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

: CMS Marketplace Benefit Name - TTL Representation

Active as of 2026-10-14

Raw ttl | Download


@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

# - resource -------------------------------------------------------------------

<http://hl7.org/fhir/CodeSystem/cms-marketplace-benefit-name> a fhir:CodeSystem ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:Resource.id [ fhir:value "cms-marketplace-benefit-name"] ;
  fhir:DomainResource.text [
     fhir:Narrative.status [ fhir:value "generated" ] ;
     fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: CodeSystem cms-marketplace-benefit-name</b></p><a name=\"cms-marketplace-benefit-name\"> </a><a name=\"hccms-marketplace-benefit-name\"> </a><p>This case-sensitive code system <code>https://haau3.com/fhir/CodeSystem/cms-marketplace-benefit-name</code> provides <b>a fragment</b> that includes following codes:</p><table class=\"codes\"><tr><td style=\"white-space:nowrap\"><b>Code</b></td></tr><tr><td style=\"white-space:nowrap\">Primary Care Visit to Treat an Injury or Illness<a name=\"cms-marketplace-benefit-name-PrimaryCareVisittoTreatanInjuryorIllness\"> </a></td></tr><tr><td style=\"white-space:nowrap\">Specialist Visit<a name=\"cms-marketplace-benefit-name-SpecialistVisit\"> </a></td></tr><tr><td style=\"white-space:nowrap\">Urgent Care Centers or Facilities<a name=\"cms-marketplace-benefit-name-UrgentCareCentersorFacilities\"> </a></td></tr><tr><td style=\"white-space:nowrap\">Emergency Room Services<a name=\"cms-marketplace-benefit-name-EmergencyRoomServices\"> </a></td></tr><tr><td style=\"white-space:nowrap\">Inpatient Hospital Services (e.g., Hospital Stay)<a name=\"cms-marketplace-benefit-name-InpatientHospitalServices.40e.46g.46.44HospitalStay.41\"> </a></td></tr><tr><td style=\"white-space:nowrap\">Outpatient Facility Fee (e.g., Ambulatory Surgery Center)<a name=\"cms-marketplace-benefit-name-OutpatientFacilityFee.40e.46g.46.44AmbulatorySurgeryCenter.41\"> </a></td></tr><tr><td style=\"white-space:nowrap\">Outpatient Surgery Physician/Surgical Services<a name=\"cms-marketplace-benefit-name-OutpatientSurgeryPhysician.47SurgicalServices\"> </a></td></tr><tr><td style=\"white-space:nowrap\">Laboratory Outpatient and Professional Services<a name=\"cms-marketplace-benefit-name-LaboratoryOutpatientandProfessionalServices\"> </a></td></tr><tr><td style=\"white-space:nowrap\">Imaging (CT/PET Scans, MRIs)<a name=\"cms-marketplace-benefit-name-Imaging.40CT.47PETScans.44MRIs.41\"> </a></td></tr><tr><td style=\"white-space:nowrap\">Rehabilitative Occupational and Rehabilitative Physical Therapy<a name=\"cms-marketplace-benefit-name-RehabilitativeOccupationalandRehabilitativePhysicalTherapy\"> </a></td></tr><tr><td style=\"white-space:nowrap\">Mental/Behavioral Health Outpatient Services<a name=\"cms-marketplace-benefit-name-Mental.47BehavioralHealthOutpatientServices\"> </a></td></tr><tr><td style=\"white-space:nowrap\">Emergency Transportation/Ambulance<a name=\"cms-marketplace-benefit-name-EmergencyTransportation.47Ambulance\"> </a></td></tr><tr><td style=\"white-space:nowrap\">Other Practitioner Office Visit (Nurse, Physician Assistant)<a name=\"cms-marketplace-benefit-name-OtherPractitionerOfficeVisit.40Nurse.44PhysicianAssistant.41\"> </a></td></tr><tr><td style=\"white-space:nowrap\">Skilled Nursing Facility<a name=\"cms-marketplace-benefit-name-SkilledNursingFacility\"> </a></td></tr><tr><td style=\"white-space:nowrap\">Home Health Care Services<a name=\"cms-marketplace-benefit-name-HomeHealthCareServices\"> </a></td></tr></table></div>"
  ] ;
  fhir:CodeSystem.url [ fhir:value "https://haau3.com/fhir/CodeSystem/cms-marketplace-benefit-name"] ;
  fhir:CodeSystem.version [ fhir:value "1.0.0"] ;
  fhir:CodeSystem.name [ fhir:value "CmsMarketplaceBenefitNameCS"] ;
  fhir:CodeSystem.title [ fhir:value "CMS Marketplace Benefit Name"] ;
  fhir:CodeSystem.status [ fhir:value "active"] ;
  fhir:CodeSystem.experimental [ fhir:value "false"^^xsd:boolean] ;
  fhir:CodeSystem.date [ fhir:value "2026-10-14T18:01:46+00:00"^^xsd:dateTime] ;
  fhir:CodeSystem.publisher [ fhir:value "haau3"] ;
  fhir:CodeSystem.contact [
     fhir:index 0 ;
     fhir:ContactDetail.name [ fhir:value "haau3" ] ;
     fhir:ContactDetail.telecom [
       fhir:index 0 ;
       fhir:ContactPoint.system [ fhir:value "url" ] ;
       fhir:ContactPoint.value [ fhir:value "https://haau3.com" ]
     ], [
       fhir:index 1 ;
       fhir:ContactPoint.system [ fhir:value "email" ] ;
       fhir:ContactPoint.value [ fhir:value "hello@haau3.com" ]
     ]
  ] ;
  fhir:CodeSystem.description [ fhir:value "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."] ;
  fhir:CodeSystem.jurisdiction [
     fhir:index 0 ;
     fhir:CodeableConcept.coding [
       fhir:index 0 ;
       fhir:Coding.system [ fhir:value "urn:iso:std:iso:3166" ] ;
       fhir:Coding.code [ fhir:value "US" ] ;
       fhir:Coding.display [ fhir:value "United States of America" ]
     ]
  ] ;
  fhir:CodeSystem.copyright [ fhir:value "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."] ;
  fhir:CodeSystem.caseSensitive [ fhir:value "true"^^xsd:boolean] ;
  fhir:CodeSystem.content [ fhir:value "fragment"] ;
  fhir:CodeSystem.concept [
     fhir:index 0 ;
     fhir:CodeSystem.concept.code [ fhir:value "Primary Care Visit to Treat an Injury or Illness" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "Primary Care Visit to Treat an Injury or Illness" ]
  ], [
     fhir:index 1 ;
     fhir:CodeSystem.concept.code [ fhir:value "Specialist Visit" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "Specialist Visit" ]
  ], [
     fhir:index 2 ;
     fhir:CodeSystem.concept.code [ fhir:value "Urgent Care Centers or Facilities" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "Urgent Care Centers or Facilities" ]
  ], [
     fhir:index 3 ;
     fhir:CodeSystem.concept.code [ fhir:value "Emergency Room Services" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "Emergency Room Services" ]
  ], [
     fhir:index 4 ;
     fhir:CodeSystem.concept.code [ fhir:value "Inpatient Hospital Services (e.g., Hospital Stay)" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "Inpatient Hospital Services (e.g., Hospital Stay)" ]
  ], [
     fhir:index 5 ;
     fhir:CodeSystem.concept.code [ fhir:value "Outpatient Facility Fee (e.g., Ambulatory Surgery Center)" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "Outpatient Facility Fee (e.g., Ambulatory Surgery Center)" ]
  ], [
     fhir:index 6 ;
     fhir:CodeSystem.concept.code [ fhir:value "Outpatient Surgery Physician/Surgical Services" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "Outpatient Surgery Physician/Surgical Services" ]
  ], [
     fhir:index 7 ;
     fhir:CodeSystem.concept.code [ fhir:value "Laboratory Outpatient and Professional Services" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "Laboratory Outpatient and Professional Services" ]
  ], [
     fhir:index 8 ;
     fhir:CodeSystem.concept.code [ fhir:value "Imaging (CT/PET Scans, MRIs)" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "Imaging (CT/PET Scans, MRIs)" ]
  ], [
     fhir:index 9 ;
     fhir:CodeSystem.concept.code [ fhir:value "Rehabilitative Occupational and Rehabilitative Physical Therapy" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "Rehabilitative Occupational and Rehabilitative Physical Therapy" ]
  ], [
     fhir:index 10 ;
     fhir:CodeSystem.concept.code [ fhir:value "Mental/Behavioral Health Outpatient Services" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "Mental/Behavioral Health Outpatient Services" ]
  ], [
     fhir:index 11 ;
     fhir:CodeSystem.concept.code [ fhir:value "Emergency Transportation/Ambulance" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "Emergency Transportation/Ambulance" ]
  ], [
     fhir:index 12 ;
     fhir:CodeSystem.concept.code [ fhir:value "Other Practitioner Office Visit (Nurse, Physician Assistant)" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "Other Practitioner Office Visit (Nurse, Physician Assistant)" ]
  ], [
     fhir:index 13 ;
     fhir:CodeSystem.concept.code [ fhir:value "Skilled Nursing Facility" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "Skilled Nursing Facility" ]
  ], [
     fhir:index 14 ;
     fhir:CodeSystem.concept.code [ fhir:value "Home Health Care Services" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "Home Health Care Services" ]
  ] .

# - ontology header ------------------------------------------------------------

<http://hl7.org/fhir/CodeSystem/cms-marketplace-benefit-name.ttl> a owl:Ontology ;
  owl:imports fhir:fhir.ttl ;
  owl:versionIRI <http://build.fhir.org/CodeSystem/cms-marketplace-benefit-name.ttl> .