FTX.095.401

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TMSIS Dataguide

Medicaid.gov

Version:

PAYMENT-CAT-XREF

Data Element

DE Number

FTX401

System DE Number

FTX.095.401

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	Cross-reference to the applicable payment category in the managed care plan's contract with the state Medicaid/CHIP agency or their fiscal intermediary.
Size	X(50)
FLF Start Position	1221
FLF Stop Position	1270
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value must be 50 characters or less 2. Conditional

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

RULE ID	RULE Definition
RULE-8391	If a financial transaction is from an FTX file, then the payment category cross reference value reported must be compatible with specified T-MSIS picture format: X(50).

Measure ID	Measure Name

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
FTX057	FTX.002.057	PAYMENT-CAT-XREF	FTX00002	INDIVIDUAL-CAPITATION-PMPM
FTX230	FTX.006.230	PAYMENT-CAT-XREF	FTX00006	VALUE-BASED-PAYMENT
FTX273	FTX.007.273	PAYMENT-CAT-XREF	FTX00007	STATE-DIRECTED-PAYMENT-SEPARATE-PAYMENT-TERM

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
09/16/2024	4.0.0	FTX.095.401	UPDATE	File segment	None	76
09/16/2024	4.0.0	FTX.095.401	ADD	N/A		Created