FTX.005.166

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TMSIS Dataguide

Medicaid.gov

Version:

PAYEE-MCR-PLAN-TYPE

Data Element

DE Number

FTX166

System DE Number

FTX.005.166

File Name

FTX - FINANCIAL TRANSACTION

File Segment Number

File Segment Name

COST-SHARING-OFFSET

Last updated

Overview Valid Values Related Rules Related DQ Measures Other Instances

Definition	This describes the type of managed care plan or care coordination model of the payee, when applicable. The valid value code set is comprised of the standard managed care plan type list from the MCR and ELG files and a complementary list of care coordination models.
Size	X(2)
FLF Start Position	431
FLF Stop Position	432
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value must be 2 characters 2. Value must be in Managed Care Plan Type List (VVL) 3. If Payee ID Type is in [02,03], then value must be populated 4. If Payee ID Type is not [02,03], then value must not be populated 5. 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-8161	If a financial transaction is from an FTX file, then the payee managed care plan type value reported must be compatible with specified T-MSIS picture format: X(2).
RULE-8461	If the payee managed care plan type is populated on the Cost Sharing Offset Transaction from a FTX file, then the payee managed care plan type reported must be found in the list of valid values.

Measure ID	Measure Name

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
FTX036	FTX.002.036	PAYEE-MCR-PLAN-TYPE	FTX00002	INDIVIDUAL-CAPITATION-PMPM
FTX209	FTX.006.209	PAYEE-MCR-PLAN-TYPE	FTX00006	VALUE-BASED-PAYMENT
FTX253	FTX.007.253	PAYEE-MCR-PLAN-TYPE	FTX00007	STATE-DIRECTED-PAYMENT-SEPARATE-PAYMENT-TERM
FTX296	FTX.008.296	PAYEE-MCR-PLAN-TYPE	FTX00008	COST-SETTLEMENT-PAYMENT
FTX335	FTX.009.335	PAYEE-MCR-PLAN-TYPE	FTX00009	FQHC-WRAP-PAYMENT
FTX376	FTX.095.376	PAYEE-MCR-PLAN-TYPE	FTX00095	MISCELLANEOUS-PAYMENT

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
09/16/2024	4.0.0	FTX.005.166	UPDATE	File segment	None	71
09/16/2024	4.0.0	FTX.005.166	ADD	N/A		Created