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TMSIS Dataguide Medicaid.gov

Version:

PAYEE-MCR-PLAN-TYPE-OTHER-TEXT

Data Element

DE Number

FTX167

System DE Number

FTX.005.167

File Segment Number

FTX00005

File Segment Name

COST-SHARING-OFFSET

Last updated

Definition This is a description of what type of managed care plan or care coordination model the payee ID was reported with a payee MCR plan or other care coordination model type of "Other".
Size X(100)
FLF Start Position 433
FLF Stop Position 532
Segment Key Field Identifier Not Applicable
Coding Requirements 1. Value must be 100 characters or less
2. Value must be populated when Payee MCR Plan Type equals "95"
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
FTX037 FTX.002.037 PAYEE-MCR-PLAN-TYPE-OTHER-TEXT FTX00002 INDIVIDUAL-CAPITATION-PMPM
FTX210 FTX.006.210 PAYEE-MCR-PLAN-TYPE-OTHER-TEXT FTX00006 VALUE-BASED-PAYMENT
FTX254 FTX.007.254 PAYEE-MCR-PLAN-TYPE-OTHER-TEXT FTX00007 STATE-DIRECTED-PAYMENT-SEPARATE-PAYMENT-TERM
FTX297 FTX.008.297 PAYEE-MCR-PLAN-TYPE-OTHER-TEXT FTX00008 COST-SETTLEMENT-PAYMENT
FTX336 FTX.009.336 PAYEE-MCR-PLAN-TYPE-OTHER-TEXT FTX00009 FQHC-WRAP-PAYMENT
FTX377 FTX.095.377 PAYEE-MCR-PLAN-TYPE-OTHER-TEXT FTX00095 MISCELLANEOUS-PAYMENT