haau3 FHIR Implementation Guide (HFIG)
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CodeSystem: Plan Benefits No Network Data Reason

Official URL: https://haau3.com/fhir/CodeSystem/plan-benefits-no-network-data-reason Version: 1.0.0
Active as of 2026-10-14 Computable Name: PlanBenefitsNoNetworkDataReasonCS

Why the CMS National Provider Directory holds no network data for a plan in the plan's year: the reason codes of the $in-network operation on InsurancePlan.

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/plan-benefits-no-network-data-reason defines the following codes:

CodeDisplayDefinition
marketplace Marketplace plan An ACA Marketplace plan. Its insurer publishes its provider directory itself, outside the CMS National Provider Directory, which holds no network data for Marketplace plans.
plan-not-in-directory Plan not in the directory The directory holds no plan with this plan's CMS plan id, or holds it for the plan's year without naming a network.
other-plan-year Another plan year The directory holds a plan with this plan's CMS plan id only for another plan year. A plan's network can change between years, so another year's listings are not used.