<?xml version="1.0" encoding="UTF-8"?>

<CodeSystem xmlns="http://hl7.org/fhir">
  <id value="cms-pbp-service-category"/>
  <text>
    <status value="generated"/><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>
  </text>
  <url value="https://haau3.com/fhir/CodeSystem/cms-pbp-service-category"/>
  <version value="1.0.0"/>
  <name value="CmsPbpServiceCategoryCS"/>
  <title value="CMS PBP Service Category"/>
  <status value="active"/>
  <experimental value="false"/>
  <date value="2026-10-14T18:01:46+00:00"/>
  <publisher value="haau3"/>
  <contact>
    <name value="haau3"/>
    <telecom>
      <system value="url"/>
      <value value="https://haau3.com"/>
    </telecom>
    <telecom>
      <system value="email"/>
      <value value="hello@haau3.com"/>
    </telecom>
  </contact>
  <description value="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 value="urn:iso:std:iso:3166"/>
      <code value="US"/>
      <display value="United States of America"/>
    </coding>
  </jurisdiction>
  <copyright value="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 &amp; 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 value="true"/>
  <content value="fragment"/>
  <concept>
    <code value="1a"/>
    <display value="Inpatient Hospital-Acute"/>
  </concept>
  <concept>
    <code value="1b"/>
    <display value="Inpatient Hospital Psychiatric"/>
  </concept>
  <concept>
    <code value="2"/>
    <display value="Skilled Nursing Facility (SNF)"/>
  </concept>
  <concept>
    <code value="3-1"/>
    <display value="Cardiac Rehabilitation Services"/>
  </concept>
  <concept>
    <code value="3-2"/>
    <display value="Intensive Cardiac Rehabilitation Services"/>
  </concept>
  <concept>
    <code value="3-3"/>
    <display value="Pulmonary Rehabilitation Services"/>
  </concept>
  <concept>
    <code value="3-4"/>
    <display value="SET for PAD Services"/>
  </concept>
  <concept>
    <code value="4a"/>
    <display value="Emergency Services"/>
  </concept>
  <concept>
    <code value="4b"/>
    <display value="Urgently Needed Services"/>
  </concept>
  <concept>
    <code value="5a"/>
    <display value="Partial Hospitalization Program"/>
  </concept>
  <concept>
    <code value="5b"/>
    <display value="Intensive Outpatient Program Services"/>
  </concept>
  <concept>
    <code value="6"/>
    <display value="Home Health Services"/>
  </concept>
  <concept>
    <code value="7a"/>
    <display value="Primary Care Physician Services"/>
  </concept>
  <concept>
    <code value="7b"/>
    <display value="Chiropractic Services"/>
  </concept>
  <concept>
    <code value="7c"/>
    <display value="Occupational Therapy Services"/>
  </concept>
  <concept>
    <code value="7d"/>
    <display value="Physician Specialist Services"/>
  </concept>
  <concept>
    <code value="7e1"/>
    <display value="Individual Sessions for Mental Health Specialty Services"/>
  </concept>
  <concept>
    <code value="7e2"/>
    <display value="Group Sessions for Mental Health Specialty Services"/>
  </concept>
  <concept>
    <code value="7f"/>
    <display value="Podiatry Services"/>
  </concept>
  <concept>
    <code value="7g"/>
    <display value="Other Health Care Professional"/>
  </concept>
  <concept>
    <code value="7h1"/>
    <display value="Individual Sessions for Psychiatric Services"/>
  </concept>
  <concept>
    <code value="7h2"/>
    <display value="Group Sessions for Psychiatric Services"/>
  </concept>
  <concept>
    <code value="7i"/>
    <display value="Physical Therapy and Speech-Language Pathology Services"/>
  </concept>
  <concept>
    <code value="7j"/>
    <display value="Additional Telehealth Benefits"/>
  </concept>
  <concept>
    <code value="7k"/>
    <display value="Opioid Treatment Program Services"/>
  </concept>
  <concept>
    <code value="8a1"/>
    <display value="Diagnostic Procedures/Tests"/>
  </concept>
  <concept>
    <code value="8a2"/>
    <display value="Lab Services"/>
  </concept>
  <concept>
    <code value="8b1"/>
    <display value="Diagnostic Radiological Services"/>
  </concept>
  <concept>
    <code value="8b2"/>
    <display value="Therapeutic Radiological Services"/>
  </concept>
  <concept>
    <code value="8b3"/>
    <display value="Outpatient X-Ray Services"/>
  </concept>
  <concept>
    <code value="9a1"/>
    <display value="Outpatient Hospital Services"/>
  </concept>
  <concept>
    <code value="9a2"/>
    <display value="Observation Services"/>
  </concept>
  <concept>
    <code value="9b"/>
    <display value="Ambulatory Surgical Center (ASC) Services"/>
  </concept>
  <concept>
    <code value="9c1"/>
    <display value="Individual Sessions for Outpatient Substance Abuse"/>
  </concept>
  <concept>
    <code value="9c2"/>
    <display value="Group Sessions for Outpatient Substance Abuse"/>
  </concept>
  <concept>
    <code value="9d"/>
    <display value="Outpatient Blood Services"/>
  </concept>
  <concept>
    <code value="10a1"/>
    <display value="Ground Ambulance Services"/>
  </concept>
  <concept>
    <code value="10a2"/>
    <display value="Air Ambulance Services"/>
  </concept>
  <concept>
    <code value="11a"/>
    <display value="Durable Medical Equipment (DME)"/>
  </concept>
  <concept>
    <code value="11b1"/>
    <display value="Prosthetic Devices"/>
  </concept>
  <concept>
    <code value="11b2"/>
    <display value="Medical Supplies"/>
  </concept>
  <concept>
    <code value="11c1"/>
    <display value="Diabetic Supplies"/>
  </concept>
  <concept>
    <code value="11c2"/>
    <display value="Diabetic Therapeutic Shoes/Inserts"/>
  </concept>
  <concept>
    <code value="11c3"/>
    <display value="Diabetic Monitors"/>
  </concept>
  <concept>
    <code value="12"/>
    <display value="Dialysis Services"/>
  </concept>
  <concept>
    <code value="14a"/>
    <display value="Medicare-covered Zero Dollar Preventive Services"/>
  </concept>
  <concept>
    <code value="14d"/>
    <display value="Kidney Disease Education Services"/>
  </concept>
  <concept>
    <code value="14e1"/>
    <display value="Glaucoma Screening"/>
  </concept>
  <concept>
    <code value="14e2"/>
    <display value="Diabetes Self-Management Training"/>
  </concept>
  <concept>
    <code value="14e4"/>
    <display value="Digital Rectal Exams"/>
  </concept>
  <concept>
    <code value="14e5"/>
    <display value="EKG following Welcome Visit"/>
  </concept>
  <concept>
    <code value="15-1-I"/>
    <display value="Medicare Part B Insulin Drugs"/>
  </concept>
  <concept>
    <code value="15-2"/>
    <display value="Medicare Part B Chemotherapy/Radiation Drugs"/>
  </concept>
  <concept>
    <code value="15-3"/>
    <display value="Other Medicare Part B Drugs"/>
  </concept>
  <concept>
    <code value="16a"/>
    <display value="Medicare Dental Services"/>
  </concept>
  <concept>
    <code value="17a"/>
    <display value="Eye Exams"/>
  </concept>
  <concept>
    <code value="17b"/>
    <display value="Eyewear"/>
  </concept>
  <concept>
    <code value="18a"/>
    <display value="Hearing Exams"/>
  </concept>
  <concept>
    <code value="20"/>
    <display value="Prescription Drugs (Cost Plans Only)"/>
  </concept>
</CodeSystem>