PRV.006.088

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TMSIS Dataguide

Medicaid.gov

Version:

PROV-CLASSIFICATION-TYPE

Data Element

DE Number

PRV088

System DE Number

PRV.006.088

File Name

File Segment Number

File Segment Name

PROV-TAXONOMY-CLASSIFICATION

Last updated

Overview Valid Values Related Rules Related DQ Measures Other Instances

Definition	A code to identify the schema used in the Provider Classification Code field to categorize providers. See T-MSIS Guidance Document, "CMS Guidance: Best Practice for Reporting Provider Classification Type and Provider Classification Code in the T-MSIS Provider File". https://www.medicaid.gov/tmsis/dataguide/t-msis-coding-blog/cms-technical-instructions-provider-classification-requirements-in-tmsis/ A provider may be reported with multiple active record segments with the same Provider Classification Type if different Provider Classification Code values apply.
Size	X(1)
FLF Start Position	52
FLF Stop Position	52
Segment Key Field Identifier	3
Coding Requirements	1. Value must be 1 character 2. Value must be in Provider Classification Type List (VVL) 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-2927	If provider classification type is populated on a provider taxonomy classification segment from a PRV file, then the provider classification type value reported must be in the list of valid values for provider classification type.
RULE-2928	If provider classification type and provider classification code are populated on a provider taxonomy classification segment from a PRV file, then the provider classification code value reported must be in the list of valid values corresponding to the provider classification type on the date specified by the provider taxonomy classification effective date.
RULE-6666	If a segment is a provider taxonomy classification segment from a PRV file, the provider classification type value reported must be compatible with the specified T-MSIS picture format: X(1).
RULE-7364	If SUBMITTING-STATE-PROV-ID is populated on a PROV-TAXONOMY-CLASSIFICATION segment from an PRV file, then PROV-CLASSIFICATION-TYPE must be populated.

Measure ID	Measure Name
PRV-4-001-1	# of providers by Provider Classification Type
MIS-11-039-39	% distinct SUBMITTING-STATE-PROV-IDs with only missing values in any active segment: PROV-CLASSIFICATION-TYPE (PRV00006)
PRV-2-009-9	% of Submitting State Provider IDs with PROV-IDENTIFIER-TYPE = 2 (NPI) that don't have any PROV-CLASSIFICATION-TYPE = 1 (taxonomy)
RULE-2928	% of PRV00006 segments with invalid Provider Classification Code for Provider Classification Type
PRV-6-001-1	% of Submitting State Provider IDs with FACILITY-GROUP-INDIVIDUAL-CODE = 01, 02 (facility or group) that do not have a Provider Classification Code that indicates a facility or group
PRV-6-002-2	% of Submitting State Provider IDs with FACILITY-GROUP-INDIVIDUAL-CODE = 03 (individual) that do not have a Provider Classification Code that indicates an individual
PRV-2-011-11	% of providers that require NPI (non-atypical) that are missing NPI (PROV-IDENTIFIER-TYPE=2)
RULE-7364	% of segments missing PROV-CLASSIFICATION-TYPE (PRV00006)

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
09/16/2024	4.0.0	PRV.006.088	UPDATE	File segment	None	92
09/16/2024	4.0.0	PRV.006.088	ADD	N/A		Created