FTX.095.390

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TMSIS Dataguide

Medicaid.gov

Version:

CATEGORY-FOR-FEDERAL-REIMBURSEMENT

Data Element

DE Number

FTX390

System DE Number

FTX.095.390

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	A code to indicate the Federal funding source for the payment.
Size	X(2)
FLF Start Position	1119
FLF Stop Position	1120
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value must be 2 characters 2. Value must be in Category for Federal Reimbursement List (VVL) 3. Conditional 4. Value must be populated when Payer ID Type equals "01"

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

RULE ID	RULE Definition
RULE-8380	If a financial transaction is from an FTX file, then the category for federal reimbursement value reported must be compatible with specified T-MSIS picture format: X(2).
RULE-8555	If the category for federal reimbursement is populated on the Miscellaneous Payment Transaction from a FTX file, then the category for federal reimbursement reported must be found in the list of valid values.
RULE-8682	If the Miscellaneous Payment segment is populated from a FTX file, then the CATEGORY-FOR-FEDERAL-REIMBURSEMENT must be populated

Measure ID	Measure Name
RULE-8682	% missing: CATEGORY-FOR-FEDERAL-REIMBURSEMENT (FTX00095)

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
CIP269	CIP.003.269	CATEGORY-FOR-FEDERAL-REIMBURSEMENT	CIP00003	CLAIM-LINE-RECORD-IP
CLT219	CLT.003.219	CATEGORY-FOR-FEDERAL-REIMBURSEMENT	CLT00003	CLAIM-LINE-RECORD-LT
COT210	COT.003.210	CATEGORY-FOR-FEDERAL-REIMBURSEMENT	COT00003	CLAIM-LINE-RECORD-OT
CRX149	CRX.003.149	CATEGORY-FOR-FEDERAL-REIMBURSEMENT	CRX00003	CLAIM-LINE-RECORD-RX
FTX045	FTX.002.045	CATEGORY-FOR-FEDERAL-REIMBURSEMENT	FTX00002	INDIVIDUAL-CAPITATION-PMPM
FTX090	FTX.003.090	CATEGORY-FOR-FEDERAL-REIMBURSEMENT	FTX00003	INDIVIDUAL-HEALTH-INSURANCE-PREMIUM-PAYMENT
FTX134	FTX.004.134	CATEGORY-FOR-FEDERAL-REIMBURSEMENT	FTX00004	GROUP-INSURANCE-PREMIUM-PAYMENT
FTX176	FTX.005.176	CATEGORY-FOR-FEDERAL-REIMBURSEMENT	FTX00005	COST-SHARING-OFFSET
FTX218	FTX.006.218	CATEGORY-FOR-FEDERAL-REIMBURSEMENT	FTX00006	VALUE-BASED-PAYMENT
FTX263	FTX.007.263	CATEGORY-FOR-FEDERAL-REIMBURSEMENT	FTX00007	STATE-DIRECTED-PAYMENT-SEPARATE-PAYMENT-TERM
FTX303	FTX.008.303	CATEGORY-FOR-FEDERAL-REIMBURSEMENT	FTX00008	COST-SETTLEMENT-PAYMENT
FTX342	FTX.009.342	CATEGORY-FOR-FEDERAL-REIMBURSEMENT	FTX00009	FQHC-WRAP-PAYMENT

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
09/25/2025	4.0.18	FTX.095.390	UPDATE	Necessity	Mandatory	Conditional
09/25/2025	4.0.18	FTX.095.390	UPDATE	Coding requirement	1. Value must be 2 characters2. Value must be in Category for Federal Reimbursement List (VVL)3. Mandatory	1. Value must be 2 characters2. Value must be in Category for Federal Reimbursement List (VVL)3. Conditional4. Value must be populated when Payer ID Type equals "01"
09/16/2024	4.0.0	FTX.095.390	UPDATE	File segment	None	76
09/16/2024	4.0.0	FTX.095.390	ADD	N/A		Created