haau3 FHIR Implementation Guide (HFIG)
1.0.0 - ci-build
haau3 FHIR Implementation Guide (HFIG)
1.0.0 - ci-build
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
| Active as of 2026-10-14 |
{
"resourceType" : "CodeSystem",
"id" : "cms-pbp-service-category",
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: CodeSystem cms-pbp-service-category</b></p><a name=\"cms-pbp-service-category\"> </a><a name=\"hccms-pbp-service-category\"> </a><p>This case-sensitive code system <code>https://haau3.com/fhir/CodeSystem/cms-pbp-service-category</code> provides <b>a fragment</b> that includes following codes:</p><table class=\"codes\"><tr><td style=\"white-space:nowrap\"><b>Code</b></td><td><b>Display</b></td></tr><tr><td style=\"white-space:nowrap\">1a<a name=\"cms-pbp-service-category-1a\"> </a></td><td>Inpatient Hospital-Acute</td></tr><tr><td style=\"white-space:nowrap\">1b<a name=\"cms-pbp-service-category-1b\"> </a></td><td>Inpatient Hospital Psychiatric</td></tr><tr><td style=\"white-space:nowrap\">2<a name=\"cms-pbp-service-category-2\"> </a></td><td>Skilled Nursing Facility (SNF)</td></tr><tr><td style=\"white-space:nowrap\">3-1<a name=\"cms-pbp-service-category-3-1\"> </a></td><td>Cardiac Rehabilitation Services</td></tr><tr><td style=\"white-space:nowrap\">3-2<a name=\"cms-pbp-service-category-3-2\"> </a></td><td>Intensive Cardiac Rehabilitation Services</td></tr><tr><td style=\"white-space:nowrap\">3-3<a name=\"cms-pbp-service-category-3-3\"> </a></td><td>Pulmonary Rehabilitation Services</td></tr><tr><td style=\"white-space:nowrap\">3-4<a name=\"cms-pbp-service-category-3-4\"> </a></td><td>SET for PAD Services</td></tr><tr><td style=\"white-space:nowrap\">4a<a name=\"cms-pbp-service-category-4a\"> </a></td><td>Emergency Services</td></tr><tr><td style=\"white-space:nowrap\">4b<a name=\"cms-pbp-service-category-4b\"> </a></td><td>Urgently Needed Services</td></tr><tr><td style=\"white-space:nowrap\">5a<a name=\"cms-pbp-service-category-5a\"> </a></td><td>Partial Hospitalization Program</td></tr><tr><td style=\"white-space:nowrap\">5b<a name=\"cms-pbp-service-category-5b\"> </a></td><td>Intensive Outpatient Program Services</td></tr><tr><td style=\"white-space:nowrap\">6<a name=\"cms-pbp-service-category-6\"> </a></td><td>Home Health Services</td></tr><tr><td style=\"white-space:nowrap\">7a<a name=\"cms-pbp-service-category-7a\"> </a></td><td>Primary Care Physician Services</td></tr><tr><td style=\"white-space:nowrap\">7b<a name=\"cms-pbp-service-category-7b\"> </a></td><td>Chiropractic Services</td></tr><tr><td style=\"white-space:nowrap\">7c<a name=\"cms-pbp-service-category-7c\"> </a></td><td>Occupational Therapy Services</td></tr><tr><td style=\"white-space:nowrap\">7d<a name=\"cms-pbp-service-category-7d\"> </a></td><td>Physician Specialist Services</td></tr><tr><td style=\"white-space:nowrap\">7e1<a name=\"cms-pbp-service-category-7e1\"> </a></td><td>Individual Sessions for Mental Health Specialty Services</td></tr><tr><td style=\"white-space:nowrap\">7e2<a name=\"cms-pbp-service-category-7e2\"> </a></td><td>Group Sessions for Mental Health Specialty Services</td></tr><tr><td style=\"white-space:nowrap\">7f<a name=\"cms-pbp-service-category-7f\"> </a></td><td>Podiatry Services</td></tr><tr><td style=\"white-space:nowrap\">7g<a name=\"cms-pbp-service-category-7g\"> </a></td><td>Other Health Care Professional</td></tr><tr><td style=\"white-space:nowrap\">7h1<a name=\"cms-pbp-service-category-7h1\"> </a></td><td>Individual Sessions for Psychiatric Services</td></tr><tr><td style=\"white-space:nowrap\">7h2<a name=\"cms-pbp-service-category-7h2\"> </a></td><td>Group Sessions for Psychiatric Services</td></tr><tr><td style=\"white-space:nowrap\">7i<a name=\"cms-pbp-service-category-7i\"> </a></td><td>Physical Therapy and Speech-Language Pathology Services</td></tr><tr><td style=\"white-space:nowrap\">7j<a name=\"cms-pbp-service-category-7j\"> </a></td><td>Additional Telehealth Benefits</td></tr><tr><td style=\"white-space:nowrap\">7k<a name=\"cms-pbp-service-category-7k\"> </a></td><td>Opioid Treatment Program Services</td></tr><tr><td style=\"white-space:nowrap\">8a1<a name=\"cms-pbp-service-category-8a1\"> </a></td><td>Diagnostic Procedures/Tests</td></tr><tr><td style=\"white-space:nowrap\">8a2<a name=\"cms-pbp-service-category-8a2\"> </a></td><td>Lab Services</td></tr><tr><td style=\"white-space:nowrap\">8b1<a name=\"cms-pbp-service-category-8b1\"> </a></td><td>Diagnostic Radiological Services</td></tr><tr><td style=\"white-space:nowrap\">8b2<a name=\"cms-pbp-service-category-8b2\"> </a></td><td>Therapeutic Radiological Services</td></tr><tr><td style=\"white-space:nowrap\">8b3<a name=\"cms-pbp-service-category-8b3\"> </a></td><td>Outpatient X-Ray Services</td></tr><tr><td style=\"white-space:nowrap\">9a1<a name=\"cms-pbp-service-category-9a1\"> </a></td><td>Outpatient Hospital Services</td></tr><tr><td style=\"white-space:nowrap\">9a2<a name=\"cms-pbp-service-category-9a2\"> </a></td><td>Observation Services</td></tr><tr><td style=\"white-space:nowrap\">9b<a name=\"cms-pbp-service-category-9b\"> </a></td><td>Ambulatory Surgical Center (ASC) Services</td></tr><tr><td style=\"white-space:nowrap\">9c1<a name=\"cms-pbp-service-category-9c1\"> </a></td><td>Individual Sessions for Outpatient Substance Abuse</td></tr><tr><td style=\"white-space:nowrap\">9c2<a name=\"cms-pbp-service-category-9c2\"> </a></td><td>Group Sessions for Outpatient Substance Abuse</td></tr><tr><td style=\"white-space:nowrap\">9d<a name=\"cms-pbp-service-category-9d\"> </a></td><td>Outpatient Blood Services</td></tr><tr><td style=\"white-space:nowrap\">10a1<a name=\"cms-pbp-service-category-10a1\"> </a></td><td>Ground Ambulance Services</td></tr><tr><td style=\"white-space:nowrap\">10a2<a name=\"cms-pbp-service-category-10a2\"> </a></td><td>Air Ambulance Services</td></tr><tr><td style=\"white-space:nowrap\">11a<a name=\"cms-pbp-service-category-11a\"> </a></td><td>Durable Medical Equipment (DME)</td></tr><tr><td style=\"white-space:nowrap\">11b1<a name=\"cms-pbp-service-category-11b1\"> </a></td><td>Prosthetic Devices</td></tr><tr><td style=\"white-space:nowrap\">11b2<a name=\"cms-pbp-service-category-11b2\"> </a></td><td>Medical Supplies</td></tr><tr><td style=\"white-space:nowrap\">11c1<a name=\"cms-pbp-service-category-11c1\"> </a></td><td>Diabetic Supplies</td></tr><tr><td style=\"white-space:nowrap\">11c2<a name=\"cms-pbp-service-category-11c2\"> </a></td><td>Diabetic Therapeutic Shoes/Inserts</td></tr><tr><td style=\"white-space:nowrap\">11c3<a name=\"cms-pbp-service-category-11c3\"> </a></td><td>Diabetic Monitors</td></tr><tr><td style=\"white-space:nowrap\">12<a name=\"cms-pbp-service-category-12\"> </a></td><td>Dialysis Services</td></tr><tr><td style=\"white-space:nowrap\">14a<a name=\"cms-pbp-service-category-14a\"> </a></td><td>Medicare-covered Zero Dollar Preventive Services</td></tr><tr><td style=\"white-space:nowrap\">14d<a name=\"cms-pbp-service-category-14d\"> </a></td><td>Kidney Disease Education Services</td></tr><tr><td style=\"white-space:nowrap\">14e1<a name=\"cms-pbp-service-category-14e1\"> </a></td><td>Glaucoma Screening</td></tr><tr><td style=\"white-space:nowrap\">14e2<a name=\"cms-pbp-service-category-14e2\"> </a></td><td>Diabetes Self-Management Training</td></tr><tr><td style=\"white-space:nowrap\">14e4<a name=\"cms-pbp-service-category-14e4\"> </a></td><td>Digital Rectal Exams</td></tr><tr><td style=\"white-space:nowrap\">14e5<a name=\"cms-pbp-service-category-14e5\"> </a></td><td>EKG following Welcome Visit</td></tr><tr><td style=\"white-space:nowrap\">15-1-I<a name=\"cms-pbp-service-category-15-1-I\"> </a></td><td>Medicare Part B Insulin Drugs</td></tr><tr><td style=\"white-space:nowrap\">15-2<a name=\"cms-pbp-service-category-15-2\"> </a></td><td>Medicare Part B Chemotherapy/Radiation Drugs</td></tr><tr><td style=\"white-space:nowrap\">15-3<a name=\"cms-pbp-service-category-15-3\"> </a></td><td>Other Medicare Part B Drugs</td></tr><tr><td style=\"white-space:nowrap\">16a<a name=\"cms-pbp-service-category-16a\"> </a></td><td>Medicare Dental Services</td></tr><tr><td style=\"white-space:nowrap\">17a<a name=\"cms-pbp-service-category-17a\"> </a></td><td>Eye Exams</td></tr><tr><td style=\"white-space:nowrap\">17b<a name=\"cms-pbp-service-category-17b\"> </a></td><td>Eyewear</td></tr><tr><td style=\"white-space:nowrap\">18a<a name=\"cms-pbp-service-category-18a\"> </a></td><td>Hearing Exams</td></tr><tr><td style=\"white-space:nowrap\">20<a name=\"cms-pbp-service-category-20\"> </a></td><td>Prescription Drugs (Cost Plans Only)</td></tr></table></div>"
},
"url" : "https://haau3.com/fhir/CodeSystem/cms-pbp-service-category",
"version" : "1.0.0",
"name" : "CmsPbpServiceCategoryCS",
"title" : "CMS PBP Service Category",
"status" : "active",
"experimental" : false,
"date" : "2026-10-14T18:01:46+00:00",
"publisher" : "haau3",
"contact" : [
{
"name" : "haau3",
"telecom" : [
{
"system" : "url",
"value" : "https://haau3.com"
},
{
"system" : "email",
"value" : "hello@haau3.com"
}
]
}
],
"description" : "The Medicare-covered service categories of CMS's Plan Benefit Package (PBP) Benefits 2027 files, with their codes and labels as CMS's data dictionary gives them. A Medicare Advantage benefit in Plan Benefits carries one of these beside its SBC benefit category, as the fixed reference to CMS's files. CMS publishes no code system for them; haau3 hosts them, verbatim, until CMS or the SBC guide does. The supplemental categories are not yet included.",
"jurisdiction" : [
{
"coding" : [
{
"system" : "urn:iso:std:iso:3166",
"code" : "US",
"display" : "United States of America"
}
]
}
],
"copyright" : "Codes and labels from the Plan Benefit Package (PBP) Benefits 2027 data dictionary (PBP_Benefits_2027_dictionary.xlsx, in https://www.cms.gov/files/zip/pbp-benefits-2027.zip), published by the Centers for Medicare & Medicaid Services, a work of the U.S. Government. Each label is the dictionary's own with its leading code removed. CMS does not endorse haau3 or this guide.",
"caseSensitive" : true,
"content" : "fragment",
"concept" : [
{
"code" : "1a",
"display" : "Inpatient Hospital-Acute"
},
{
"code" : "1b",
"display" : "Inpatient Hospital Psychiatric"
},
{
"code" : "2",
"display" : "Skilled Nursing Facility (SNF)"
},
{
"code" : "3-1",
"display" : "Cardiac Rehabilitation Services"
},
{
"code" : "3-2",
"display" : "Intensive Cardiac Rehabilitation Services"
},
{
"code" : "3-3",
"display" : "Pulmonary Rehabilitation Services"
},
{
"code" : "3-4",
"display" : "SET for PAD Services"
},
{
"code" : "4a",
"display" : "Emergency Services"
},
{
"code" : "4b",
"display" : "Urgently Needed Services"
},
{
"code" : "5a",
"display" : "Partial Hospitalization Program"
},
{
"code" : "5b",
"display" : "Intensive Outpatient Program Services"
},
{
"code" : "6",
"display" : "Home Health Services"
},
{
"code" : "7a",
"display" : "Primary Care Physician Services"
},
{
"code" : "7b",
"display" : "Chiropractic Services"
},
{
"code" : "7c",
"display" : "Occupational Therapy Services"
},
{
"code" : "7d",
"display" : "Physician Specialist Services"
},
{
"code" : "7e1",
"display" : "Individual Sessions for Mental Health Specialty Services"
},
{
"code" : "7e2",
"display" : "Group Sessions for Mental Health Specialty Services"
},
{
"code" : "7f",
"display" : "Podiatry Services"
},
{
"code" : "7g",
"display" : "Other Health Care Professional"
},
{
"code" : "7h1",
"display" : "Individual Sessions for Psychiatric Services"
},
{
"code" : "7h2",
"display" : "Group Sessions for Psychiatric Services"
},
{
"code" : "7i",
"display" : "Physical Therapy and Speech-Language Pathology Services"
},
{
"code" : "7j",
"display" : "Additional Telehealth Benefits"
},
{
"code" : "7k",
"display" : "Opioid Treatment Program Services"
},
{
"code" : "8a1",
"display" : "Diagnostic Procedures/Tests"
},
{
"code" : "8a2",
"display" : "Lab Services"
},
{
"code" : "8b1",
"display" : "Diagnostic Radiological Services"
},
{
"code" : "8b2",
"display" : "Therapeutic Radiological Services"
},
{
"code" : "8b3",
"display" : "Outpatient X-Ray Services"
},
{
"code" : "9a1",
"display" : "Outpatient Hospital Services"
},
{
"code" : "9a2",
"display" : "Observation Services"
},
{
"code" : "9b",
"display" : "Ambulatory Surgical Center (ASC) Services"
},
{
"code" : "9c1",
"display" : "Individual Sessions for Outpatient Substance Abuse"
},
{
"code" : "9c2",
"display" : "Group Sessions for Outpatient Substance Abuse"
},
{
"code" : "9d",
"display" : "Outpatient Blood Services"
},
{
"code" : "10a1",
"display" : "Ground Ambulance Services"
},
{
"code" : "10a2",
"display" : "Air Ambulance Services"
},
{
"code" : "11a",
"display" : "Durable Medical Equipment (DME)"
},
{
"code" : "11b1",
"display" : "Prosthetic Devices"
},
{
"code" : "11b2",
"display" : "Medical Supplies"
},
{
"code" : "11c1",
"display" : "Diabetic Supplies"
},
{
"code" : "11c2",
"display" : "Diabetic Therapeutic Shoes/Inserts"
},
{
"code" : "11c3",
"display" : "Diabetic Monitors"
},
{
"code" : "12",
"display" : "Dialysis Services"
},
{
"code" : "14a",
"display" : "Medicare-covered Zero Dollar Preventive Services"
},
{
"code" : "14d",
"display" : "Kidney Disease Education Services"
},
{
"code" : "14e1",
"display" : "Glaucoma Screening"
},
{
"code" : "14e2",
"display" : "Diabetes Self-Management Training"
},
{
"code" : "14e4",
"display" : "Digital Rectal Exams"
},
{
"code" : "14e5",
"display" : "EKG following Welcome Visit"
},
{
"code" : "15-1-I",
"display" : "Medicare Part B Insulin Drugs"
},
{
"code" : "15-2",
"display" : "Medicare Part B Chemotherapy/Radiation Drugs"
},
{
"code" : "15-3",
"display" : "Other Medicare Part B Drugs"
},
{
"code" : "16a",
"display" : "Medicare Dental Services"
},
{
"code" : "17a",
"display" : "Eye Exams"
},
{
"code" : "17b",
"display" : "Eyewear"
},
{
"code" : "18a",
"display" : "Hearing Exams"
},
{
"code" : "20",
"display" : "Prescription Drugs (Cost Plans Only)"
}
]
}