What is a service type code?

Service type codes are used to identify business groupings for healthcare services and benefits. They are included in Care Cost Estimator API request body and then submitted to payers on an eligibility and benefit inquiry transaction to get patient’s eligibility and benefit details for out of pocket cost estimate. The service type code consists of value and valueType. An example:

"service": {
    "codes": [
      {
        "value": "98",
        "valueType": "ServiceTypeCode"
      }

Each payer may have different supported service types for eligibility and benefit inquiries. You may visit individual payer site to find supported service type codes and the service type code best to use for the procedure you or your patients are trying to get an estimate of out of pocket cost. We recommend using the 270 Implementation Guide specs (which you would need to purchase) or the list of service type codes you can find on Connect Center – under Verification | Start New Eligibility Request and look at the drop down list found under ‘Service Information’ | Service Type.
If you are not sure what service type code to use, you can use service type code “30” for a general Health Benefit Plan Coverage inquiry.