| 52078-3 | Alcohol-substance abuse rehabilitation treatment plan, Referral information Set |
| 52079-1 | Alcohol-substance abuse rehabilitation treatment plan, Referral information (narrative) |
| 52149-2 | Pulmonary therapy treatment plan, Referral information Set |
| 52150-0 | Pulmonary therapy treatment plan, Referral information (narrative) |
| 52191-4 | Cardiac rehabilitation treatment plan, Referral information Set |
| 52192-2 | Cardiac rehabilitation treatment plan, Referral information (narrative) |
| 52218-5 | Medical social services treatment plan, Referral information Set |
| 52219-3 | Medical social services treatment plan, Referral information (narrative) |
| 52244-1 | Occupational therapy treatment plan, Referral information Set |
| 52245-8 | Occupational therapy treatment plan, Referral information (narrative) |
| 52273-0 | Physical therapy treatment plan, Referral information Set |
| 52274-8 | Physical therapy treatment plan, Referral information (narrative) |
| 52304-3 | Psychiatric rehabilitation treatment plan, Referral information Set |
| 52305-0 | Psychiatric rehabilitation treatment plan, Referral information (narrative) |
| 52335-7 | Respiratory therapy treatment plan, Referral information Set |
| 52336-5 | Respiratory therapy treatment plan, Referral information (narrative) |
| 52358-9 | Skilled nursing treatment plan, Referral information Set |
| 52359-7 | Skilled nursing treatment plan, Referral information (narrative) |
| 52385-2 | Speech therapy treatment plan, Referral information Set |
| 52386-0 | Speech therapy treatment plan, Referral information (narrative) |