Medical Management Type

active

URL

http://terminology.hl7.org/ValueSet/medical-management-type

Version

1.0.0

PublisherHealth Level Seven InternationalDate2025-05-26T00:00:00+00:00Description

This value set includes types of medical management requirements or processes used by health insurers (payers) that may impact whether a service or item is covered or reimbursement rates.

Expansion

Code	Display	System
concurrent-review	Concurrent Review	http://terminology.hl7.org/CodeSystem/medical-management-type
prior-auth	Prior Authorization	http://terminology.hl7.org/CodeSystem/medical-management-type
step-therapy	Step Therapy (Fail First)	http://terminology.hl7.org/CodeSystem/medical-management-type

{
  "description" : "This value set includes types of medical management requirements or processes used by health insurers (payers) that may impact whether a service or item is covered or reimbursement rates.",
  "compose" : {
    "exclude" : [ ],
    "include" : [ {
      "system" : "http://terminology.hl7.org/CodeSystem/medical-management-type"
    } ]
  },
  "date" : "2025-05-26T00:00:00+00:00",
  "meta" : {
    "lastUpdated" : "2025-05-26T00:00:00+00:00",
    "profile" : [ "http://hl7.org/fhir/StructureDefinition/shareablevalueset" ]
  },
  "publisher" : "Health Level Seven International",
  "name" : "MedicalManagementType",
  "copyright" : "This material derives from the HL7 Terminology THO. THO is copyright ©1989+ Health Level Seven International and is made available under the CC0 designation. For more licensing information see: https://terminology.hl7.org/license.html",
  "experimental" : false,
  "resourceType" : "ValueSet",
  "title" : "Medical Management Type",
  "extension" : [ {
    "valueCode" : "fm",
    "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg"
  }, {
    "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
    "valueInteger" : 1
  }, {
    "url" : "http://health-samurai.io/extensions/source",
    "valueCode" : "db"
  } ],
  "status" : "active",
  "id" : "3723ca11-7558-43ce-80a2-3938a87d9616",
  "url" : "http://terminology.hl7.org/ValueSet/medical-management-type",
  "identifier" : [ {
    "system" : "urn:ietf:rfc:3986",
    "value" : "urn:oid:2.16.840.1.113883.11.21037"
  } ],
  "immutable" : true,
  "version" : "1.0.0",
  "contact" : [ {
    "telecom" : [ {
      "system" : "url",
      "value" : "http://hl7.org"
    }, {
      "system" : "email",
      "value" : "hq@HL7.org"
    } ]
  } ],
  "text" : {
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: ValueSet medical-management-type</b></p><a name=\"medical-management-type\"> </a><a name=\"hcmedical-management-type\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Last updated: 2025-05-26 00:00:00+0000</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/R5/shareablevalueset.html\">Shareable ValueSet</a></p></div><ul><li>Include all codes defined in <a href=\"CodeSystem-medical-management-type.html\"><code>http://terminology.hl7.org/CodeSystem/medical-management-type</code></a></li></ul></div>",
    "status" : "generated"
  }
}