FTX.095.365

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TMSIS Dataguide

Medicaid.gov

Version:

PAYMENT-OR-RECOUPMENT-AMOUNT

Data Element

DE Number

FTX365

System DE Number

FTX.095.365

File Name

FTX - FINANCIAL TRANSACTION

File Segment Number

File Segment Name

MISCELLANEOUS-PAYMENT

Last updated

Overview Valid Values Related Rules Related DQ Measures Other Instances

Definition	The Record ID represents the type of segment being reported. The Record ID communicates how the contents of a given row of data should be interpreted depending on which segment type the Record ID represents. Each type of segment collects different data elements so each segment type has a distinct layout. The first 3 characters identify the relevant file (e.g., ELG, PRV, CIP, etc.). The last 5 digits are the segment identifier padded with leading zeros (e.g., 00001, 00002, 00003, etc.).
Size	S9(11)V99
FLF Start Position	131
FLF Stop Position	143
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value must be between -99999999999.99 and 99999999999.99 2. Value must be expressed as a number with 2-digit precision (e.g. 100.50) 3. 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-8355	If a financial transaction is from an FTX file, then the payment or recoupment amount value reported must be compatible with specified T-MSIS picture format: S9(11)V99.
RULE-8709	If the Miscellaneous Payment segment is populated from a FTX file, then the PAYMENT-OR-RECOUPMENT-AMOUNT must be populated

Measure ID	Measure Name

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
FTX025	FTX.002.025	PAYMENT-OR-RECOUPMENT-AMOUNT	FTX00002	INDIVIDUAL-CAPITATION-PMPM
FTX157	FTX.005.157	PAYMENT-OR-RECOUPMENT-AMOUNT	FTX00005	COST-SHARING-OFFSET
FTX200	FTX.006.200	PAYMENT-OR-RECOUPMENT-AMOUNT	FTX00006	VALUE-BASED-PAYMENT
FTX244	FTX.007.244	PAYMENT-OR-RECOUPMENT-AMOUNT	FTX00007	STATE-DIRECTED-PAYMENT-SEPARATE-PAYMENT-TERM
FTX287	FTX.008.287	PAYMENT-OR-RECOUPMENT-AMOUNT	FTX00008	COST-SETTLEMENT-PAYMENT
FTX326	FTX.009.326	PAYMENT-OR-RECOUPMENT-AMOUNT	FTX00009	FQHC-WRAP-PAYMENT

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
10/10/2025	4.0.19	FTX.095.365	UPDATE	Definition	The dollar amount being paid to the payee or recouped from the payee for a previous payment. A recoupment should be reported as a negative amount.	The Record ID represents the type of segment being reported. The Record ID communicates how the contents of a given row of data should be interpreted depending on which segment type the Record ID represents. Each type of segment collects different data elements so each segment type has a distinct layout. The first 3 characters identify the relevant file (e.g., ELG, PRV, CIP, etc.). The last 5 digits are the segment identifier padded with leading zeros (e.g., 00001, 00002, 00003, etc.).
05/29/2025	4.0.9	FTX.095.365	UPDATE	Definition	The Record ID represents the type of segment being reported. The Record ID communicates how the contents of a given row of data should be interpreted depending on which segment type the Record ID represents. Each type of segment collects different data elements so each segment type has a distinct layout. The first 3 characters identify the relevant file (e.g., ELG, PRV, CIP, etc.). The last 5 digits are the segment identifier padded with leading zeros (e.g., 00001, 00002, 00003, etc.).	The dollar amount being paid to the payee or recouped from the payee for a previous payment. A recoupment should be reported as a negative amount.
09/16/2024	4.0.0	FTX.095.365	UPDATE	File segment	None	76
09/16/2024	4.0.0	FTX.095.365	ADD	N/A		Created