FTX.002.045

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TMSIS Dataguide

Medicaid.gov

Version:

CATEGORY-FOR-FEDERAL-REIMBURSEMENT

Data Element

DE Number

FTX045

System DE Number

FTX.002.045

File Name

FTX - FINANCIAL TRANSACTION

File Segment Number

File Segment Name

INDIVIDUAL-CAPITATION-PMPM

Last updated

Overview Valid Values Related Rules Related DQ Measures Other Instances

Definition	A code to indicate the Federal funding source for the payment.
Size	X(2)
FLF Start Position	903
FLF Stop Position	904
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value must be 2 characters 2. Value must be in Category for Federal Reimbursement List (VVL) 3. Conditional 4. Value must be populated when Payer ID Type equals "01" 5. If Subcapitation Indicator equals "2", then value must not be populated

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

RULE ID	RULE Definition
RULE-8043	If a financial transaction is from an FTX file, then the category for federal reimbursement value reported must be compatible with specified T-MSIS picture format: X(2).
RULE-8411	If the category for federal reimbursement is populated on the Individual Capitation PMPM transaction from a FTX file, then the category for federal reimbursement reported must be found in the list of valid values.
RULE-8674	If the Individual Capitation Payment segment is populated from a FTX file, then the CATEGORY-FOR-FEDERAL-REIMBURSEMENT must be populated

Measure ID	Measure Name
RULE-8674	% missing: CATEGORY-FOR-FEDERAL-REIMBURSEMENT (FTX00002)

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
CIP269	CIP.003.269	CATEGORY-FOR-FEDERAL-REIMBURSEMENT	CIP00003	CLAIM-LINE-RECORD-IP
CLT219	CLT.003.219	CATEGORY-FOR-FEDERAL-REIMBURSEMENT	CLT00003	CLAIM-LINE-RECORD-LT
COT210	COT.003.210	CATEGORY-FOR-FEDERAL-REIMBURSEMENT	COT00003	CLAIM-LINE-RECORD-OT
CRX149	CRX.003.149	CATEGORY-FOR-FEDERAL-REIMBURSEMENT	CRX00003	CLAIM-LINE-RECORD-RX
FTX090	FTX.003.090	CATEGORY-FOR-FEDERAL-REIMBURSEMENT	FTX00003	INDIVIDUAL-HEALTH-INSURANCE-PREMIUM-PAYMENT
FTX134	FTX.004.134	CATEGORY-FOR-FEDERAL-REIMBURSEMENT	FTX00004	GROUP-INSURANCE-PREMIUM-PAYMENT
FTX176	FTX.005.176	CATEGORY-FOR-FEDERAL-REIMBURSEMENT	FTX00005	COST-SHARING-OFFSET
FTX218	FTX.006.218	CATEGORY-FOR-FEDERAL-REIMBURSEMENT	FTX00006	VALUE-BASED-PAYMENT
FTX263	FTX.007.263	CATEGORY-FOR-FEDERAL-REIMBURSEMENT	FTX00007	STATE-DIRECTED-PAYMENT-SEPARATE-PAYMENT-TERM
FTX303	FTX.008.303	CATEGORY-FOR-FEDERAL-REIMBURSEMENT	FTX00008	COST-SETTLEMENT-PAYMENT
FTX342	FTX.009.342	CATEGORY-FOR-FEDERAL-REIMBURSEMENT	FTX00009	FQHC-WRAP-PAYMENT
FTX390	FTX.095.390	CATEGORY-FOR-FEDERAL-REIMBURSEMENT	FTX00095	MISCELLANEOUS-PAYMENT

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
09/25/2025	4.0.18	FTX.002.045	UPDATE	Coding requirement	1. Value must be 2 characters2. Value must be in Category for Federal Reimbursement List (VVL)3. Conditional4. Value must be populated when Payer ID Type equals "01"	1. Value must be 2 characters2. Value must be in Category for Federal Reimbursement List (VVL)3. Conditional4. Value must be populated when Payer ID Type equals "01"5. If Subcapitation Indicator equals "2", then value must not be populated
02/27/2025	4.0.3	FTX.002.045	UPDATE	Necessity	Mandatory	Conditional
02/27/2025	4.0.3	FTX.002.045	UPDATE	Coding requirement	1. Value must be 2 characters2. Value must be in Category for Federal Reimbursement List (VVL)3. Mandatory	1. Value must be 2 characters2. Value must be in Category for Federal Reimbursement List (VVL)3. Conditional4. Value must be populated when Payer ID Type equals "01"
09/16/2024	4.0.0	FTX.002.045	UPDATE	File segment	None	68
09/16/2024	4.0.0	FTX.002.045	ADD	N/A		Created