An official website of the United States government

Official websites use .gov
A .gov website belongs to an official government organization in the United States.

Secure .gov websites use HTTPS
A lock () or https:// means you've safely connected to the .gov website. Share sensitive information only on official, secure websites.

TMSIS Dataguide Medicaid.gov

Version:

3.39.0

PAYMENT-CAT-XREF

Data Element

DE Number

FTX057

System DE Number

FTX.002.057

File Name

FTX - FINANCIAL TRANSACTION

File Segment Number

FTX00002

File Segment Name

INDIVIDUAL-CAPITATION-PMPM

Last updated

Overview Valid Values Related Rules Related DQ Measures Other Instances
Definition Cross-reference to the applicable payment category in the managed care plan's contract with the state Medicaid/CHIP agency or their fiscal intermediary.
Size X(50)
FLF Start Position 1006
FLF Stop Position 1055
Segment Key Field Identifier Not Applicable
Coding Requirements 1. Value must be 50 characters or less
2. If Subcapitation Indicator equals "1", then value must be populated
3. Conditional
Valid Value Code Set Valid Value Code Valid Value Name Valid Value Description Effective Start Date Effective End Date
DE Number System DE Number DE Name File Segment Number File Segment Name
FTX230 FTX.006.230 PAYMENT-CAT-XREF FTX00006 VALUE-BASED-PAYMENT
FTX273 FTX.007.273 PAYMENT-CAT-XREF FTX00007 STATE-DIRECTED-PAYMENT-SEPARATE-PAYMENT-TERM
FTX401 FTX.095.401 PAYMENT-CAT-XREF FTX00095 MISCELLANEOUS-PAYMENT