CRX.003.135

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TMSIS Dataguide

Medicaid.gov

Version:

HCBS-SERVICE-CODE

Data Element

DE Number

CRX135

System DE Number

CRX.003.135

File Name

CRX - CLAIM PHARMACY

File Segment Number

File Segment Name

CLAIM-LINE-RECORD-RX

Last updated

Overview Valid Values Related Rules Related DQ Measures Other Instances

Definition	A code to indicate that the service represents a long-term care home and community based service or support for an individual with chronic medical and/or mental conditions. The codes help to delineate between acute care and long-term care provided in the home and community setting (e.g. 1915(c), 1915(i), 1915(j), and 1915(k) services).
Size	X(1)
FLF Start Position	331
FLF Stop Position	331
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value must be 1 character 2. Value must be in HCBS Service Code List (VVL) 3. If value is in [1-7], then HCBS Taxonomy must be populated 4. Situational

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

RULE ID	RULE Definition
RULE-1940	If the HCBS service code is populated on a non-denied RX claim line and the unit of measure is populated, then the HCBS service code value reported must be in the list of valid values.
RULE-6378	If a claim line is a non-denied claim line from an RX file, then the HCBS service code value reported must be compatible with specified T-MSIS picture format: X(1).

Measure ID	Measure Name

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
COT187	COT.003.187	HCBS-SERVICE-CODE	COT00003	CLAIM-LINE-RECORD-OT

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
07/10/2025	4.0.13	CRX.003.135	UPDATE	Necessity	Conditional	Situational
07/10/2025	4.0.13	CRX.003.135	UPDATE	Coding requirement	1. Value must be 1 character2. Value must be in HCBS Service Code List (VVL)3. If value is in [1-7], then HCBS Taxonomy must be populated4. Conditional	1. Value must be 1 character2. Value must be in HCBS Service Code List (VVL)3. If value is in [1-7], then HCBS Taxonomy must be populated4. Situational
09/16/2024	4.0.0	CRX.003.135	UPDATE	File segment	None	41
09/16/2024	4.0.0	CRX.003.135	ADD	N/A		Created