CRX.002.054

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TMSIS Dataguide

Medicaid.gov

Version:

FUNDING-SOURCE-NONFEDERAL-SHARE

Data Element

DE Number

CRX054

System DE Number

CRX.002.054

File Name

CRX - CLAIM PHARMACY

File Segment Number

File Segment Name

CLAIM-HEADER-RECORD-RX

Last updated

Overview Valid Values Related Rules Related DQ Measures Other Instances

Definition	A code to indicate the type of non-federal share used by the state to finance its expenditure to the provider. In the event of two sources, states are to report the portion which represents the largest proportion not funded by the Federal government.
Size	X(2)
FLF Start Position	326
FLF Stop Position	327
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value must be 2 characters 2. Value must be in Funding Source Non-Federal Share List (VVL) 3. If Type of Claim is not in [3,C,W], then value must be populated 4. Conditional

Valid Value Code Set	Valid Value Code	Valid Value Name	Valid Value Description	Effective Start Date	Effective End Date

RULE ID	RULE Definition
RULE-1813	If the funding source non-federal share is populated on a non-denied claim from an RX file, then the funding source non-federal share reported must be found in the list of valid values.
RULE-6671	If a claim is a non-denied claim from an RX file, then the funding source non federal share value reported must be compatible with specified T-MSIS picture format: X(2).

Measure ID	Measure Name

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
CIP127	CIP.002.127	FUNDING-SOURCE-NONFEDERAL-SHARE	CIP00002	CLAIM-HEADER-RECORD-IP
CLT077	CLT.002.077	FUNDING-SOURCE-NONFEDERAL-SHARE	CLT00002	CLAIM-HEADER-RECORD-LT
COT063	COT.002.063	FUNDING-SOURCE-NONFEDERAL-SHARE	COT00002	CLAIM-HEADER-RECORD-OT
FTX052	FTX.002.052	FUNDING-SOURCE-NONFEDERAL-SHARE	FTX00002	INDIVIDUAL-CAPITATION-PMPM
FTX097	FTX.003.097	FUNDING-SOURCE-NONFEDERAL-SHARE	FTX00003	INDIVIDUAL-HEALTH-INSURANCE-PREMIUM-PAYMENT
FTX141	FTX.004.141	FUNDING-SOURCE-NONFEDERAL-SHARE	FTX00004	GROUP-INSURANCE-PREMIUM-PAYMENT
FTX183	FTX.005.183	FUNDING-SOURCE-NONFEDERAL-SHARE	FTX00005	COST-SHARING-OFFSET
FTX225	FTX.006.225	FUNDING-SOURCE-NONFEDERAL-SHARE	FTX00006	VALUE-BASED-PAYMENT
FTX270	FTX.007.270	FUNDING-SOURCE-NONFEDERAL-SHARE	FTX00007	STATE-DIRECTED-PAYMENT-SEPARATE-PAYMENT-TERM
FTX310	FTX.008.310	FUNDING-SOURCE-NONFEDERAL-SHARE	FTX00008	COST-SETTLEMENT-PAYMENT
FTX349	FTX.009.349	FUNDING-SOURCE-NONFEDERAL-SHARE	FTX00009	FQHC-WRAP-PAYMENT
FTX397	FTX.095.397	FUNDING-SOURCE-NONFEDERAL-SHARE	FTX00095	MISCELLANEOUS-PAYMENT

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
04/24/2025	4.0.7	CRX.002.054	UPDATE	Coding requirement	1. Value must be 2 characters2. Value must be in Funding Source Non-Federal Share List (VVL)3. If Type of Claim is in [3,C,W], then value must be populated4. Conditional	1. Value must be 2 characters2. Value must be in Funding Source Non-Federal Share List (VVL)3. If Type of Claim is not in [3,C,W], then value must be populated4. Conditional
09/16/2024	4.0.0	CRX.002.054	UPDATE	File segment	None	40
09/16/2024	4.0.0	CRX.002.054	ADD	N/A		Created