HL7 GP2 Grouping/Reimbursement - Procedure Line Item
HL7 field reference GP2 fields from HL7 v2.5.1 Show fields
These are the generated fields for the version selected at the top of the page. The document stays the same, but the reference panel follows that version.
Fields
| Field | Name | Required | Repeatable | Type | Table |
|---|---|---|---|---|---|
| GP2.1 | Revenue Code | No | No | IS | 0456 |
| GP2.2 | Number of Service Units | No | No | NM | |
| GP2.3 | Charge | No | No | CP | |
| GP2.4 | Reimbursement Action Code | No | No | IS | 0459 |
| GP2.5 | Denial or Rejection Code | No | No | IS | 0460 |
| GP2.6 | OCE Edit Code | No | Yes | IS | 0458 |
| GP2.7 | Ambulatory Payment Classification Code | No | No | CE | 0466 |
| GP2.8 | Modifier Edit Code | No | Yes | IS | 0467 |
| GP2.9 | Payment Adjustment Code | No | No | IS | 0468 |
| GP2.10 | Packaging Status Code | No | No | IS | 0469 |
| GP2.11 | Expected CMS Payment Amount | No | No | CP | |
| GP2.12 | Reimbursement Type Code | No | No | IS | 0470 |
| GP2.13 | Co-Pay Amount | No | No | CP | |
| GP2.14 | Pay Rate per Service Unit | No | No | NM |
GP2 carries procedure-line grouping and reimbursement detail, usually more granular than GP1.
Billing segments are where clinical activity starts turning into charge, reimbursement, and account data. They can look administrative, but a bad code or account reference can cause real downstream cleanup.
Treat charge codes, revenue codes, grouping values, effective dates, and account identifiers as controlled data. Free-text labels are useful for humans, but receivers usually post, price, or group from the coded values.
The v2.5.1 structures show GP2 in BAR_P10 - Transmit Ambulatory Payment Classification(APC). That tells you where it can appear, but the implementation guide still decides which optional fields are meaningful.
For practical interface work, read the generated field panel for datatype, required, repeatable, and table details, then use the notes below to decide what the field should mean in the receiving workflow.
GP2-1 identifies the Revenue Code for this billing workflow. Send the identifier that the receiving system actually keys on, and keep the assigning authority or coding system visible when the datatype supports it.
The generated panel links this to HL7 table 0456; many real interfaces narrow that list further, so follow the receiver's implementation guide.
GP2-2 is a count or total for this billing workflow. Make the counting rule explicit before using it for reconciliation, billing, or workflow limits.
GP2-3 carries a measured, counted, priced, or dosed value. A number without the expected unit, currency, or companion qualifier is much easier to misread than an empty field.
GP2-4 says what action is being taken for this segment or record: add, update, delete, cancel, clear, or another profile-defined operation. It needs to agree with the message trigger and the previous state.
The generated panel links this to HL7 table 0459; many real interfaces narrow that list further, so follow the receiver's implementation guide.
GP2-5 identifies the Denial or Rejection Code for this billing workflow. Send the identifier that the receiving system actually keys on, and keep the assigning authority or coding system visible when the datatype supports it.
The generated panel links this to HL7 table 0460; many real interfaces narrow that list further, so follow the receiver's implementation guide.
GP2-6 identifies the OCE Edit Code for this billing workflow. Send the identifier that the receiving system actually keys on, and keep the assigning authority or coding system visible when the datatype supports it.
If there are several identifiers, use repetitions deliberately and make each repeat self-explanatory rather than relying on position alone.
GP2-7 identifies the Ambulatory Payment Classification Code for this billing workflow. Send the identifier that the receiving system actually keys on, and keep the assigning authority or coding system visible when the datatype supports it.
The generated panel links this to HL7 table 0466; many real interfaces narrow that list further, so follow the receiver's implementation guide.
GP2-8 identifies the Modifier Edit Code for this billing workflow. Send the identifier that the receiving system actually keys on, and keep the assigning authority or coding system visible when the datatype supports it.
If there are several identifiers, use repetitions deliberately and make each repeat self-explanatory rather than relying on position alone.
GP2-9 identifies the Payment Adjustment Code for this billing workflow. Send the identifier that the receiving system actually keys on, and keep the assigning authority or coding system visible when the datatype supports it.
The generated panel links this to HL7 table 0468; many real interfaces narrow that list further, so follow the receiver's implementation guide.
GP2-10 tells the receiver the state of this billing workflow. Status fields often drive workflow branches, so use the agreed code and do not infer a status just because another field looks complete.
The coded value should follow HL7 table 0469 or the narrower table in the local profile.
GP2-11 carries a measured, counted, priced, or dosed value. A number without the expected unit, currency, or companion qualifier is much easier to misread than an empty field.
GP2-12 identifies the Reimbursement Type Code for this billing workflow. Send the identifier that the receiving system actually keys on, and keep the assigning authority or coding system visible when the datatype supports it.
The generated panel links this to HL7 table 0470; many real interfaces narrow that list further, so follow the receiver's implementation guide.
GP2-13 carries a measured, counted, priced, or dosed value. A number without the expected unit, currency, or companion qualifier is much easier to misread than an empty field.
GP2-14 carries a measured, counted, priced, or dosed value. A number without the expected unit, currency, or companion qualifier is much easier to misread than an empty field.