FTX.008.290

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TMSIS Dataguide

Medicaid.gov

Version:

PAYER-ID

Data Element

DE Number

FTX290

System DE Number

FTX.008.290

File Name

FTX - FINANCIAL TRANSACTION

File Segment Number

File Segment Name

COST-SETTLEMENT-PAYMENT

Last updated

Overview Valid Values Related Rules Related DQ Measures Other Instances

Definition	This is the identifier that corresponds with the payer's role in relation to the Medicaid/CHIP system. The payer is the subject taking the action of either making a payment or taking a recoupment, as opposed to the payee who is the object of the transaction. The payer is the entity that is either making a payment or recouping a payment from another entity or individual. The payee is the individual or entity that is either receiving a payment or having a previous payment recouped.
Size	X(30)
FLF Start Position	167
FLF Stop Position	196
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value must be 30 characters or less 2. 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-8282	If a financial transaction is from an FTX file, then the payer id value reported must be compatible with specified T-MSIS picture format: X(30).
RULE-8743	If a financial transaction is a non-void, and the payer ID is populated on Cost Settlement Payment segment from the FTX file and the payer id type is Sub-capitated network provider ID, then the payer ID value reported must be equal to a submitting state provider ID on a provider main attributes segment from a PRV file where the effective and end dates of the provider main attributes segment overlap with the cost settlement period start date on the financial transaction.
RULE-8764	If a financial transaction is a non-void, and the PAYER ID is populated on Cost Settlement Payment segment from the FTX file and the PAYER ID Type is Capitated plan ID, then the PAYER ID value reported must be equal to a State Plan Identification Number on a managed care main segment from a MCR file where the managed care contract effective and end dates of the managed care main segment overlap with the cost settlement period start date on the financial transaction.
RULE-8800	If a financial transaction is a non-void, and the PAYER ID is populated on Cost Settlement Payment segment from the FTX file and the PAYER ID Type is State, then the PAYER ID value reported must be equal to the value populated for submitting state.

Measure ID	Measure Name

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
FTX028	FTX.002.028	PAYER-ID	FTX00002	INDIVIDUAL-CAPITATION-PMPM
FTX075	FTX.003.075	PAYER-ID	FTX00003	INDIVIDUAL-HEALTH-INSURANCE-PREMIUM-PAYMENT
FTX116	FTX.004.116	PAYER-ID	FTX00004	GROUP-INSURANCE-PREMIUM-PAYMENT
FTX160	FTX.005.160	PAYER-ID	FTX00005	COST-SHARING-OFFSET
FTX203	FTX.006.203	PAYER-ID	FTX00006	VALUE-BASED-PAYMENT
FTX247	FTX.007.247	PAYER-ID	FTX00007	STATE-DIRECTED-PAYMENT-SEPARATE-PAYMENT-TERM
FTX329	FTX.009.329	PAYER-ID	FTX00009	FQHC-WRAP-PAYMENT
FTX368	FTX.095.368	PAYER-ID	FTX00095	MISCELLANEOUS-PAYMENT

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
09/16/2024	4.0.0	FTX.008.290	UPDATE	File segment	None	74
09/16/2024	4.0.0	FTX.008.290	ADD	N/A		Created