Release 4 FHIR CI-Build

This page is part of the Continuous Integration Build of FHIR Specification (v4.0.1: R4 - Mixed Normative and STU ) in it's permanent home (it will always (will be available incorrect/inconsistent at this URL). The current version which supercedes this version is 5.0.0 . For a full list of available versions, see times).
See the Directory of published versions icon . Page versions: R5 R4B R4

Using Codes Code Systems Value Sets Concept Maps Identifier Systems

4.4.1.103 4.4.1.122 Value Set ValueSet http://hl7.org/fhir/ValueSet/insuranceplan-applicability

  Maturity Level : 0
Responsible Owner: Patient Administration icon Work Group Trial Use Use Context : Any Country: World
This is a value set defined by the FHIR project. Summary
  • Defining URL: Narrative http://hl7.org/fhir/ValueSet/insuranceplan-applicability
  • XML Version:
  • 4.0.1 JSON
  • Name: TTL BenefitCostApplicability
Committee:
Official URL : Title: http://hl7.org/fhir/ValueSet/insuranceplan-applicability Benefit cost applicability Definition: Whether the cost applies to in-network or out-of-network providers. Version : 6.0.0-ballot3
draft as of 2018-06-05 Patient Administration Computable Name : BenefitCostApplicability Work Group
OID: Flags : Immutable 2.16.840.1.113883.4.642.3.0 (for OID based terminology systems) Source Resource XML / JSON : 2.16.840.1.113883.4.642.3.0

This value set is used in the following places:

4.4.1.103.1 4.4.1.122.1 Definition

Whether the cost applies to in-network or out-of-network providers.

4.4.1.122.2 Content Logical Definition

This value set includes codes from the following code systems:

Generated Narrative: ValueSet insuranceplan-applicability

Last updated: 2025-11-10T15:17:08.817Z

 

4.4.1.103.2 4.4.1.122.3 Expansion

This expansion generated 01 10 Nov 2019 2025

ValueSet This value set contains 3 concepts

Expansion performed internally based on http://terminology.hl7.org/CodeSystem/applicability version 4.0.1 All codes from system http://terminology.hl7.org/CodeSystem/applicability codesystem Benefit cost applicability v1.0.1 (CodeSystem) icon

This value set contains 3 concepts

System Code Display Definition
http://terminology.hl7.org/CodeSystem/applicability    in-network icon In Network Provider is contracted with the health insurance company to provide services to plan members for specific pre-negotiated rates
http://terminology.hl7.org/CodeSystem/applicability    out-of-network icon Out of Network Provider is not contracted with the health insurance company to provide services to plan members for specific pre-negotiated rates
http://terminology.hl7.org/CodeSystem/applicability    other icon Other Other applicability

 

See the full registry of value sets defined as part of FHIR.

Explanation of the columns that may appear on this page:

Lvl A few code lists that FHIR defines are hierarchical - each code is assigned a level. For value sets, levels are mostly used to organize codes for user convenience, but may follow code system hierarchy - see Code System for further information
Source 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). If the code is in italics, this indicates that the code is not selectable ('Abstract')
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