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HL7 v2Segment9 min read

HL7 PRC Segment: Pricing

The PRC (Pricing) segment carries the facility-specific and patient-class-specific pricing detail for a single charge-master entry. Where the CDM segment defines what a charge is, the PRC segment defines what it costs and under what conditions that price applies. A single charge can have many PRC rows — one per facility, department, or patient class — so PRC almost always repeats within a charge-master record.

The PRC segment is the pricing companion to CDM inside a charge-description master. Its key fields are Primary Key Value - PRC (PRC-1), which links the price row to its charge, Facility ID - PRC (PRC-2), and Price (PRC-5).

Purpose

The PRC segment exists to transmit how a chargeable item is priced in a given context. It does the following:

  • Links a price row to a charge-master entry through a shared primary key.
  • Scopes pricing to a facility, department, and set of valid patient classes.
  • Carries the actual price, any pricing formula, and quantity and price boundaries.
  • Records effective start and end dates so receivers can apply time-bounded pricing.
  • Flags chargeability, override behavior, and cost.

PRC carries no patient or encounter data. Like CDM, it is reference data maintained centrally and synchronized through master-file notification messages.

Used in

PRC (Pricing) carries charge-master pricing data in MFN^M04 master-file notification messages. Within an MFN^M04, each charge-master record is introduced by an MFE (Master File Entry) segment and a CDM (Charge Description Master) segment, after which one or more PRC segments follow to supply pricing for that charge. The message opens with an MFI (Master File Identification) segment identifying the charge-description master.

Typical placement inside the MFN^M04:

  • MSH (Message Header)
  • MFI (Master File Identification)
  • MFE (Master File Entry) — one per charge-master record
  • CDM (Charge Description Master) — the charge definition
  • PRC (Pricing) — one or more pricing rows for that charge

Field-by-field reference

Source: HAPI HL7v2 v2.5.1 javadocs (PRC). Length ; Required and Table # from the HL7 v2.5.1 standard where well-established.

SeqNameData TypeLengthReqRepeatTable #Description
PRC-1Primary Key Value - PRCceRHL70132Charge code linking the price to its entry
PRC-2Facility ID - PRCceOYHL70464Facility for which this price applies
PRC-3DepartmentceOYHL70184Department for which this price applies
PRC-4Valid Patient ClassesisOYHL70004Patient classes eligible for this price
PRC-5PricecpOYThe price amount and price type
PRC-6FormulastOYFormula used to derive the price
PRC-7Minimum QuantitynmOMinimum chargeable quantity
PRC-8Maximum QuantitynmOMaximum chargeable quantity
PRC-9Minimum PricemoOFloor price for this charge
PRC-10Maximum PricemoOCeiling price for this charge
PRC-11Effective Start DatetsODate this price becomes effective
PRC-12Effective End DatetsODate this price stops being effective
PRC-13Price Override FlagisOHL70268Whether the price may be overridden
PRC-14Billing CategoryceOYHL70293Billing category for the charge
PRC-15Chargeable FlagidOHL70136Whether the item is chargeable
PRC-16Active/Inactive FlagidOHL70183Whether the price row is active
PRC-17CostmoOCost of the item to the facility
PRC-18Charge On IndicatorisOHL70269When the charge is triggered

Most-used fields

  • PRC-1 Primary Key Value - PRC is the link back to the charge. It must match the CDM-1 of the charge being priced, or the price row is orphaned.
  • PRC-2 Facility ID - PRC scopes the price to a facility, which is what lets one charge carry many prices in a multi-facility system.
  • PRC-5 Price is the core payload — the amount and price type (for example total price versus professional component).
  • PRC-11 Effective Start Date and PRC-12 Effective End Date define the time window in which the price applies and drive correct historical pricing.
  • PRC-16 Active/Inactive Flag tells receivers whether to apply or retire the price row.

Version differences (2.3 to 2.8.2)

  • PRC was introduced alongside the master-file framework and has carried these eighteen fields since HL7 v2.3.
  • Across v2.3 through v2.5.1 the field set and order are stable; changes were limited to data-type refinements such as the monetary MO type used for Minimum Price, Maximum Price, and Cost, and to table references.
  • In v2.6 through v2.8.2 the segment retains all eighteen fields in the same sequence. CE-typed fields are frequently represented as CWE in tooling, but the PRC definition itself is not restructured.
  • No PRC fields have been deprecated or withdrawn across 2.3 to 2.8.2, making it a dependable segment for cross-version charge-master interfaces.

Common mistakes

  • Mismatching PRC-1 against CDM-1. The two primary keys must agree, including coding system, or pricing is silently dropped.
  • Sending Price (PRC-5) without a price type component, leaving the receiver to guess whether it is a total, professional, or technical price.
  • Ignoring Effective Start/End Dates (PRC-11/PRC-12) and overwriting current pricing with a future-dated row.
  • Confusing PRC-9/PRC-10 (Minimum/Maximum Price, MO) with PRC-7/PRC-8 (Minimum/Maximum Quantity, NM).
  • Collapsing repeating Facility ID (PRC-2) or Valid Patient Classes (PRC-4) into a single value and losing scope.
  • Forgetting that PRC-15 Chargeable Flag and PRC-16 Active/Inactive Flag are independent — an active row can still be flagged non-chargeable.

Examples

Minimal PRC (charge key and a single price):

PRC|10042^Chest X-Ray Single View^L|||175.00^USD^^^TP

Fully populated PRC:

PRC|10042^Chest X-Ray Single View^L|MERCYGEN^Mercy General^L|RAD^Radiology^L|I~O|175.00^USD^^^TP|BASE*1.0|1|3|150.00^USD|400.00^USD|20260101|20261231|N|DIAG^Diagnostic^L|Y|A|62.40^USD|ON_ORDER

Annotated breakdown of the fully populated example:

PRC-1  Primary Key Value - PRC  10042^Chest X-Ray Single View^L  (links to CDM-1)
PRC-2  Facility ID - PRC        MERCYGEN^Mercy General^L          (priced for this facility)
PRC-3  Department               RAD^Radiology^L                   (radiology department)
PRC-4  Valid Patient Classes    I~O                               (inpatient and outpatient)
PRC-5  Price                    175.00^USD^^^TP                   (total price, US dollars)
PRC-6  Formula                  BASE*1.0                          (pricing formula)
PRC-7  Minimum Quantity         1                                 (minimum chargeable qty)
PRC-8  Maximum Quantity         3                                 (maximum chargeable qty)
PRC-9  Minimum Price            150.00^USD                        (floor price)
PRC-10 Maximum Price            400.00^USD                        (ceiling price)
PRC-11 Effective Start Date     20260101                          (price effective from)
PRC-12 Effective End Date       20261231                          (price effective to)
PRC-13 Price Override Flag      N                                 (no override allowed)
PRC-14 Billing Category         DIAG^Diagnostic^L                 (billing category)
PRC-15 Chargeable Flag          Y                                 (chargeable)
PRC-16 Active/Inactive Flag     A                                 (active price row)
PRC-17 Cost                     62.40^USD                         (facility cost)
PRC-18 Charge On Indicator      ON_ORDER                          (charge triggered on order)

In-context excerpt 1 — PRC inside an MFN^M04 charge-master notification, following CDM:

MSH|^~&|CHARGEMASTER|MERCYGEN|BILLING|MERCYGEN|20260610093000||MFN^M04^MFN_M04|MSG00231|P|2.5.1
MFI|CM^Charge Master^HL70175|MERCYGEN|UPD|20260610093000||AL
MFE|MAD|||10042^Chest X-Ray Single View^L|CM
CDM|10042^Chest X-Ray Single View^L||CXR 1V|Radiology Chest X-Ray, Single Frontal View|N||71045^Radiologic exam chest single view^CPT|A|||||N
PRC|10042^Chest X-Ray Single View^L|MERCYGEN^Mercy General^L|RAD||175.00^USD^^^TP||1|1|||20260101|||N|DIAG^Diagnostic^L|Y|A|62.40^USD|

In-context excerpt 2 — one charge with two PRC rows (inpatient and outpatient pricing):

MFE|MAD|||10042^Chest X-Ray Single View^L|CM
CDM|10042^Chest X-Ray Single View^L||CXR 1V|Radiology Chest X-Ray, Single Frontal View|N||71045^Radiologic exam chest single view^CPT|A|||||N
PRC|10042^Chest X-Ray Single View^L|MERCYGEN^Mercy General^L|RAD|I|175.00^USD^^^TP||||||20260101|||N|DIAG^Diagnostic^L|Y|A||
PRC|10042^Chest X-Ray Single View^L|MERCYGEN^Mercy General^L|RAD|O|140.00^USD^^^TP||||||20260101|||N|DIAG^Diagnostic^L|Y|A||

FHIR mapping

PRC is not mapped at the segment level. No segment-level ConceptMap is published in the v2-to-FHIR Implementation Guide for PRC. Conceptually, a PRC pricing row corresponds most closely to a FHIR ChargeItemDefinition, where the price maps to ChargeItemDefinition.propertyGroup.priceComponent, the effective dates map to ChargeItemDefinition.applicability, and the active flag maps to ChargeItemDefinition.status. Because the published IG does not define a normalized field-by-field mapping for PRC, any such projection is an integration design decision rather than a standard transform.

Engine considerations

  • PRC frequently repeats within one charge record; engines must preserve each repetition as a distinct pricing row rather than merging them.
  • Repeating fields inside a PRC (PRC-2, PRC-3, PRC-4, PRC-5, PRC-6, PRC-14) require repetition (~) handling; flattening loses facility, class, or price-type scope.
  • Effective-date handling (PRC-11/PRC-12) should be modeled as a date range so future-dated rows do not overwrite current pricing.
  • Because PRC-1 must match CDM-1, validate the join during transformation and reject or quarantine orphaned price rows.
  • Monetary fields (MO) and the CP price field carry currency components; normalize currency before any arithmetic.

How Vorro parses and produces PRC

When consuming an MFN^M04, Vorro binds each PRC to the CDM that precedes it within the same charge-master record group, validating that PRC-1 matches CDM-1 before persisting the price. Each PRC repetition is kept as a separate pricing row keyed by facility (PRC-2), department (PRC-3), and patient class (PRC-4), with effective dates modeled as a closed or open range. Price and cost fields are normalized to a normalized currency representation, preserving the price-type component so totals are not confused with professional or technical components.

When producing PRC, Vorro emits PRC-1 as the required link to the charge, then populates facility, price, and effective dates from the source pricing record. Multiple price contexts are emitted as repeated PRC segments under a single CDM, and empty trailing fields are suppressed. The MFE/CDM/PRC grouping is always preserved so receivers parse pricing in the context of its charge definition.

Sources

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