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TMSIS Dataguide Medicaid.gov

Version:

3.39.0

PRV-4-001-1

Data Quality Measure
Last updated

Key Information

Measure Name # of providers by Provider Classification Type
File Type PRV
Measure ID PRV-4-001-1
Measure Type Frequency
Content area PRO

Validation

Validation Type Frequency

Measure Priority

Measure Priority N/A
Focus Area N/A
Category N/A

Claim Information

Claim Type N/A
Adjustment Type N/A
Crossover Type N/A

Thresholds

Minimum N/A
Maximum N/A
TA Minimun
TA Maximum
Longitudinal Threshold N/A
For TA
(for including in compliance training) 		No
For TA
(Longitudinal) 		No

Data Elements

DD Data Element PROV-CLASSIFICATION-TYPE
DD Data Element Number PRV088

Annotation For the data element, provider classification type code, run the frequency of unique state submitting provider IDs for each valid value, any valid value, and any invalid value, including missing
Specification STEP 1: Provider enrolled on the last day of DQ report month

Define the provider population from segment PROV-MEDICAID-ENROLLMENT-PRV00007 by keeping active records that satisfy the following criteria:

1. PROV-MEDICAID-EFF-DATE <= last day of the reporting month

2. PROV-MEDICAID-END-DATE >= last day of the reporting month OR missing

3. SUBMITTING-STATE-PROV-ID is not missing



STEP 2: Provider taxonomy on the last day of DQ report month

Of the providers that meet the criteria from STEP 1, further refine the population using segment PROV-TAXONOMY-CLASSIFICATION-PRV00006 by keeping records that satisfy the following criteria:

1a. PROV-TAXONOMY-CLASSIFICATION-EFF-DATE <= last day of the reporting month

2a. PROV-TAXONOMY-CLASSIFICATION-END-DATE >= last day of the reporting month OR missing

OR

1b. PROV-TAXONOMY-CLASSIFICATION-EFF-DATE is missing

2b. PROV-TAXONOMY-CLASSIFICATION-END-DATE is missing



STEP 3: Frequency

Count the number of unique SUBMITTING-STATE-PROV-IDs from STEP 2 for:

1. (1,2,3,4) Each valid value: PROV-CLASSIFICATION-TYPE = ("1", "2", "3", "4", respectively)

2. (A) Any valid value: PROV-CLASSIFICATION-TYPE = ("1" or "2" or "3" or "4")

3. (N) No valid value: PROV-CLASSIFICATION-TYPE (NOT ("1" or "2" or "3" or "4") or missing

4. (T) total: PROV-CLASSIFICATION-TYPE = (any missing or non-missing value)