haau3 FHIR Implementation Guide (HFIG)
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haau3 FHIR Implementation Guide (HFIG) - Local Development build (v1.0.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

CodeSystem: CMS Marketplace Benefit Name

Official URL: https://haau3.com/fhir/CodeSystem/cms-marketplace-benefit-name Version: 1.0.0
Active as of 2026-10-14 Computable Name: CmsMarketplaceBenefitNameCS

Copyright/Legal: Centers for Medicare & Medicaid Services. (2025). 2026 Health Insurance Exchange Public Use Files (Benefits and Cost Sharing PUF) [Data file and code book]. Retrieved from http://www.cms.gov/CCIIO/Resources/Data-Resources/marketplace-puf.html. Benefit names reproduced verbatim. CMS does not endorse haau3 or this guide.

The benefit names (BenefitName) of CMS's 2026 Health Insurance Exchange Benefits and Cost Sharing public use file for the services Plan Benefits serves. Each code is the name exactly as the file writes it. An ACA Marketplace benefit in Plan Benefits carries one of these beside its SBC benefit category, as the fixed reference to CMS's file. CMS publishes no code system for them; haau3 hosts them, verbatim, until CMS or the SBC guide does.

This Code system is referenced in the content logical definition of the following value sets:

This case-sensitive code system https://haau3.com/fhir/CodeSystem/cms-marketplace-benefit-name provides a fragment that includes following codes:

Code
Primary Care Visit to Treat an Injury or Illness
Specialist Visit
Urgent Care Centers or Facilities
Emergency Room Services
Inpatient Hospital Services (e.g., Hospital Stay)
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)
Outpatient Surgery Physician/Surgical Services
Laboratory Outpatient and Professional Services
Imaging (CT/PET Scans, MRIs)
Rehabilitative Occupational and Rehabilitative Physical Therapy
Mental/Behavioral Health Outpatient Services
Emergency Transportation/Ambulance
Other Practitioner Office Visit (Nurse, Physician Assistant)
Skilled Nursing Facility
Home Health Care Services