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TMSIS Dataguide Medicaid.gov

Version:

3.38.0

PAYEE-MCR-PLAN-TYPE

Data Element

DE Number

FTX209

System DE Number

FTX.006.209

File Name

FTX - FINANCIAL TRANSACTION

File Segment Number

FTX00006

File Segment Name

VALUE-BASED-PAYMENT

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
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
FTX166 FTX.005.166 PAYEE-MCR-PLAN-TYPE FTX00005 COST-SHARING-OFFSET
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