HL7 FT1 Segment: Financial Transaction

The FT1 segment carries a single financial transaction — a charge, payment, or adjustment — for a patient account. It records the transaction code and amount, quantity, the performing and ordering providers, and links to the diagnosis and procedure that justify the charge. FT1 is the workhorse of the DFT (Detailed Financial Transaction) message.

Purpose

FT1 communicates one billable event: what was charged (FT1-7 Transaction Code), how much (FT1-11/FT1-12 amounts), how many (FT1-10), and the clinical justification (FT1-19 diagnosis, FT1-25 procedure). Multiple FT1 segments itemize an encounter's charges.

Used in

FT1 appears in financial messages: DFT (detailed financial transactions) and BAR (add/change billing account). See DFT.

Field-by-field reference

Source: HAPI HL7v2 v2.5.1 javadocs (FT1) for sequence, name, and data type. Length is not published in the javadocs (—); Required and Table # are filled from the HL7 v2.5.1 standard where well-established.

Seq	Name	Data Type	Length	Req	Repeat	Table #	Description
FT1-1	Set ID - FT1	SI	—	O	—	—	Sequence number.
FT1-2	Transaction ID	ST	—	O	—	—	Transaction identifier.
FT1-3	Transaction Batch ID	ST	—	O	—	—	Batch identifier.
FT1-4	Transaction Date	DR	—	R	—	—	Date/period of the transaction.
FT1-5	Transaction Posting Date	TS	—	O	—	—	Posting date.
FT1-6	Transaction Type	IS	—	R	—	HL70017	Charge, payment, adjustment, etc.
FT1-7	Transaction Code	CE	—	R	—	HL70132	The charge/service code.
FT1-8	Transaction Description	ST	—	O	—	—	Description.
FT1-9	Transaction Description - Alt	ST	—	O	—	—	Alternate description.
FT1-10	Transaction Quantity	NM	—	O	—	—	Quantity.
FT1-11	Transaction Amount - Extended	CP	—	O	—	—	Extended amount.
FT1-12	Transaction Amount - Unit	CP	—	O	—	—	Unit amount.
FT1-13	Department Code	CE	—	O	—	HL70049	Department.
FT1-14	Insurance Plan ID	CE	—	O	—	HL70072	Insurance plan.
FT1-15	Insurance Amount	CP	—	O	—	—	Insurance amount.
FT1-16	Assigned Patient Location	PL	—	O	—	—	Patient location.
FT1-17	Fee Schedule	IS	—	O	—	HL70024	Fee schedule.
FT1-18	Patient Type	IS	—	O	—	HL70018	Patient type.
FT1-19	Diagnosis Code - FT1	CE	—	O	Y	HL70051	Diagnosis justifying the charge.
FT1-20	Performed By Code	XCN	—	O	Y	—	Performing provider.
FT1-21	Ordered By Code	XCN	—	O	Y	—	Ordering provider.
FT1-22	Unit Cost	CP	—	O	—	—	Unit cost.
FT1-23	Filler Order Number	EI	—	O	—	—	Filler order number.
FT1-24	Entered By Code	XCN	—	O	Y	—	Who entered the transaction.
FT1-25	Procedure Code	CE	—	O	—	HL70088	Procedure (CPT) code.
FT1-26	Procedure Code Modifier	CE	—	O	Y	HL70340	Procedure modifier.
FT1-27	Advanced Beneficiary Notice Code	CE	—	O	—	HL70339	ABN code.
FT1-28	Medically Necessary Duplicate Procedure Reason	CWE	—	O	—	HL70476	Duplicate procedure reason.
FT1-29	NDC Code	CNE	—	O	—	—	National Drug Code.
FT1-30	Payment Reference ID	CX	—	O	—	—	Payment reference.
FT1-31	Transaction Reference Key	SI	—	O	Y	—	Links related transactions.

Most-used fields

FT1-7 Transaction Code is the charge/service being billed; FT1-6 classifies it (charge vs payment vs adjustment).
FT1-11 Transaction Amount - Extended and FT1-10 Quantity drive the billed total.
FT1-19 Diagnosis and FT1-25 Procedure provide the clinical justification payers require.

Version differences (2.3 to 2.8.2)

2.4/2.5: FT1-25 onward (procedure code, modifiers, ABN, NDC) added for US billing.
Coded fields migrate from CE toward CWE/CNE in later versions.

Common mistakes

Misreading FT1-6 and posting a payment as a charge.
Dropping repeating FT1-19 diagnoses needed for claim adjudication.
Treating FT1-11 (extended) and FT1-12 (unit) amounts interchangeably.

Examples

Minimal valid FT1:

FT1|1|||20260610||CG|99213^Office Visit^CPT

Fully-populated FT1:

FT1|1|TX5567||20260610|20260610|CG|99213^Office Visit^CPT|Office Visit|||1|150.00|150.00|||||||E11.9^Type 2 diabetes^I10|1234^SMITH^JANE^^^^MD|||99213^Office Visit^CPT

Annotated breakdown of the fully-populated example (selected fields):

FT1                       ← segment ID
1                         ← FT1-1  Set ID
20260610                  ← FT1-4  Transaction Date
CG                        ← FT1-6  Transaction Type (Charge)
99213^Office Visit^CPT    ← FT1-7  Transaction Code
1                         ← FT1-10 Quantity
150.00                    ← FT1-11 Transaction Amount - Extended
E11.9^Type 2 diabetes^I10 ← FT1-19 Diagnosis Code
1234^SMITH^JANE^^^^MD     ← FT1-20 Performed By Code

In-context inside a DFT^P03 (financial transaction):

MSH|^~&|ADT|MERCYGEN|FIN|MERCYGEN|20260610120000||DFT^P03^DFT_P03|MSG903|P|2.5.1
PID|1||MR12345^^^MERCYGEN^MR||DOE^JOHN^Q||19800101|M
PV1|1|O|CLINIC
FT1|1||||20260610|20260610|CG|99213^Office Visit^CPT||||1|150.00

In-context inside a BAR^P01 (add account with charges):

MSH|^~&|ADT|MERCYGEN|FIN|MERCYGEN|20260610120500||BAR^P01^BAR_P01|MSG904|P|2.5.1
PID|1||MR12345^^^MERCYGEN^MR||DOE^JOHN^Q||19800101|M
FT1|1||||20260610|20260610|CG|85025^CBC^CPT||||1|25.00

FHIR mapping

No segment-level ConceptMap is published in the v2-to-FHIR IG for FT1. Conceptually a financial transaction maps to ChargeItem (with Account and, for adjudication, Claim/ClaimResponse); implementations define this locally.

Engine considerations

Required in practice: FT1-4, FT1-6, FT1-7; billing also needs amounts and diagnosis/procedure.
Preserve repeating diagnosis (FT1-19) and modifier (FT1-26) fields.
Use FT1-6 transaction type to route charges, payments, and adjustments correctly.

How Vorro parses and produces FT1

Vorro classifies each FT1 by transaction type, preserves repeating diagnosis and modifier fields, and maps charges to ChargeItem with the procedure/diagnosis context intact on the FHIR side.

GT1 — the guarantor responsible for the charges.
IN1 — insurance coverage applied to the transaction.
DFT messages — the financial message FT1 heads.

Sources

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