HCP Health Care Pricing
Opt
AtMax 1
To specify pricing or repricing information about a health care claim or line item
Elements
| Position | Element | Name | Type | Min/Max | Repeat | |
|---|---|---|---|---|---|---|
| 1 | 1473 | Pricing Methodology Code | Rel | ID | 2/2 | AtMax 1 |
| 2 | 782 | Monetary Amount | Opt | Decimal | 1/18 | AtMax 1 |
| 3 | 782 | Monetary Amount | Opt | Decimal | 1/18 | AtMax 1 |
| 4 | 127 | Reference Identification | Opt | Alphanumeric | 1/80 | AtMax 1 |
| 5 | 118 | Rate | Opt | Decimal | 1/9 | AtMax 1 |
| 6 | 127 | Reference Identification | Opt | Alphanumeric | 1/80 | AtMax 1 |
| 7 | 782 | Monetary Amount | Opt | Decimal | 1/18 | AtMax 1 |
| 8 | 234 | Product/Service ID | Opt | Alphanumeric | 1/80 | AtMax 1 |
| 9 | 235 | Product/Service ID Qualifier | Rel | ID | 2/2 | AtMax 1 |
| 10 | 234 | Product/Service ID | Rel | Alphanumeric | 1/80 | AtMax 1 |
| 11 | 355 | Unit or Basis for Measurement Code | Rel | ID | 2/2 | AtMax 1 |
| 12 | 380 | Quantity | Rel | Decimal | 1/15 | AtMax 1 |
| 13 | 901 | Reject Reason Code | Rel | ID | 2/2 | AtMax 1 |
| 14 | 1526 | Policy Compliance Code | Opt | ID | 1/2 | AtMax 1 |
| 15 | 1527 | Exception Code | Opt | ID | 1/2 | AtMax 1 |
Element Details
ID1473
NamePricing Methodology Code
LengthMin 2 / Max 2
Position1
RequirementRel
Codes
- <>07Flat Rate Pricing
- <>13Cost Reimbursed
- <>14Adjustment Pricing
- <>00Zero Pricing (Not Covered Under Contract)
- <>12Ratio of Cost
- <>01Priced as Billed at 100%
- <>04Bundled Pricing
- <>02Priced at the Standard Fee Schedule
- <>05Peer Review Pricing
- <>08Combination Pricing
- <>11Lower of Cost
- <>03Priced at a Contractual Percentage
- <>06Per Diem Pricing
- <>10Other Pricing
- <>09Maternity Pricing