay Copay Amount A standard fixed currency amount applied to all classes or service or product not otherwise specified.
deductible Deductible The accumulated amount of patient payment before the coverage begins to pay for services.
maxoutofpocket Maximum out of pocket The maximum amout of payment for services which a patient, or family, is expected to incur - typically annually.

Source1

{
  "resourceType": "CodeSystem",
  "id": "coverage-copay-type",
  "text": {
    "status": "generated",
    "div": "<!-- snip (see above) -->"
  },
  "extension": [
    {
      "extension": [
        {
          "url": "packageId",
          "valueId": "hl7.fhir.uv.xver-r4b.r4"
        },
        {
          "url": "version",
          "valueString": "0.0.1-snapshot-2"
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/package-source"
    },
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
      "valueCode": "fm"
    }
  ],
  "url": "http://terminology.hl7.org/CodeSystem/coverage-copay-type",
  "version": "4.3.0",
  "name": "CoverageCoPayTypeCodes",
  "title": "Coverage CoPay Type Codes",
  "status": "draft",
  "experimental": false,
  "date": "2025-09-13T16:38:45-04:00",
  "publisher": "Financial Management",
  "contact": [
    {
      "name": "Financial Management",
      "telecom": [
        {
          "system": "url",
          "value": "http://www.hl7.org/Special/committees/fm"
        }
      ]
    }
  ],
  "description": "This codeset includes Coverage Copayment Type codes.",
  "jurisdiction": [
    {
      "coding": [
        {
          "system": "http://unstats.un.org/unsd/methods/m49/m49.htm",
          "code": "001",
          "display": "World"
        }
      ]
    }
  ],
  "copyright": "HL7 Inc.",
  "caseSensitive": true,
  "content": "complete",
  "concept": [
    {
      "code": "gpvisit",
      "display": "GP Office Visit",
      "definition": "An office visit for a general practitioner of a discipline."
    },
    {
      "code": "spvisit",
      "display": "Specialist Office Visit",
      "definition": "An office visit for a specialist practitioner of a discipline"
    },
    {
      "code": "emergency",
      "display": "Emergency",
      "definition": "An episode in an emergency department."
    },
    {
      "code": "inpthosp",
      "display": "Inpatient Hospital",
      "definition": "An episode of an Inpatient hospital stay."
    },
    {
      "code": "televisit",
      "display": "Tele-visit",
      "definition": "A visit held where the patient is remote relative to the practitioner, e.g. by phone, computer or video conference."
    },
    {
      "code": "urgentcare",
      "display": "Urgent Care",
      "definition": "A visit to an urgent care facility - typically a community care clinic."
    },
    {
      "code": "copaypct",
      "display": "Copay Percentage",
      "definition": "A standard percentage applied to all classes or service or product not otherwise specified."
    },
    {
      "code": "copay",
      "display": "Copay Amount",
      "definition": "A standard fixed currency amount applied to all classes or service or product not otherwise specified."
    },
    {
      "code": "deductible",
      "display": "Deductible",
      "definition": "The accumulated amount of patient payment before the coverage begins to pay for services."
    },
    {
      "code": "maxoutofpocket",
      "display": "Maximum out of pocket",
      "definition": "The maximum amout of payment for services which a patient, or family, is expected to incur - typically annually."
    }
  ]
}