With the on-going changes to the national health care environment, the Centers for Medicare & Medicaid Services (CMS) has made significant investments to meet the organizational and information technology (IT) infrastructure to adequately represent CMS’ role in the healthcare marketplace. The Transformed Medicaid Statistical Information System (T-MSIS) is a critical data and systems component of the CMS Medicaid and CHIP Business Information Solution (MACBIS).
CMS has been working with states to transform our MSIS system, which was used to collect utilization and claims data as well as other key Medicaid and CHIP program information, to keep pace with the data needed to improve beneficiary quality of care, assess beneficiary to care and enrollment, improve program integrity, and support our states, the private market, and stakeholders with key information.
The T-MSIS data set contains:
- Enhanced information about beneficiary eligibility
- Beneficiary and provider enrollment
- Service utilization
- Claims and managed care data
- Expenditure data for Medicaid and CHIP
Learn more in the T-MSIS Informational Bulletin (PDF, 134.56 KB) , T-MSIS State Health Official (PDF, 136.4 KB) and T-MSIS State Medicaid Director letters, as well as the T-MSIS Data Dictionary (ZIP, 1.73 MB) .
The following factors influence the T-MSIS file submission status:
- Currency of state data – Files for a reporting period are submitted before the end of the subsequent month.
- Completeness of state data – Current or historical resubmissions contain all data for those reporting months, and the data is complete and usable.
- States completing Large System Enhancements (LSE) remain compliant, with no gaps in reporting
T-MSIS State File Submission Status
T-MSIS State Overall Progress as of 12/09/2019
51 states (includes DC), 4 entities (IA CHIP, PA CHIP, WY CHIP, and Montana TPA) and 2 territories (Virgin Islands and Puerto Rico) are in production and submitting monthly (100%)
0 states in production and no longer current by 2 -6 months
0 states in production and no longer current by 6+ months
1 territory (Guam) working towards production
2 territories (American Samoa and Northern Mariana Islands) do not participate in T-MSIS
T-MSIS Coding Guidance Listserv
Receive announcements as well as new and updated CMS guidance about coding information related to the Transformed Medicaid Statistical Information System (T-MSIS).
The Medicaid and Statistical Information System (MSIS) used by the Centers for Medicare and Medicaid Services (CMS) to gather key eligibility, enrollment, program, utilization and expenditure data for the Medicaid and Children's Health Insurance Program (CHIP) has been decommissioned and replaced by T-MSIS.