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Healthcare/HL7 v2/MCP
Segment

Master File Coverage Policy

Carries coverage policy pricing information for services and test observations within a payer master file. Each instance identifies a service or test, its acceptable price range (low and high values), and a textual reason for the cost range. It appears in MFN/MFR master file messages and is used by billing and claims adjudication systems to validate charges against payer-defined price boundaries.

5fields
2required
v2.9HL7 version
mcp.py
from zato.hl7v2 import MCP

mcp = MCP()
mcp.set_id_mcp = '1'
Python examples

Build MCP segments in Python

How to construct and work with real-world MCP segments.

1

Lab test price range

Coverage policy entry defining an acceptable price range for a laboratory test

from zato.hl7v2.v2_9 import MCP
from zato.hl7v2.v2_9 import CWE, MO

mcp = MCP()
mcp.set_id_mcp = '1'
mcp.producers_service_test_observation_id = CWE(
    identifier='80053',
    text='Comp metabolic panel',
    name_of_coding_system='CPT4'
)
mcp.universal_service_price_range_low_value = MO(quantity='15.00')
mcp.universal_service_price_range_high_value = MO(quantity='45.00')
mcp.reason_for_universal_service_cost_range = 'Regional fee schedule'
2

Imaging service policy

Coverage policy for a radiology procedure with facility-based pricing

from zato.hl7v2.v2_9 import MCP
from zato.hl7v2.v2_9 import CWE, MO

mcp = MCP()
mcp.set_id_mcp = '2'
mcp.producers_service_test_observation_id = CWE(
    identifier='71046',
    text='Chest X-ray 2 views',
    name_of_coding_system='CPT4'
)
mcp.universal_service_price_range_low_value = MO(quantity='50.00')
mcp.universal_service_price_range_high_value = MO(quantity='200.00')
mcp.reason_for_universal_service_cost_range = 'Facility type variation'
3

Office visit cost range

Coverage policy entry for an outpatient evaluation with geographic price variance

from zato.hl7v2.v2_9 import MCP
from zato.hl7v2.v2_9 import CWE, MO

mcp = MCP()
mcp.set_id_mcp = '3'
mcp.producers_service_test_observation_id = CWE(
    identifier='99213',
    text='Office visit estab',
    name_of_coding_system='CPT4'
)
mcp.universal_service_price_range_low_value = MO(quantity='75.00')
mcp.universal_service_price_range_high_value = MO(quantity='150.00')
mcp.reason_for_universal_service_cost_range = 'Geographic adjustment'
Tutorials

Learn by building

Step-by-step guides for working with HL7 v2 in Zato.

MLLP
Receive and parse HL7 v2 messages
Set up an MLLP channel, parse incoming messages, and respond with acknowledgments.
Start tutorial Build
Build and send HL7 v2 messages
Construct HL7 v2 messages from scratch using typed segment classes and send them over MLLP.
Start tutorial
Related segments

Commonly used with MCP

PM1 Payer master file IN1 Insurance MFI Master file identification MFE Master file entry FT1 Financial transaction MSH Message header
FAQ

Frequently asked questions

MCP carries coverage policy pricing data in payer master file messages. It specifies acceptable price ranges for individual services or tests and the rationale for the range, enabling claims systems to validate charges against payer-defined boundaries.

The producers_service_test_observation_id field uses the CWE datatype with a coding system such as CPT4:

from zato.hl7v2.v2_9 import MCP, CWE

mcp = MCP()
mcp.producers_service_test_observation_id = CWE(
    identifier='80053',
    text='Comp metabolic panel',
    name_of_coding_system='CPT4'
)

Use the MO (money) datatype for both the low and high price boundaries:

from zato.hl7v2.v2_9 import MCP, MO

mcp = MCP()
mcp.universal_service_price_range_low_value = MO(quantity='15.00')
mcp.universal_service_price_range_high_value = MO(quantity='45.00')

The reason_for_universal_service_cost_range field is a free-text string explaining the price variance:

from zato.hl7v2.v2_9 import MCP

mcp = MCP()
mcp.reason_for_universal_service_cost_range = 'Regional fee schedule'

Set all fields together to define a full coverage policy price record:

from zato.hl7v2.v2_9 import MCP, CWE, MO

mcp = MCP()
mcp.set_id_mcp = '1'
mcp.producers_service_test_observation_id = CWE(
    identifier='80053',
    text='Comp metabolic panel',
    name_of_coding_system='CPT4'
)
mcp.universal_service_price_range_low_value = MO(quantity='15.00')
mcp.universal_service_price_range_high_value = MO(quantity='45.00')
mcp.reason_for_universal_service_cost_range = 'Regional fee schedule'

Zato connects to any system that speaks HL7v2 over MLLP or FHIR over REST. This includes Epic, Cerner, Meditech, Allscripts, and other EHR platforms.

Yes, Zato has built-in MLLP support for sending and receiving HL7v2 messages. MLLP channels handle the framing protocol automatically.

Zato supports HL7 v2.9, which is backward compatible with earlier versions including v2.3, v2.5, and v2.7. Standard segments and datatypes are available as typed Python classes.

Yes. Zato handles both HL7v2 and FHIR natively, so you can parse v2 messages and build FHIR resources with IG-specific extensions in the same service. Typed Python classes are available for both protocols, including extensions from US Core, UK Core, Da Vinci, and other Implementation Guides.

Reference

MCP field reference

Complete list of fields in the MCP segment, HL7 v2.9.

#Python nameDatatypeUsageRepeatableTable
1set_id_mcpSIRequiredNo-
2▶producers_service_test_observation_idCWERequiredNo-
3▶universal_service_price_range_low_valueMOOptionalNo-
4▶universal_service_price_range_high_valueMOOptionalNo-
5reason_for_universal_service_cost_rangeSTOptionalNo-

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