FTX.006.204

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TMSIS Dataguide

Medicaid.gov

Version:

PAYER-ID-TYPE

Data Element

DE Number

FTX204

System DE Number

FTX.006.204

File Name

FTX - FINANCIAL TRANSACTION

File Segment Number

File Segment Name

VALUE-BASED-PAYMENT

Last updated

Overview Valid Values Related Rules Related DQ Measures Other Instances

Definition	This is a qualifier that indicates what type of ID the payer ID is. For example, if the payer ID represents the state Medicaid or CHIP agency, then the payer ID type will indicate that the payer ID should be interpreted as a submitting state code.
Size	X(2)
FLF Start Position	197
FLF Stop Position	198
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value must be 2 characters 2. Value must be in Payer ID Type List (VVL) 3. Mandatory 4. When value equals "01" then Payer ID must equal Submitting State (FTX.006.193) 5. When value equals "02" then Payer ID must equal State Plan Identification Number (MCR.002.019) 6. When value equals "04" then Payer ID must equal must equal Submitting State Provider Identifier (PRV.002.019)

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

RULE ID	RULE Definition
RULE-8198	If a financial transaction is from an FTX file, then the payer id type value reported must be compatible with specified T-MSIS picture format: X(2).
RULE-8476	If the payer id type is populated on the Value Based Payment Transaction from a FTX file, then the payer id 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
FTX029	FTX.002.029	PAYER-ID-TYPE	FTX00002	INDIVIDUAL-CAPITATION-PMPM
FTX076	FTX.003.076	PAYER-ID-TYPE	FTX00003	INDIVIDUAL-HEALTH-INSURANCE-PREMIUM-PAYMENT
FTX117	FTX.004.117	PAYER-ID-TYPE	FTX00004	GROUP-INSURANCE-PREMIUM-PAYMENT
FTX161	FTX.005.161	PAYER-ID-TYPE	FTX00005	COST-SHARING-OFFSET
FTX248	FTX.007.248	PAYER-ID-TYPE	FTX00007	STATE-DIRECTED-PAYMENT-SEPARATE-PAYMENT-TERM
FTX291	FTX.008.291	PAYER-ID-TYPE	FTX00008	COST-SETTLEMENT-PAYMENT
FTX330	FTX.009.330	PAYER-ID-TYPE	FTX00009	FQHC-WRAP-PAYMENT
FTX369	FTX.095.369	PAYER-ID-TYPE	FTX00095	MISCELLANEOUS-PAYMENT

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
12/19/2024	4.0.1	FTX.006.204	UPDATE	Coding requirement	1. Value must be 2 characters2. Value must be in Payer ID Type List (VVL)3. Mandatory4. When value equals "01" then Payer ID must equal Submitting State (FTX.001.007)5. When value equals "02" then Payer ID must equal State Plan Identification Number (MCR.002.019)6. When value equals "04" then Payer ID must equal must equal Submitting State Provider Identifier (PRV.002.019)	1. Value must be 2 characters2. Value must be in Payer ID Type List (VVL)3. Mandatory4. When value equals "01" then Payer ID must equal Submitting State (FTX.006.193)5. When value equals "02" then Payer ID must equal State Plan Identification Number (MCR.002.019)6. When value equals "04" then Payer ID must equal must equal Submitting State Provider Identifier (PRV.002.019)
09/16/2024	4.0.0	FTX.006.204	UPDATE	File segment	None	72
09/16/2024	4.0.0	FTX.006.204	ADD	N/A		Created