FTX.004.113

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TMSIS Dataguide

Medicaid.gov

Version:

PAYMENT-AMOUNT

Data Element

DE Number

FTX113

System DE Number

FTX.004.113

File Name

FTX - FINANCIAL TRANSACTION

File Segment Number

File Segment Name

GROUP-INSURANCE-PREMIUM-PAYMENT

Last updated

Overview Valid Values Related Rules Related DQ Measures Other Instances

Definition	The dollar amount being paid to the payee. When a single payment covers multiple people, the full Medicaid Group Insurance payment amount should be reported on the FTX00004 transaction representing the policy subscriber, regardless of whether this person is a Medicaid enrollee. The FTX00004 transactions for the other covered people under the policy should have payment amount values of zero ($0.00).
Size	S9(11)V99
FLF Start Position	131
FLF Stop Position	143
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value must be between -99999999999.99 and 99999999999.99 2. Value must be expressed as a number with 2-digit precision (e.g. 100.50) 3. Mandatory

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

RULE ID	RULE Definition
RULE-8109	If a financial transaction is from an FTX file, then the payment or recoupment amount value reported must be compatible with specified T-MSIS picture format: S9(11)V99.
RULE-8703	If the Group Insurance Premium Payment Transactions segment is populated from a FTX file, then the PAYMENT-AMOUNT must be populated

Measure ID	Measure Name

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
FTX072	FTX.003.072	PAYMENT-AMOUNT	FTX00003	INDIVIDUAL-HEALTH-INSURANCE-PREMIUM-PAYMENT

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
06/19/2025	4.0.11	FTX.004.113	UPDATE	Definition	The dollar amount being paid to the payee.	The dollar amount being paid to the payee. When a single payment covers multiple people, the full Medicaid Group Insurance payment amount should be reported on the FTX00004 transaction representing the policy subscriber, regardless of whether this person is a Medicaid enrollee. The FTX00004 transactions for the other covered people under the policy should have payment amount values of zero ($0.00).
09/16/2024	4.0.0	FTX.004.113	UPDATE	File segment	None	70
09/16/2024	4.0.0	FTX.004.113	ADD	N/A		Created