T-MSIS Valid Value Lists v4.0.0 508.xlsx

[Medicaid] Transformed - Medicaid Statistical Information System (T-MSIS) (CMS-R-284)

T-MSIS Valid Value Lists v4.0.0 508.xlsx

OMB: 0938-0345

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Overview

Cover Page
T-MSIS VVLs v4.0.0

Sheet 1: Cover Page

Centers for Medicaid and CHIP Services (CMCS)



Transformed Medicaid Statistical Information System (T-MSIS)



Valid Value Lists (VVLs)



Version: v4.0.0



Last Modified: 2024-06-03



















PRA Disclosure Statement: The Transformed Medicaid Statistical Information System (T-MSIS) is used to assist the Centers for Medicare & Medicaid Services (CMS) with monitoring and oversight of Medicaid and CHIP programs, to enable evaluation of demonstrations under section 1115 of the Social Security Act



and to calculate quality measures and other metrics, including those reported through the new Medicaid and CHIP Scoreboard. Section 4735 of the Balanced Budget Act of 1997 included a statutory requirement for states to submit claims data, enrollee encounter data, and supporting information. Section 6504 of the Affordable Care Act strengthened



this provision by requiring states to include data elements the Secretary determines necessary for program integrity, program oversight, and administration. Under the Privacy Act of 1974 any personally identifying information obtained will be kept private to the extent of the law. According to the Paperwork Reduction Act of 1995, no persons are



required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0938-0345 (Expires: 03/31/2026). The time required to complete this information collection is estimated to average 10 hours per response, including the time to review instructions,



search existing data resources, gather the data needed, and complete and review the information collection. If you have comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: CMS, 7500 Security Boulevard, Attn: PRA Reports Clearance Officer, Mail Stop C4-26-05, Baltimore, Maryland 21244-1850.


Sheet 2: T-MSIS VVLs v4.0.0
T-MSIS Valid Value Lists (VVLs) - v4.0.0




VVL Field
 VVL Name
 VVL Code
 VVL Code Description
 Effective Start Date
 Effective End Date
1115A-DEMONSTRATION-IND 1115A Demonstration Indicator List 0 Not a 1115A 01/01/0001 12/31/9999
1115A-DEMONSTRATION-IND 1115A Demonstration Indicator List 1 1115A 01/01/0001 12/31/9999
21.P-FORM 21.P Form List 2 Inpatient Hospital 01/01/0001 12/31/9999
21.P-FORM 21.P Form List 3 Inpatient Mental Health 01/01/0001 12/31/9999
21.P-FORM 21.P Form List 4 Nursing Care Services 01/01/0001 12/31/9999
21.P-FORM 21.P Form List 5 Physician/Surgical 01/01/0001 12/31/9999
21.P-FORM 21.P Form List 6 Outpatient Hospital 01/01/0001 12/31/9999
21.P-FORM 21.P Form List 7 Outpatient Mental Health 01/01/0001 12/31/9999
21.P-FORM 21.P Form List 8 Prescribed Drugs 01/01/0001 12/31/9999
21.P-FORM 21.P Form List 9 Dental Services 01/01/0001 12/31/9999
21.P-FORM 21.P Form List 10 Vision Services 01/01/0001 12/31/9999
21.P-FORM 21.P Form List 11 Other Practitioners 01/01/0001 12/31/9999
21.P-FORM 21.P Form List 12 Clinic Services 01/01/0001 12/31/9999
21.P-FORM 21.P Form List 13 Therapy Services 01/01/0001 12/31/9999
21.P-FORM 21.P Form List 14 Laboratory/Radiological 01/01/0001 12/31/9999
21.P-FORM 21.P Form List 15 Medical Equipment 01/01/0001 12/31/9999
21.P-FORM 21.P Form List 16 Family Planning 01/01/0001 12/31/9999
21.P-FORM 21.P Form List 17 Abortions 01/01/0001 12/31/9999
21.P-FORM 21.P Form List 18 Screening Services 01/01/0001 12/31/9999
21.P-FORM 21.P Form List 19 Home Health 01/01/0001 12/31/9999
21.P-FORM 21.P Form List 20 Health Services Initiatives 01/01/0001 12/31/9999
21.P-FORM 21.P Form List 21 Home and Community 01/01/0001 12/31/9999
21.P-FORM 21.P Form List 22 Hospice 01/01/0001 12/31/9999
21.P-FORM 21.P Form List 23 Medical Transportation 01/01/0001 12/31/9999
21.P-FORM 21.P Form List 24 Case Management 01/01/0001 12/31/9999
21.P-FORM 21.P Form List 25 Translation and Interpretation 01/01/0001 12/31/9999
21.P-FORM 21.P Form List 26 ARP Section 9821 COVID Vaccine/Vaccine Administration 01/01/0001 12/31/9999
21.P-FORM 21.P Form List 31 Other Services 01/01/0001 12/31/9999
21.P-FORM 21.P Form List 32 Outreach 01/01/0001 12/31/9999
21.P-FORM 21.P Form List 33 Administration 01/01/0001 12/31/9999
21.P-FORM 21.P Form List 34 PERM Administration 01/01/0001 12/31/9999
21.P-FORM 21.P Form List 35 Citizenship Verification Technology-CHIPRA 01/01/0001 12/31/9999
21.P-FORM 21.P Form List 1A Premiums: Up To 150% - Gross Premiums Paid 01/01/0001 12/31/9999
21.P-FORM 21.P Form List 1B Premiums: Up To 150% - Cost Sharing Offset 01/01/0001 12/31/9999
21.P-FORM 21.P Form List 1C Premiums: Over 150% - Gross Premiums Paid 01/01/0001 12/31/9999
21.P-FORM 21.P Form List 1D Premiums: Over 150% - Cost Sharing Offset 01/01/0001 12/31/9999
21.P-FORM 21.P Form List 32A Increased Outreach and Enrollment of Indians 01/01/0001 12/31/9999
21.P-FORM 21.P Form List 32B Increase Outreach and Enrollment of children through premium subsidies 01/01/0001 12/31/9999
21.P-FORM 21.P Form List 35A CVT Development 01/01/0001 12/31/9999
21.P-FORM 21.P Form List 35B CVT Operation 01/01/0001 12/31/9999
21.P-FORM 21.P Form List 8A Drug Rebate 01/01/0001 12/31/9999
21BASE-FORM 21BASE Form List 2 Inpatient Hospital 01/01/0001 12/31/9999
21BASE-FORM 21BASE Form List 3 Inpatient Mental Health 01/01/0001 12/31/9999
21BASE-FORM 21BASE Form List 4 Nursing Care 01/01/0001 12/31/9999
21BASE-FORM 21BASE Form List 5 Physician/Surgical 01/01/0001 12/31/9999
21BASE-FORM 21BASE Form List 6 Outpatient Hospital 01/01/0001 12/31/9999
21BASE-FORM 21BASE Form List 7 Outpatient Mental Health 01/01/0001 12/31/9999
21BASE-FORM 21BASE Form List 8 Prescribed Drugs 01/01/0001 12/31/9999
21BASE-FORM 21BASE Form List 9 Dental Services 01/01/0001 12/31/9999
21BASE-FORM 21BASE Form List 10 Vision Services 01/01/0001 12/31/9999
21BASE-FORM 21BASE Form List 11 Other Practitioners 01/01/0001 12/31/9999
21BASE-FORM 21BASE Form List 12 Clinic Services 01/01/0001 12/31/9999
21BASE-FORM 21BASE Form List 13 Therapy 01/01/0001 12/31/9999
21BASE-FORM 21BASE Form List 14 Laboratory/Radiological 01/01/0001 12/31/9999
21BASE-FORM 21BASE Form List 15 Medical Equipment 01/01/0001 12/31/9999
21BASE-FORM 21BASE Form List 16 Family Planning 01/01/0001 12/31/9999
21BASE-FORM 21BASE Form List 17 Abortions 01/01/0001 12/31/9999
21BASE-FORM 21BASE Form List 18 Screening Services 01/01/0001 12/31/9999
21BASE-FORM 21BASE Form List 19 Home Health 01/01/0001 12/31/9999
21BASE-FORM 21BASE Form List 20 Health Services Initiatives 01/01/0001 12/31/9999
21BASE-FORM 21BASE Form List 21 Home And Community-Based Services 01/01/0001 12/31/9999
21BASE-FORM 21BASE Form List 22 Hospice 01/01/0001 12/31/9999
21BASE-FORM 21BASE Form List 23 Medical Transportation 01/01/0001 12/31/9999
21BASE-FORM 21BASE Form List 24 Case Management 01/01/0001 12/31/9999
21BASE-FORM 21BASE Form List 25 Translation and Interpretation 01/01/0001 12/31/9999
21BASE-FORM 21BASE Form List 26 ARP Section 9821 COVID Vaccine/Vaccine Administration 01/01/0001 12/31/9999
21BASE-FORM 21BASE Form List 31 Other Services 01/01/0001 12/31/9999
21BASE-FORM 21BASE Form List 32 Outreach 01/01/0001 12/31/9999
21BASE-FORM 21BASE Form List 33 Administration 01/01/0001 12/31/9999
21BASE-FORM 21BASE Form List 34 PERM Administration 01/01/0001 12/31/9999
21BASE-FORM 21BASE Form List 35 Citizenship Verification Technology-CHIPRA 01/01/0001 12/31/9999
21BASE-FORM 21BASE Form List 1A Premiums - Up To 150%: Gross Premiums Paid 01/01/0001 12/31/9999
21BASE-FORM 21BASE Form List 1B Premiums - Up To 150%: Cost Sharing Offset 01/01/0001 12/31/9999
21BASE-FORM 21BASE Form List 1C Premiums - Over 150%: Gross Premiums Paid 01/01/0001 12/31/9999
21BASE-FORM 21BASE Form List 1D Premiums - Over 150%: Cost Sharing Offset 01/01/0001 12/31/9999
21BASE-FORM 21BASE Form List 32A Increased Outreach and Enrollment of Indians 01/01/0001 12/31/9999
21BASE-FORM 21BASE Form List 32B Increase Outreach and Enrollment of children through premium subsidies 01/01/0001 12/31/9999
21BASE-FORM 21BASE Form List 35A CVT Development 01/01/0001 12/31/9999
21BASE-FORM 21BASE Form List 35B CVT Operation 01/01/0001 12/31/9999
21BASE-FORM 21BASE Form List 8A Drug Rebate 01/01/0001 12/31/9999
64.10BASE-FORM 64.10BASE Form List 29 Non-Emergency Medical Transportation 01/01/0001 12/31/9999
64.21U-FORM 64.21U Form List 2 Inpatient Hospital Services - Reg. Payments 01/01/0001 12/31/9999
64.21U-FORM 64.21U Form List 3 Inpatient Mental Health - Reg. Payment 01/01/0001 12/31/9999
64.21U-FORM 64.21U Form List 4 Nursing Care Services 01/01/0001 12/31/9999
64.21U-FORM 64.21U Form List 5 Physician/Surgical 01/01/0001 12/31/9999
64.21U-FORM 64.21U Form List 6 Outpatient Hospital Services 01/01/0001 12/31/9999
64.21U-FORM 64.21U Form List 7 Outpatient Mental Health 01/01/0001 12/31/9999
64.21U-FORM 64.21U Form List 8 Prescribed Drugs 01/01/0001 12/31/9999
64.21U-FORM 64.21U Form List 9 Dental Services 01/01/0001 12/31/9999
64.21U-FORM 64.21U Form List 10 Vision Services 01/01/0001 12/31/9999
64.21U-FORM 64.21U Form List 11 Other Practitioners 01/01/0001 12/31/9999
64.21U-FORM 64.21U Form List 12 Clinic Services 01/01/0001 12/31/9999
64.21U-FORM 64.21U Form List 13 Therapy Services 01/01/0001 12/31/9999
64.21U-FORM 64.21U Form List 14 Laboratory/Radiological 01/01/0001 12/31/9999
64.21U-FORM 64.21U Form List 15 Medical Equipment 01/01/0001 12/31/9999
64.21U-FORM 64.21U Form List 16 Family Planning 01/01/0001 12/31/9999
64.21U-FORM 64.21U Form List 17 Abortions 01/01/0001 12/31/9999
64.21U-FORM 64.21U Form List 18 Screening Services 01/01/0001 12/31/9999
64.21U-FORM 64.21U Form List 19 Home Health 01/01/0001 12/31/9999
64.21U-FORM 64.21U Form List 20 Medicare Payments 01/01/0001 12/31/9999
64.21U-FORM 64.21U Form List 21 Home And Community 01/01/0001 12/31/9999
64.21U-FORM 64.21U Form List 22 Hospice 01/01/0001 12/31/9999
64.21U-FORM 64.21U Form List 23 Medical Transport 01/01/0001 12/31/9999
64.21U-FORM 64.21U Form List 24 Case Management 01/01/0001 12/31/9999
64.21U-FORM 64.21U Form List 26 ARP Section 9821 COVID Vaccine/Vaccine Administration 01/01/0001 12/31/9999
64.21U-FORM 64.21U Form List 31 Other Services 01/01/0001 12/31/9999
64.21U-FORM 64.21U Form List 1A Premiums: Up To 150% - Gross Premiums Paid 01/01/0001 12/31/9999
64.21U-FORM 64.21U Form List 1B Premiums: Up To 150% - Cost Sharing Offset 01/01/0001 12/31/9999
64.21U-FORM 64.21U Form List 1C Premiums: Over 150% - Gross Premiums Paid 01/01/0001 12/31/9999
64.21U-FORM 64.21U Form List 1D Premiums: Over 150% - Cost Sharing Offset 01/01/0001 12/31/9999
64.21U-FORM 64.21U Form List 21A Home and Community-Based Services - Regular Payment (WAIVER) 01/01/0001 12/31/9999
64.21U-FORM 64.21U Form List 2A Inpatient Hospital Services - DSH 01/01/0001 12/31/9999
64.21U-FORM 64.21U Form List 3A Inpatient Mental Health - DSH 01/01/0001 12/31/9999
64.21U-FORM 64.21U Form List 3B Certified Community Behavior Health Clinic Payments 01/01/0001 12/31/9999
64.21U-FORM 64.21U Form List 8A1 Drug Rebate - National 01/01/0001 12/31/9999
64.21U-FORM 64.21U Form List 8A2 Drug Rebate - State 01/01/0001 12/31/9999
64.21U-FORM 64.21U Form List 8A3 MCO - National Agreement 01/01/0001 12/31/9999
64.21U-FORM 64.21U Form List 8A4 MCO - State Sidebar Agreement 01/01/0001 12/31/9999
64.21U-FORM 64.21U Form List 8A5 Increased ACA OFFSET - Fee for Service - 100% 01/01/0001 12/31/9999
64.21U-FORM 64.21U Form List 8A6 Increased ACA OFFSET - MCO - 100% 01/01/0001 12/31/9999
64.21U-FORM 64.21U Form List 8A7 Drug Rebate Offset - Value Based Purchasing 01/01/0001 12/31/9999
64.21UP-FORM 64.21UP Form List 2 Inpatient Hospital - Reg. Payments 01/01/0001 12/31/9999
64.21UP-FORM 64.21UP Form List 3 Inpatient Mental Health - Reg. Payments 01/01/0001 12/31/9999
64.21UP-FORM 64.21UP Form List 4 Nursing 01/01/0001 12/31/9999
64.21UP-FORM 64.21UP Form List 5 Physician/Surgical 01/01/0001 12/31/9999
64.21UP-FORM 64.21UP Form List 6 Outpatient Hospital 01/01/0001 12/31/9999
64.21UP-FORM 64.21UP Form List 7 Outpatient Mental Health 01/01/0001 12/31/9999
64.21UP-FORM 64.21UP Form List 8 Prescribed Drugs 01/01/0001 12/31/9999
64.21UP-FORM 64.21UP Form List 9 Dental Services 01/01/0001 12/31/9999
64.21UP-FORM 64.21UP Form List 10 Vision Services 01/01/0001 12/31/9999
64.21UP-FORM 64.21UP Form List 11 Other Practitioners 01/01/0001 12/31/9999
64.21UP-FORM 64.21UP Form List 12 Clinic services 01/01/0001 12/31/9999
64.21UP-FORM 64.21UP Form List 13 Therapy Services 01/01/0001 12/31/9999
64.21UP-FORM 64.21UP Form List 14 Laboratory/Radiological 01/01/0001 12/31/9999
64.21UP-FORM 64.21UP Form List 15 Medical Equipment 01/01/0001 12/31/9999
64.21UP-FORM 64.21UP Form List 16 Family Planning 01/01/0001 12/31/9999
64.21UP-FORM 64.21UP Form List 17 Abortions 01/01/0001 12/31/9999
64.21UP-FORM 64.21UP Form List 18 Screening 01/01/0001 12/31/9999
64.21UP-FORM 64.21UP Form List 19 Home Health 01/01/0001 12/31/9999
64.21UP-FORM 64.21UP Form List 20 Medicare Payments 01/01/0001 12/31/9999
64.21UP-FORM 64.21UP Form List 21 Home And Community 01/01/0001 12/31/9999
64.21UP-FORM 64.21UP Form List 22 Hospice 01/01/0001 12/31/9999
64.21UP-FORM 64.21UP Form List 23 Medical Transport 01/01/0001 12/31/9999
64.21UP-FORM 64.21UP Form List 24 Case Management 01/01/0001 12/31/9999
64.21UP-FORM 64.21UP Form List 26 ARP Section 9821 COVID Vaccine/Vaccine Administration 01/01/0001 12/31/9999
64.21UP-FORM 64.21UP Form List 31 Other Services 01/01/0001 12/31/9999
64.21UP-FORM 64.21UP Form List 1A Premiums Up To 150% - Gross Premiums Paid 01/01/0001 12/31/9999
64.21UP-FORM 64.21UP Form List 1B Premiums Up To 150% - Cost Sharing Offset 01/01/0001 12/31/9999
64.21UP-FORM 64.21UP Form List 1C Premiums Over 150% - Gross Premiums Paid 01/01/0001 12/31/9999
64.21UP-FORM 64.21UP Form List 1D Premiums Over 150% - Cost Sharing Offset 01/01/0001 12/31/9999
64.21UP-FORM 64.21UP Form List 21A Home and Community-Based Services - Regular Payment (WAIVER) 01/01/0001 12/31/9999
64.21UP-FORM 64.21UP Form List 2A Inpatient Hospital - DSH 01/01/0001 12/31/9999
64.21UP-FORM 64.21UP Form List 3A Inpatient Mental Health - DSH 01/01/0001 12/31/9999
64.21UP-FORM 64.21UP Form List 3B Certified Community Behavior Health Clinic Payments 01/01/0001 12/31/9999
64.21UP-FORM 64.21UP Form List 8A1 Drug Rebate - National 01/01/0001 12/31/9999
64.21UP-FORM 64.21UP Form List 8A2 Drug Rebate - State 01/01/0001 12/31/9999
64.21UP-FORM 64.21UP Form List 8A3 MCO - National Agreement 01/01/0001 12/31/9999
64.21UP-FORM 64.21UP Form List 8A4 MCO - State Sidebar Agreement 01/01/0001 12/31/9999
64.21UP-FORM 64.21UP Form List 8A5 Increased ACA OFFSET - Fee for Service - 100% 01/01/0001 12/31/9999
64.21UP-FORM 64.21UP Form List 8A6 Increased ACA OFFSET - MCO - 100% 01/01/0001 12/31/9999
64.21UP-FORM 64.21UP Form List 8A7 Drug Rebate Offset - Value Based Purchasing 01/01/0001 12/31/9999
64.9A-FORM 64.9A Form List A1A Medicare Collections 01/01/0001 12/31/9999
64.9A-FORM 64.9A Form List A1B1 Other Collection - Health Insurance 01/01/0001 12/31/9999
64.9A-FORM 64.9A Form List A1B2 Other Collections - Casualty Insurance 01/01/0001 12/31/9999
64.9A-FORM 64.9A Form List A1C Total Collections - Cooperative Agreements & Assign of Rights 01/01/0001 12/31/9999
64.9A-FORM 64.9A Form List A1C1 Less: Excess Paid to Individuals 01/01/0001 12/31/9999
64.9A-FORM 64.9A Form List A1C2 Net Collections To Reimburse State Title XIX Medical Payments 01/01/0001 12/31/9999
64.9A-FORM 64.9A Form List A1C3 Less 15% Incentive Actually Paid Under Section 1903(p)(1) 01/01/0001 12/31/9999
64.9A-FORM 64.9A Form List A1C4 Net Federal Share 01/01/0001 12/31/9999
64.9A-FORM 64.9A Form List A2 Total TPL Collections 01/01/0001 12/31/9999
64.9A-FORM 64.9A Form List B1 Medicare Title XVIII 01/01/0001 12/31/9999
64.9A-FORM 64.9A Form List B2 Health Insurance 01/01/0001 12/31/9999
64.9A-FORM 64.9A Form List B3 Other Cost Avoidance 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 7 Prescribed Drugs 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 8 Dental Services 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 11 Laboratory/Radiological 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 12 Home Health Services 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 13 Sterilizations 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 14 Abortions 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 15 EPSDT Screening 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 16 Rural Health 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 22 All-Inclusive Care Elderly 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 25 Primary Care Case Management 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 26 Hospice Benefits 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 27 Emergency Services for Undocumented Aliens 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 28 Federally-Qualified Health Center 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 30 Physical Therapy 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 31 Occupational Therapy 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 32 Services for Speech, Hearing & Language 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 33 Prosthetic Devices, Dentures, Eyeglasses 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 34 Diagnostic Screening & Preventive Services 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 35 Nurse Mid-Wife 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 36 Emergency Hospital Services 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 38 Nurse Practitioner Services 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 39 School Based Services 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 40 Rehabilitative Services (non-school-based) 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 41 Private Duty Nursing 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 42 Freestanding Birth Center 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 43 Health Home for Enrollees w Chronic Conditions 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 44 Tobacco Cessation for Pregnant Women 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 45 Health Home for Enrollees w Substance-Use-Disorder 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 46 OUD Medicaid Assisted Treatment – Drugs 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 47 ARP Section 9811 COVID Vaccine/Vaccine Administration 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 48 ARP Section 9813 Qualified Community Based Mobile Crisis Intervention – 85% 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 49 Health Homes for Children with Medically Complex Conditions 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 69 Other Care Services 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 10A Clinic Services - Reg. Payments 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 10B Clinic Services - Sup. Payments 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 17A Medicare - Part A 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 17B Medicare - Part B 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 17C1 120% - 134% Of Poverty 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 17D Coinsurance 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 18A Medicaid - MCO 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 18A1 Medicaid MCO - Evaluation and Management 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 18A2 Medicaid MCO - Vaccine codes 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 18A3 Medicaid MCO - Community First Choice 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 18A4 Medicaid MCO - Preventive Services Grade A OR B, ACIP Vaccines and their Admin 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 18A5 Medicaid MCO - Certified Community Behavior Health Clinic Payments 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 18A6 Medicaid MCO - Services Subject to Electronic Visit Verification Requirements 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 18B1 Prepaid Ambulatory Health Plan 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 18B1a MCO PAHP - Evaluation and Management 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 18B1b MCO PAHP - Vaccine codes 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 18B1c MCO PAHP - Community First Choice 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 18B1d MCO PAHP - Preventive Services Grade A OR B, ACIP Vaccines and their Admin 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 18B1e Medicaid PAHP - Certified Community Behavior Health Clinic Payments 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 18B1f MCO PAHP - Services Subject to Electronic Visit Verification Requirements 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 18B2 Prepaid Inpatient Health Plan 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 18B2a MCO PIHP - Evaluation and Management 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 18B2b MCO PIHP - Vaccine codes 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 18B2c MCO PIHP - Community First Choice 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 18B2d MCO PIHP - Preventive Services Grade A OR B, ACIP Vaccines and their Admin 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 18B2e Medicaid PIHP - Certified Community Behavior Health Clinic Payments 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 18B2f MCO PIHP - Services Subject to Electronic Visit Verification Requirements 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 18C Medicaid - Group Health 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 18D Medicaid - Coinsurance 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 18E Medicaid - Other 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 19A Home & Community-Based Services - Regular Payment (1915(c) Waiver) 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 19B Home & Community-Based Services - St. Plan 1915(i) Only Pay. 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 19C Home & Community-Based Services - St. Plan 1915(j) Only Pay. 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 19D Home & Community Based Services State Plan 1915(k) Community First Choice 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 1A Inpatient Hospital - Reg. Payments 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 1B Inpatient Hospital - DSH 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 1C Inpatient Hospital - Sup. Payments 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 1D Inpatient Hospital - GME Sup Payments 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 23A Personal Care Services - Reg. Payments 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 23B Personal Care Services - SDS 1915(j) 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 24A Targeted Case Management Services - Com. Case-Man. 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 24B Case Management - State Wide 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 29A Non-Emergency Medical Transportation - Reg. Payments 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 29B Non-Emergency Medical Transportation - Sup. Payments 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 2A Mental Health Facility Services - Reg. Payments 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 2B Mental Health Facility - DSH 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 2C Certified Community Behavior Health Clinic Payments 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 34A Preventive Services Grade A OR B, ACIP Vaccines and their Admin 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 37A Critical Access Hospitals - Reg. Payments 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 37B Critical Access Hospitals Inpatient - Sup. Payments 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 37C Critical Access Hospitals Outpatient - Sup. Payments 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 3A Nursing Facility Services - Reg. Payments 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 3B Nursing Facility Services - Sup. Payments 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 46A1 OUD MAT DRUG REBATE/National Agreement 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 46A2 OUD MAT DRUG REBATE/State Sidebar 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 46A3 OUD MAT DRUG REBATE MCO /National Agreement 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 46A4 OUD MAT DRUG REBATE MCO /State Sidebar 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 46A5 OUD MAT DRUG REBATE/Increased ACA Offset Fee for Service - 100% 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 46A6 OUD MAT DRUG REBATE/Increased ACA Offset MCO – 100% 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 46B OUD Medicaid Assisted Treatment Services 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 4A Intermediate Care Facility Services - Ind. with Intellectual Disabilities: Public Providers 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 4B Intermediate Care Facility Services - Ind. with Intellectual Disabilities: Private Providers 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 4C Intermediate Care Facility Services - Ind. with Intellectual Disabilities: Supplemental Payments 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 5A Physician & Surgical Services - Reg. Payments 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 5B Physician & Surgical Services - Sup. Payments 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 5C Physician & Surgical Services - Evaluation and Management 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 5D Physician & Surgical Services - Vaccine codes 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 6A Outpatient Hospital Services - Reg. Payments 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 6B Outpatient Hospital Services - Sup. Payments 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 7A1 Drug Rebate Offset - National 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 7A2 Drug Rebate Offset - State Sidebar Agreement 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 7A3 MCO - National Agreement 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 7A4 MCO - State Sidebar Agreement 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 7A5 Increased ACA OFFSET - Fee for Service - 100% 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 7A6 Increased ACA OFFSET - MCO - 100% 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 7A7 Drug Rebate Offset - Value Based Purchasing 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 9A Other Practitioners Services - Reg. Payments 01/01/0001 12/31/9999
64.9BASE-FORM 64.9BASE Form List 9B Other Practitioners Services - Sup. Payments 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 7 Prescribed Drugs 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 8 Dental Services 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 11 Laboratory/Radiological 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 12 Home Health 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 13 Sterilizations 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 14 Abortions 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 15 EPSDT Screen 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 16 Rural Health Clinic 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 22 Programs/All-Inclusive 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 25 Primary Care Case Manage 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 26 Hospice 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 27 Emergency Services for Undocumented Aliens 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 28 Federally-Qualified Health Center 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 30 Physical Therapy 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 31 Occupational Therapy 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 32 Services for Speech, Hearing & Language 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 33 Prosthetic Devices, Dentures, Eyeglasses 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 34 Diagnostic Screening & Preventive Services 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 35 Nurse Mid-Wife 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 36 Emergency Hospital Services 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 38 Nurse Practitioner Services 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 39 School Based Services 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 40 Rehabilitative Services (non-school-based) 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 41 Private Duty Nursing 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 42 Freestanding Birth Center 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 43 Health Home for Enrollees w Chronic Conditions 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 44 Tobacco Cessation for Pregnant Women 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 45 Health Home for Enrollees w Substance-Use-Disorder 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 46 OUD Medicaid Assisted Treatment – Drugs 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 47 ARP Section 9811 COVID Vaccine/Vaccine Administration 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 48 ARP Section 9813 Qualified Community Based Mobile Crisis Intervention – 85% 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 49 Health Homes for Children with Medically Complex Conditions 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 69 Other Care Services 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 10A Clinic Services - Reg. Payments 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 10B Clinic Services - Sup. Payments 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 17A MHIP - Part A 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 17B MHIP - Part B 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 17C1 MHIP - Qual. Ind. 120-134 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 17D MHIP - Coinsurance 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 18A MHIP - MCO 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 18A1 Medicaid MCO - Evaluation and Management 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 18A2 Medicaid MCO - Vaccine codes 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 18A3 Medicaid MCO - Community First Choice 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 18A4 Medicaid MCO - Preventive Services Grade A OR B, ACIP Vaccines and their Admin 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 18A5 Medicaid MCO - Certified Community Behavior Health Clinic Payments 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 18A6 Medicaid MCO - Services Subject to Electronic Visit Verification Requirements 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 18B1 Prepaid Ambulatory Health Plan 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 18B1a MCO PAHP - Evaluation and Management 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 18B1b MCO PAHP - Vaccine codes 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 18B1c MCO PAHP - Community First Choice 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 18B1d MCO PAHP - Preventive Services Grade A OR B, ACIP Vaccines and their Admin 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 18B1e Medicaid PAHP - Certified Community Behavior Health Clinic Payments 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 18B1f MCO PAHP - Services Subject to Electronic Visit Verification Requirements 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 18B2 Prepaid Inpatient Health Plan 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 18B2a MCO PIHP - Evaluation and Management 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 18B2b MCO PIHP - Vaccine codes 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 18B2c MCO PIHP - Community First Choice 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 18B2d MCO PIHP - Preventive Services Grade A OR B, ACIP Vaccines and their Admin 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 18B2e Medicaid PIHP - Certified Community Behavior Health Clinic Payments 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 18B2f MCO PIHP - Services Subject to Electronic Visit Verification Requirements 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 18C MHIP - Group Health Plan 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 18D MHIP - Coinsurance and Deductibles 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 18E MHIP - Other 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 19A Home & Community-Based Services - Regular Payment (1915(c) Waiver) 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 19B Home & Community-Based Services - St. Plan 1915(i) Only Pay. 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 19C Home & Community-Based Services - St. Plan 1915(j) Only Pay. 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 19D Home & Community Based Services State Plan 1915(k) Community First Choice 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 1A Inpat. Hos. Serv. - Reg. Payments 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 1B Inpat. Hos. Serv. - DSH 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 1C Inpatient Hospital - Sup. Payments 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 1D Inpatient Hospital - GME Sup Payments 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 23A Personal Care Services - Reg. Payments 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 23B Personal Care Services - SDS 1915(j) 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 24A Targeted Case Management Services - Com. Case-Man. 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 24B Case Management - State Wide 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 29A Non-Emergency Medical Transportation - Reg. Payments 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 29B Non-Emergency Medical Transportation - Sup. Payments 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 2A Men. Health Fac. Serv. - Reg. Payments 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 2B Men. Health Fac. Serv. - DSH Adjustment Payments 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 2C Certified Community Behavior Health Clinic Payments 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 34A Preventive Services Grade A OR B, ACIP Vaccines and their Admin 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 37A Critical Access Hospitals - Reg. Payments 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 37B Critical Access Hospitals Inpatient - Sup. Payments 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 37C Critical Access Hospitals Outpatient - Sup. Payments 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 3A Nursing Facility Services - Reg. Payments 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 3B Nursing Facility Services - Sup. Payments 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 46A1 OUD MAT DRUG REBATE/National Agreement 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 46A2 OUD MAT DRUG REBATE/State Sidebar 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 46A3 OUD MAT DRUG REBATE MCO /National Agreement 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 46A4 OUD MAT DRUG REBATE MCO /State Sidebar 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 46A5 OUD MAT DRUG REBATE/Increased ACA Offset Fee for Service - 100% 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 46A6 OUD MAT DRUG REBATE/Increased ACA Offset MCO – 100% 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 46B OUD Medicaid Assisted Treatment Services 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 4A Intermediate Care Facility Services - Ind. with Intellectual Disabilities: Public Providers 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 4B Intermediate Care Facility Services - Ind. with Intellectual Disabilities: Private Providers 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 4C Intermediate Care Facility Services - Ind. with Intellectual Disabilities: Supplemental Payments 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 5A Physician & Surgical Services - Reg. Payments 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 5B Physician & Surgical Services - Sup. Payments 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 5C Physician & Surgical Services - Evaluation and Management 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 5D Physician & Surgical Services - Vaccine codes 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 6A Outpatient Hospital Services - Reg. Payments 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 6B Outpatient Hospital Services - Sup. Payments 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 7A1 Drug Rebate - National 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 7A2 Drug Rebate - State 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 7A3 MCO - National Agreement 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 7A4 MCO - State Sidebar Agreement 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 7A5 Increased ACA OFFSET - Fee for Service - 100% 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 7A6 Increased ACA OFFSET - MCO - 100% 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 7A7 Drug Rebate Offset - Value Based Purchasing 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 9A Other Practitioners Services - Reg. Payments 01/01/0001 12/31/9999
64.9P-FORM 64.9P Form List 9B Other Practitioners Services - Sup. Payments 01/01/0001 12/31/9999
ACCEPTING-NEW-PATIENTS-IND Accepting New Patients Indicator List 0 No 01/01/0001 12/31/9999
ACCEPTING-NEW-PATIENTS-IND Accepting New Patients Indicator List 1 Yes 01/01/0001 12/31/9999
ACCEPTING-NEW-PATIENTS-IND Accepting New Patients Indicator List 8 N/A - The individual only practices as a member of a group. 01/01/0001 12/31/9999
ACCREDITATION-ORGANIZATION Accreditation Organization List 01 National committee for quality assurance - excellent 01/01/0001 12/31/9999
ACCREDITATION-ORGANIZATION Accreditation Organization List 02 National committee for quality assurance - commendable 01/01/0001 12/31/9999
ACCREDITATION-ORGANIZATION Accreditation Organization List 03 National committee for quality assurance - provisional 01/01/0001 12/31/9999
ACCREDITATION-ORGANIZATION Accreditation Organization List 05 URAC - full 01/01/0001 12/31/9999
ACCREDITATION-ORGANIZATION Accreditation Organization List 06 URAC - conditional 01/01/0001 12/31/9999
ACCREDITATION-ORGANIZATION Accreditation Organization List 07 URAC - provisional 01/01/0001 12/31/9999
ACCREDITATION-ORGANIZATION Accreditation Organization List 08 Accreditation Association for Ambulatory Health Care, Inc. (AAAHC) - 3 years 01/01/0001 12/31/9999
ACCREDITATION-ORGANIZATION Accreditation Organization List 11 Not accredited 01/01/0001 12/31/9999
ACCREDITATION-ORGANIZATION Accreditation Organization List 12 Other 01/01/0001 12/31/9999
ACCREDITATION-ORGANIZATION Accreditation Organization List 13 National committee for quality assurance-- accredited 01/01/0001 12/31/9999
ACCREDITATION-ORGANIZATION Accreditation Organization List 14 National committee for quality assurance - interim 01/01/0001 12/31/9999
ACCREDITATION-ORGANIZATION Accreditation Organization List 15 National committee for quality assurance - denied 01/01/0001 12/31/9999
ACCREDITATION-ORGANIZATION Accreditation Organization List 16 JCAHO (Joint Commission on Accreditation of Healthcare Organizations) 01/01/0001 12/31/9999
ACCREDITATION-ORGANIZATION Accreditation Organization List See "VVL_Code_Description" field This data element's valid value code set is maintained by a Code Set Maintenance Organization (CSMO), the official licensing organization for specific valid value code sets. The CSMO is the system of record for those specific valid value code sets. While T-MSIS endeavors to be in-sync with CMSO's updates, minor delays may occur but that shouldn't block T-MSIS data submissions using the CSMO's latest version.

For background and context, see https://www.ncqa.org/programs/health-plans/health-plan-accreditation-hpa/ and https://www.aaahc.org/accreditation/accreditation-general-information/terms-of-accreditation/		 N/A N/A
ADDR-BORDER-STATE-IND Address Border State Indicator List 0 No 01/01/0001 12/31/9999
ADDR-BORDER-STATE-IND Address Border State Indicator List 1 Yes 01/01/0001 12/31/9999
ADDR-BORDER-STATE-IND Address Border State Indicator List 8 N/A - State does not distinguish "border state providers". 01/01/0001 12/31/9999
ADJUSTMENT-IND Adjustment Indicator List 0 Original Claim/Encounter/Payment/Financial Transaction - Indicates that this is the first (and, when applicable, only) fully adjudicated transaction in a claim/encounter/payment/financial transaction family (one or more claims with the related ICN-ORIG and/or ICN-ADJ and typically the same MSIS ID and provider ID(s) also). 01/01/0001 12/31/9999
ADJUSTMENT-IND Adjustment Indicator List 1 Void/Reversal/Cancel of a prior submission - Use this code to convey that the purpose of the transaction is to void/reverse/cancel a previously paid/approved claim/encounter/payment/financial transaction where the claim/encounter/payment/financial transaction is not being replaced by a new paid/approved version of the claim/encounter/payment/financial transaction. Typically, this would be the last claim/encounter/payment/financial transaction that would ever be associated with a given claim/encounter/payment/financial transaction family. These records must have the same ICN-ORIG or ICN-ADJ as the claim/encounter/financial transaction being voided. CMS expects a void transaction to also have the same MSIS ID and provider ID(s) as the claim/encounter/payment/financial transaction being voided/reversed/cancelled. 01/01/0001 12/31/9999
ADJUSTMENT-IND Adjustment Indicator List 4 Replacement/Resubmission of a previously paid/approved claim/encounter/payment/financial transaction - Use when the purpose of the transaction is to replace a previously paid/approved claim/encounter/payment/financial transaction with a new paid/approved version of the claim/encounter/payment/financial transaction. These records must have the same ICN-ORIG or ICN-ADJ as the claim/encounter/payment/financial transaction being replaced. CMS expects a replacement transaction to also have the same MSIS ID and provider ID(s) as the claim/encounter/payment/financial transaction being replaced/resubmitted. 01/01/0001 12/31/9999
ADJUSTMENT-IND Adjustment Indicator List 5 Credit Gross Adjustment - Use this code to indicate an aggregate provider-level recoupment of payments (e.g., not attributable to a single beneficiary). Amounts on these claims should be expressed as negative numbers. If a credit gross adjustment is reported with an ICN that is related to an ICN(s) of another gross adjustment (credit or debit) then CMS will interpret this to mean that the credit gross adjustment with the more recent adjudication/transaction date should completely replace the preceding related gross adjustment. If the ICNs of a credit gross adjustment are not related to any other gross adjustments (credit or debit) then the credit gross adjustment will always be treated as a distinct financial transaction. 01/01/0001 12/31/9999
ADJUSTMENT-IND Adjustment Indicator List 6 Debit Gross Adjustment - Use this code to indicate an aggregate provider-level payment to a provider (e.g., not attributable to a single beneficiary). Amounts on these claims should be expressed as positive numbers. If a debit gross adjustment is reported with an ICN that is related to an ICN(s) of another gross adjustment (credit or debit) then CMS will interpret this to mean that the credit gross adjustment with the more recent adjudication/transaction date should completely replace the preceding related gross adjustment. If the ICNs of a debit gross adjustment are not related to any other gross adjustments (credit or debit) then the debit gross adjustment will always be treated as a distinct financial transaction. 01/01/0001 12/31/9999
ADJUSTMENT-REASON-CODE Adjustment Reason Code List See "VVL_Code_Description" field This data element's valid value code set is maintained by a Code Set Maintenance Organization (CSMO), the official licensing organization for specific valid value code sets. The CSMO is the system of record for those specific valid value code sets. While T-MSIS endeavors to be in-sync with CMSO's updates, minor delays may occur but that shouldn't block T-MSIS data submissions using the CSMO's latest version.

For background and context, see https://x12.org/codes/claim-adjustment-reason-codes		 N/A N/A
ADMISSION-TYPE Admission Type List 1 EMERGENCY 01/01/0001 12/31/9999
ADMISSION-TYPE Admission Type List 2 URGENT 01/01/0001 12/31/9999
ADMISSION-TYPE Admission Type List 3 ELECTIVE 01/01/0001 12/31/9999
ADMISSION-TYPE Admission Type List 4 NEWBORN 01/01/0001 12/31/9999
ADMISSION-TYPE Admission Type List 5 TRAUMA 01/01/0001 12/31/9999
ADMISSION-TYPE Admission Type List 9 UNKNOWN 01/01/0001 12/31/9999
ADMISSION-TYPE Admission Type List See "VVL_Code_Description" field This data element's valid value code set is maintained by a Code Set Maintenance Organization (CSMO), the official licensing organization for specific valid value code sets. The CSMO is the system of record for those specific valid value code sets. While T-MSIS endeavors to be in-sync with CMSO's updates, minor delays may occur but that shouldn't block T-MSIS data submissions using the CSMO's latest version.

For background and context, see https://www.nubc.org/license		 N/A N/A
AFFILIATED-PROGRAM-TYPE Affiliated Program Type List 2 Health Plan (state-assigned health plan ID) - The value in the AFFILIATED-PROGRAM-ID data element contains the state-assigned health plan Identifier of health plan in which the provider is enrolled to provide services including through the state plan and a waiver. 01/01/0001 12/31/9999
AFFILIATED-PROGRAM-TYPE Affiliated Program Type List 3 Waiver - The value in the AFFILIATED-PROGRAM-ID data element contains an identifier for the waiver in which a provider is allowed to deliver services to eligible beneficiaries. 01/01/0001 12/31/9999
AFFILIATED-PROGRAM-TYPE Affiliated Program Type List 4 Health Home Entity - The value in the AFFILIATED-PROGRAM-ID data element contains the name of the health home in which a provider is participating. The health home entity is responsible for providing health home services to the patient in conformance with the Health Home SPA. This is the name that the state uses to uniquely identify the health home team. This entity can be a designated provider (e.g., physician, clinic, behavioral health organization), a health team which links to a designated provider, or a health team (physicians, nurses, behavioral health professionals). 01/01/0001 12/31/9999
AFFILIATED-PROGRAM-TYPE Affiliated Program Type List 5 Other - The value in the AFFILIATED-PROGRAM-ID data element contains an identifier for something other than a health plan, waiver, or health home entity 01/01/0001 12/31/9999
AFFILIATED-PROGRAM-TYPE Affiliated Program Type List 6 Sub-capitated Network provider – The value in the AFFILIATED-PROGRAM-ID data element contains the state-assigned health plan identifier with which the network provider has a sub-capitated contract to provide services for managed care plan enrollees. 01/01/0001 12/31/9999
AFFILIATED-PROGRAM-TYPE Affiliated Program Type List 7 Fee-For-Service - (This value is used to identify providers that are affiliated directly with the state’s Medicaid or CHIP agency (or their fiscal intermediary) and reimbursed by the Medicaid or CHIP agency on a FFS basis. The value in the AFFILIATED-PROGRAM-ID data element contains the ANSI state code of the state in which the provider is enrolled to provide services including through the state plan and a waiver.) 01/01/0001 12/31/9999
AMERICAN-INDIAN-ALASKA-NATIVE-INDICATOR American Indian Alaska Native Indicator List 0 Individual does not meet the definition of an American Indian/Alaska Native 01/01/0001 12/31/9999
AMERICAN-INDIAN-ALASKA-NATIVE-INDICATOR American Indian Alaska Native Indicator List 1 Individual meets the definition of an American Indian/Alaska Native 01/01/0001 12/31/9999
AMERICAN-INDIAN-ALASKA-NATIVE-INDICATOR American Indian Alaska Native Indicator List 2 Yes, Individual does have CDIB 01/01/0001 02/14/2020
ATYPICAL-PROV-IND Atypical Provider Indicator List 0 No, the State does not consider this to be an atypical provider 01/01/0001 12/31/9999
ATYPICAL-PROV-IND Atypical Provider Indicator List 1 Yes, the State considers this to be an atypical provider 01/01/0001 12/31/9999
BED-TYPE-CODE Bed Type Code List 1 Intermediate Care Facility for the Intellectually Disabled bed not in an Institution for Mental Disease 01/01/0001 12/31/9999
BED-TYPE-CODE Bed Type Code List 2 Inpatient bed not in an Institution for Mental Disease 01/01/0001 12/31/9999
BED-TYPE-CODE Bed Type Code List 3 Nursing Facility bed not in an Institution for Mental Disease 01/01/0001 12/31/9999
BED-TYPE-CODE Bed Type Code List 4 Title 18 Skilled Nursing Facility (T18 SNF) bed not in an Institution for Mental Disease 01/01/0001 12/31/9999
BED-TYPE-CODE Bed Type Code List 5 Intermediate Care Facility for the Intellectually Disabled bed in an Institution for Mental Disease 01/01/0001 12/31/9999
BED-TYPE-CODE Bed Type Code List 6 Inpatient bed in an Institution for Mental Disease 01/01/0001 12/31/9999
BED-TYPE-CODE Bed Type Code List 7 Nursing Facility bed in an Institution for Mental Disease 01/01/0001 12/31/9999
BILLING-UNIT Billing Unit List 01 Per Day 01/01/0001 12/31/9999
BILLING-UNIT Billing Unit List 02 Per Hour 01/01/0001 12/31/9999
BILLING-UNIT Billing Unit List 03 Per Case 01/01/0001 12/31/9999
BILLING-UNIT Billing Unit List 04 Per Encounter 01/01/0001 12/31/9999
BILLING-UNIT Billing Unit List 05 Per Week 01/01/0001 12/31/9999
BILLING-UNIT Billing Unit List 06 Per Month 01/01/0001 12/31/9999
BILLING-UNIT Billing Unit List 07 Other Arrangements 01/01/0001 12/31/9999
BORDER-STATE-IND Border State Indicator List 0 No 01/01/0001 12/31/9999
BORDER-STATE-IND Border State Indicator List 1 Yes 01/01/0001 12/31/9999
BRAND-GENERIC-IND Brand Generic Indicator List 0 Non-Drug 01/01/0001 12/31/9999
BRAND-GENERIC-IND Brand Generic Indicator List 1 Generic 01/01/0001 12/31/9999
BRAND-GENERIC-IND Brand Generic Indicator List 2 Brand 01/01/0001 12/31/9999
CATEGORY-FOR-FEDERAL-REIMBURSEMENT Category for Federal Reimbursement List 01 Federal funding under Title XIX 01/01/0001 12/31/9999
CATEGORY-FOR-FEDERAL-REIMBURSEMENT Category for Federal Reimbursement List 02 Federal funding under Title XXI 01/01/0001 12/31/9999
CATEGORY-FOR-FEDERAL-REIMBURSEMENT Category for Federal Reimbursement List 03 Federal funding under ACA 01/01/0001 09/30/2020
CATEGORY-FOR-FEDERAL-REIMBURSEMENT Category for Federal Reimbursement List 04 Federal funding under other legislation 01/01/0001 12/31/9999
CHIP-CODE CHIP Code List 0 Individual was not Medicaid eligible and not eligible for separate CHIP for the month 01/01/0001 02/14/2020
CHIP-CODE CHIP Code List 1 Individual was Medicaid eligible, but was not included in either Medicaid-Expansion CHIP or a separate title XXI CHIP) program for the month 01/01/0001 12/31/9999
CHIP-CODE CHIP Code List 2 Individual was included in the Medicaid-Expansion CHIP program and subject to enhanced Federal matching for the month 01/01/0001 12/31/9999
CHIP-CODE CHIP Code List 3 Individual was not Medicaid-Expansion CHIP eligible, but was included in a separate title XXI CHIP program for the month. 01/01/0001 12/31/9999
CITIZENSHIP-IND Citizenship Indicator List 0 Non-citizen 01/01/0001 12/31/9999
CITIZENSHIP-IND Citizenship Indicator List 1 U.S. Citizen (If the state’s eligibility determination system does not distinguish between U.S. citizens and U.S. nationals who are not U.S. citizens, then use this value for all U.S. citizens and U.S. nationals (see 42 CFR 435 and 436.).) 01/01/0001 12/31/9999
CITIZENSHIP-IND Citizenship Indicator List 2 U.S. National (If the state’s eligibility determination system does distinguish between U.S. citizens and U.S. nationals who are not U.S. citizens, then use this value for U.S. nationals who are not U.S. citizens (see 42 CFR 435 and 436.).) 01/01/0001 12/31/9999
CITIZENSHIP-VERIFICATION-FLAG Citizenship Verification Flag List 0 Citizenship Verified 01/01/0001 12/31/9999
CITIZENSHIP-VERIFICATION-FLAG Citizenship Verification Flag List 1 Enrolled in Medicaid pending citizenship verification 01/01/0001 12/31/9999
CLAIM-DENIED-INDICATOR Claim Denied Indicator List 0 Denied: The payment of claim in its entirety was denied by the state. 01/01/0001 12/31/9999
CLAIM-DENIED-INDICATOR Claim Denied Indicator List 1 Not Denied: The state paid some or all of the claim. 01/01/0001 12/31/9999
CLAIM-PYMT-REM-CODE Claim Payment Remittance Code List See "VVL_Code_Description" field This data element's valid value code set is maintained by a Code Set Maintenance Organization (CSMO), the official licensing organization for specific valid value code sets. The CSMO is the system of record for those specific valid value code sets. While T-MSIS endeavors to be in-sync with CMSO's updates, minor delays may occur but that shouldn't block T-MSIS data submissions using the CSMO's latest version.

For background and context, see https://x12.org/codes/remittance-advice-remark-codes		 N/A N/A
CLAIM-STATUS Claim Status Code List See "VVL_Code_Description" field This data element's valid value code set is maintained by a Code Set Maintenance Organization (CSMO), the official licensing organization for specific valid value code sets. The CSMO is the system of record for those specific valid value code sets. While T-MSIS endeavors to be in-sync with CMSO's updates, minor delays may occur but that shouldn't block T-MSIS data submissions using the CSMO's latest version.

For background and context, see https://x12.org/codes/claim-status-codes and https://x12.org/codes/claim-status-codes		 N/A N/A
CLAIM-STATUS-CATEGORY Claim Status Category List See "VVL_Code_Description" field This data element's valid value code set is maintained by a Code Set Maintenance Organization (CSMO), the official licensing organization for specific valid value code sets. The CSMO is the system of record for those specific valid value code sets. While T-MSIS endeavors to be in-sync with CMSO's updates, minor delays may occur but that shouldn't block T-MSIS data submissions using the CSMO's latest version.

For background and context, see http://www.wpc-edi.com/reference/codelists/healthcare/claim-status-category-codes/		 N/A N/A
COMPOUND-DOSAGE-FORM Compound Dosage Form List 01 Capsule 01/01/0001 12/31/9999
COMPOUND-DOSAGE-FORM Compound Dosage Form List 02 Ointment 01/01/0001 12/31/9999
COMPOUND-DOSAGE-FORM Compound Dosage Form List 03 Cream 01/01/0001 12/31/9999
COMPOUND-DOSAGE-FORM Compound Dosage Form List 04 Suppository 01/01/0001 12/31/9999
COMPOUND-DOSAGE-FORM Compound Dosage Form List 05 Powder 01/01/0001 12/31/9999
COMPOUND-DOSAGE-FORM Compound Dosage Form List 06 Emulsion 01/01/0001 12/31/9999
COMPOUND-DOSAGE-FORM Compound Dosage Form List 07 Liquid 01/01/0001 12/31/9999
COMPOUND-DOSAGE-FORM Compound Dosage Form List 10 Tablet 01/01/0001 12/31/9999
COMPOUND-DOSAGE-FORM Compound Dosage Form List 11 Solution 01/01/0001 12/31/9999
COMPOUND-DOSAGE-FORM Compound Dosage Form List 12 Suspension 01/01/0001 12/31/9999
COMPOUND-DOSAGE-FORM Compound Dosage Form List 13 Lotion 01/01/0001 12/31/9999
COMPOUND-DOSAGE-FORM Compound Dosage Form List 14 Shampoo 01/01/0001 12/31/9999
COMPOUND-DOSAGE-FORM Compound Dosage Form List 15 Elixir 01/01/0001 12/31/9999
COMPOUND-DOSAGE-FORM Compound Dosage Form List 16 Syrup 01/01/0001 12/31/9999
COMPOUND-DOSAGE-FORM Compound Dosage Form List 17 Lozenge 01/01/0001 12/31/9999
COMPOUND-DOSAGE-FORM Compound Dosage Form List 18 Enema 01/01/0001 12/31/9999
COMPOUND-DOSAGE-FORM Compound Dosage Form List See "VVL_Code_Description" field This data element's valid value code set is maintained by a Code Set Maintenance Organization (CSMO), the official licensing organization for specific valid value code sets. The CSMO is the system of record for those specific valid value code sets. While T-MSIS endeavors to be in-sync with CMSO's updates, minor delays may occur but that shouldn't block T-MSIS data submissions using the CSMO's latest version.

For background and context, see https://www.ncpdp.org/		 N/A N/A
COMPOUND-DRUG-IND Compound Drug Indicator List 0 Not Compound 01/01/0001 12/31/9999
COMPOUND-DRUG-IND Compound Drug Indicator List 1 Compound 01/01/0001 12/31/9999
CONCEPTION-TO-BIRTH-IND Conception to Birth Indicator List 0 No 01/01/0001 12/31/9999
CONCEPTION-TO-BIRTH-IND Conception to Birth Indicator List 1 Yes 01/01/0001 12/31/9999
CONTINUOUS-ELIGIBILITY-CODE Continuous Eligibility Code List 001 Continuous eligibility for children (optional per SSA 1902(e)(12) or 2105(a)(4)(A)) 01/01/0001 12/31/9999
CONTINUOUS-ELIGIBILITY-CODE Continuous Eligibility Code List 002 1115 waiver for continuous eligibility 01/01/0001 12/31/9999
CONTINUOUS-ELIGIBILITY-CODE Continuous Eligibility Code List 995 Other 01/01/0001 12/31/9999
COPAY-WAIVED-IND Copay Waived Indicator List 0 Not Waived: The provider did not waive the beneficiary's copayment. 01/01/0001 12/31/9999
COPAY-WAIVED-IND Copay Waived Indicator List 1 Waived: The provider waived the beneficiary's copayment. 01/01/0001 12/31/9999
CORE-BASED-STATISTICAL-AREA-CODE Core Based Statistical Area Code List 1 The MCOs service area falls partially or entirely inside one or more metropolitan areas. 01/01/0001 12/31/9999
CORE-BASED-STATISTICAL-AREA-CODE Core Based Statistical Area Code List 2 The MCOs service area falls partially or entirely inside one or more micropolitan areas, but not within any metropolitan areas. 01/01/0001 12/31/9999
CORE-BASED-STATISTICAL-AREA-CODE Core Based Statistical Area Code List 3 The MCOs service area falls entirely outside of all metropolitan and micropolitan areas. 01/01/0001 12/31/9999
COUNTY US County Code List See "VVL_Code_Description" field This data element's valid value code set is maintained by a Code Set Maintenance Organization (CSMO), the official licensing organization for specific valid value code sets. The CSMO is the system of record for those specific valid value code sets. While T-MSIS endeavors to be in-sync with CMSO's updates, minor delays may occur but that shouldn't block T-MSIS data submissions using the CSMO's latest version.

For background and context, see https://www.census.gov/library/reference/code-lists/ansi.html#cou		 N/A N/A
COVERAGE-TYPE Coverage Type List 01 Drug 01/01/0001 12/31/9999
COVERAGE-TYPE Coverage Type List 02 Professional (Physician) Visit - Office 01/01/0001 12/31/9999
COVERAGE-TYPE Coverage Type List 03 Dental Care 01/01/0001 12/31/9999
COVERAGE-TYPE Coverage Type List 04 Inpatient Hospital 01/01/0001 12/31/9999
COVERAGE-TYPE Coverage Type List 05 Outpatient Hospital 01/01/0001 12/31/9999
COVERAGE-TYPE Coverage Type List 06 Nursing Home 01/01/0001 12/31/9999
COVERAGE-TYPE Coverage Type List 07 Vision 01/01/0001 12/31/9999
COVERAGE-TYPE Coverage Type List 08 Durable Med Equip (rent) 01/01/0001 12/31/9999
COVERAGE-TYPE Coverage Type List 09 Durable Med Equip (purchase) 01/01/0001 12/31/9999
COVERAGE-TYPE Coverage Type List 10 Home Health 01/01/0001 12/31/9999
COVERAGE-TYPE Coverage Type List 11 Mental health-outpatient 01/01/0001 12/31/9999
COVERAGE-TYPE Coverage Type List 12 Mental health -inpatient 01/01/0001 12/31/9999
COVERAGE-TYPE Coverage Type List 13 Psychiatric care- outpatient 01/01/0001 12/31/9999
COVERAGE-TYPE Coverage Type List 14 Psychiatric care- inpatient 01/01/0001 12/31/9999
COVERAGE-TYPE Coverage Type List 15 Rehabilitation 01/01/0001 12/31/9999
COVERAGE-TYPE Coverage Type List 16 Cancer 01/01/0001 12/31/9999
COVERAGE-TYPE Coverage Type List 17 Emergency Services 01/01/0001 12/31/9999
COVERAGE-TYPE Coverage Type List 18 Chiropractic 01/01/0001 12/31/9999
COVERAGE-TYPE Coverage Type List 19 Surgical 01/01/0001 12/31/9999
COVERAGE-TYPE Coverage Type List 20 Diagnostic Medical, including X-ray and Lab Services 01/01/0001 12/31/9999
COVERAGE-TYPE Coverage Type List 21 PT/OT/ST 01/01/0001 12/31/9999
COVERAGE-TYPE Coverage Type List 22 Hospice 01/01/0001 12/31/9999
COVERAGE-TYPE Coverage Type List 23 Transportation 01/01/0001 12/31/9999
COVERAGE-TYPE Coverage Type List 98 Other 01/01/0001 12/31/9999
CROSSOVER-INDICATOR Crossover Indicator List 0 Not Crossover Claim 01/01/0001 12/31/9999
CROSSOVER-INDICATOR Crossover Indicator List 1 Crossover Claim 01/01/0001 12/31/9999
DATA-DICTIONARY-VERSION Data Dictionary Version List DEC13V2.3
01/01/0001 12/31/9999
DATA-DICTIONARY-VERSION Data Dictionary Version List NOV07V2.1
01/01/0001 12/31/9999
DATA-DICTIONARY-VERSION Data Dictionary Version List NOV13V1.1
01/01/0001 12/31/9999
DATA-DICTIONARY-VERSION Data Dictionary Version List NOV15V2.0
01/01/0001 12/31/9999
DATA-DICTIONARY-VERSION Data Dictionary Version List NOV17V2.1
01/01/0001 12/31/9999
DATA-DICTIONARY-VERSION Data Dictionary Version List NOV23V2.2
01/01/0001 12/31/9999
DATA-DICTIONARY-VERSION Data Dictionary Version List v2.4.0
01/01/0001 12/31/9999
DATA-DICTIONARY-VERSION Data Dictionary Version List v3.0.0
06/27/2022 12/31/9999
DATA-DICTIONARY-VERSION Data Dictionary Version List v4.0.0
02/14/2025 12/31/9999
DIAGNOSIS-CODE Diagnosis Code List See "VVL_Code_Description" field This data element's valid value code set is maintained by a Code Set Maintenance Organization (CSMO), the official licensing organization for specific valid value code sets. The CSMO is the system of record for those specific valid value code sets. While T-MSIS endeavors to be in-sync with CMSO's updates, minor delays may occur but that shouldn't block T-MSIS data submissions using the CSMO's latest version.

For background and context, see https://www.cms.gov/Medicare/Coding/ICD9ProviderDiagnosticCodes/codes		 N/A N/A
DIAGNOSIS-CODE-FLAG Diagnosis Code Flag List 1 ICD-9 01/01/0001 12/31/9999
DIAGNOSIS-CODE-FLAG Diagnosis Code Flag List 2 ICD-10 01/01/0001 12/31/9999
DIAGNOSIS-POA-FLAG Diagnosis POA Flag List 1 Unreported/Not used. Exempt from POA reporting. 01/01/0001 12/31/9999
DIAGNOSIS-POA-FLAG Diagnosis POA Flag List N Diagnosis was not present at time of inpatient admission 01/01/0001 12/31/9999
DIAGNOSIS-POA-FLAG Diagnosis POA Flag List See "VVL_Code_Description" field This data element's valid value code set is maintained by a Code Set Maintenance Organization (CSMO), the official licensing organization for specific valid value code sets. The CSMO is the system of record for those specific valid value code sets. While T-MSIS endeavors to be in-sync with CMSO's updates, minor delays may occur but that shouldn't block T-MSIS data submissions using the CSMO's latest version.

For background and context, see https://www.nubc.org/license		 N/A N/A
DIAGNOSIS-POA-FLAG Diagnosis POA Flag List U Documentation insufficient to determine if condition was present at the time of inpatient admission 01/01/0001 12/31/9999
DIAGNOSIS-POA-FLAG Diagnosis POA Flag List W Clinically undetermined. Provider unable to clinically determine whether the condition was present at the time of inpatient admission. 01/01/0001 12/31/9999
DIAGNOSIS-POA-FLAG Diagnosis POA Flag List Y Diagnosis was present at time of inpatient admission 01/01/0001 12/31/9999
DIAGNOSIS-TYPE Diagnosis Type List A Admitting (from 837I or UB-04 claim for IP and LT) 01/01/0001 12/31/9999
DIAGNOSIS-TYPE Diagnosis Type List D Diagnosis Code #1-5 (from NCPDP claim for RX) or #1-12 (from 837P, CMS-1500, 837D, or ADA claim for OT) 01/01/0001 12/31/9999
DIAGNOSIS-TYPE Diagnosis Type List E External Cause of Injury #1-12 (from 837I claim for IP, LT, and OT) 01/01/0001 12/31/9999
DIAGNOSIS-TYPE Diagnosis Type List O Other Diagnosis #1-24 (for IP, LT) or #1-12 (from 837I or UB-04 claim for OT) 01/01/0001 12/31/9999
DIAGNOSIS-TYPE Diagnosis Type List P Principal (from 837I or UB-04 claim for IP, LT, and OT) 01/01/0001 12/31/9999
DIAGNOSIS-TYPE Diagnosis Type List R Reason for Visit #1-3 (from 837I claim for OT) 01/01/0001 12/31/9999
DISABILITY-TYPE-CODE Disability Type Code List 01 Individual is deaf or has serious difficulty hearing. 01/01/0001 12/31/9999
DISABILITY-TYPE-CODE Disability Type Code List 02 Individual is blind or has serious difficulty seeing, even when wearing glasses. 01/01/0001 12/31/9999
DISABILITY-TYPE-CODE Disability Type Code List 03 Individual has serious difficulty concentrating, remembering, or making decisions because of a physical, mental, or emotional condition. (Applicable only to people who are 5 years old or older.) 01/01/0001 12/31/9999
DISABILITY-TYPE-CODE Disability Type Code List 04 Individual has serious difficulty walking or climbing stairs. (Applicable only to people who are 5 years old or older.) 01/01/0001 12/31/9999
DISABILITY-TYPE-CODE Disability Type Code List 05 Individual has difficulty dressing or bathing. (Applicable only to people who are 5 years old or older.) 01/01/0001 12/31/9999
DISABILITY-TYPE-CODE Disability Type Code List 06 Individual has difficulty doing errands alone such as visiting a doctor's office or shopping because of a physical, mental, or emotional condition. (Applicable only to people who are 15 years old or older.) 01/01/0001 12/31/9999
DISABILITY-TYPE-CODE Disability Type Code List 07 Other 01/01/0001 12/31/9999
DISABILITY-TYPE-CODE Disability Type Code List 08 None 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE Drug Utilization Code List See "VVL_Code_Description" field This data element's valid value code set is maintained by a Code Set Maintenance Organization (CSMO), the official licensing organization for specific valid value code sets. The CSMO is the system of record for those specific valid value code sets. While T-MSIS endeavors to be in-sync with CMSO's updates, minor delays may occur but that shouldn't block T-MSIS data submissions using the CSMO's latest version.

For background and context, see https://www.ncpdp.org/		 N/A N/A
DRUG-UTILIZATION-CODE-E4 Drug Utilization Reason for Service Code List AD 439-E4: Additional Drug Needed 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E4 Drug Utilization Reason for Service Code List AN 439-E4: Prescription Authentication 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E4 Drug Utilization Reason for Service Code List AR 439-E4: Adverse Drug Reaction 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E4 Drug Utilization Reason for Service Code List AT 439-E4: Additive Toxicity 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E4 Drug Utilization Reason for Service Code List CD 439-E4: Chronic Disease Management 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E4 Drug Utilization Reason for Service Code List CH 439-E4: Call Help Desk 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E4 Drug Utilization Reason for Service Code List CS 439-E4: Patient Complaint/Symptom 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E4 Drug Utilization Reason for Service Code List DA 439-E4: Drug-Allergy 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E4 Drug Utilization Reason for Service Code List DC 439-E4: Drug-Disease (Inferred) 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E4 Drug Utilization Reason for Service Code List DD 439-E4: Drug-Drug Interaction 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E4 Drug Utilization Reason for Service Code List DF 439-E4: Drug-Food interaction 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E4 Drug Utilization Reason for Service Code List DI 439-E4: Drug Incompatibility 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E4 Drug Utilization Reason for Service Code List DL 439-E4: Drug-Lab Conflict 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E4 Drug Utilization Reason for Service Code List DM 439-E4: Apparent Drug Misuse 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E4 Drug Utilization Reason for Service Code List DS 439-E4: Tobacco Use 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E4 Drug Utilization Reason for Service Code List ED 439-E4: Patient Education/Instruction 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E4 Drug Utilization Reason for Service Code List ER 439-E4: Overuse 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E4 Drug Utilization Reason for Service Code List EX 439-E4: Excessive Quantity 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E4 Drug Utilization Reason for Service Code List HD 439-E4: High Dose 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E4 Drug Utilization Reason for Service Code List IC 439-E4: Iatrogenic Condition 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E4 Drug Utilization Reason for Service Code List ID 439-E4: Ingredient Duplication 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E4 Drug Utilization Reason for Service Code List LD 439-E4: Low Dose 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E4 Drug Utilization Reason for Service Code List LK 439-E4: Lock In Recipient 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E4 Drug Utilization Reason for Service Code List LR 439-E4: Underuse 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E4 Drug Utilization Reason for Service Code List MC 439-E4: Drug-Disease (Reported) 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E4 Drug Utilization Reason for Service Code List MN 439-E4: Insufficient Duration 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E4 Drug Utilization Reason for Service Code List MS 439-E4: Missing Information/Clarification 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E4 Drug Utilization Reason for Service Code List MX 439-E4: Excessive Duration 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E4 Drug Utilization Reason for Service Code List NA 439-E4: Drug Not Available 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E4 Drug Utilization Reason for Service Code List NC 439-E4: Non-covered Drug Purchase 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E4 Drug Utilization Reason for Service Code List ND 439-E4: New Disease/Diagnosis 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E4 Drug Utilization Reason for Service Code List NF 439-E4: Non-Formulary Drug 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E4 Drug Utilization Reason for Service Code List NN 439-E4: Unnecessary Drug 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E4 Drug Utilization Reason for Service Code List NP 439-E4: New Patient Processing 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E4 Drug Utilization Reason for Service Code List NR 439-E4: Lactation/Nursing Interaction 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E4 Drug Utilization Reason for Service Code List NS 439-E4: Insufficient Quantity 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E4 Drug Utilization Reason for Service Code List OH 439-E4: Alcohol Conflict 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E4 Drug Utilization Reason for Service Code List PA 439-E4: Drug-Age 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E4 Drug Utilization Reason for Service Code List PC 439-E4: Patient Question/Concern 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E4 Drug Utilization Reason for Service Code List PG 439-E4: Drug-Pregnancy 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E4 Drug Utilization Reason for Service Code List PH 439-E4: Preventive Health Care 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E4 Drug Utilization Reason for Service Code List PN 439-E4: Prescriber Consultation 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E4 Drug Utilization Reason for Service Code List PP 439-E4: Plan Protocol 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E4 Drug Utilization Reason for Service Code List PR 439-E4: Prior Adverse Reaction 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E4 Drug Utilization Reason for Service Code List PS 439-E4: Product Selection Opportunity 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E4 Drug Utilization Reason for Service Code List RE 439-E4: Suspected Environmental Risk 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E4 Drug Utilization Reason for Service Code List RF 439-E4: Health Provider Referral 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E4 Drug Utilization Reason for Service Code List SC 439-E4: Suboptimal Compliance 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E4 Drug Utilization Reason for Service Code List SD 439-E4: Suboptimal Drug/Indication 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E4 Drug Utilization Reason for Service Code List SE 439-E4: Side Effect 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E4 Drug Utilization Reason for Service Code List SF 439-E4: Suboptimal Dosage Form 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E4 Drug Utilization Reason for Service Code List SR 439-E4: Suboptimal Regimen 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E4 Drug Utilization Reason for Service Code List SX 439-E4: Drug-Gender 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E4 Drug Utilization Reason for Service Code List TD 439-E4: Therapeutic 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E4 Drug Utilization Reason for Service Code List TN 439-E4: Laboratory Test Needed 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E4 Drug Utilization Reason for Service Code List TP 439-E4: Payer/Processor Question 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E5 Drug Utilization Professional Service Code List 00 440-E5: No intervention 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E5 Drug Utilization Professional Service Code List AS 440-E5: Patient assessment 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E5 Drug Utilization Professional Service Code List CC 440-E5: Coordination of care 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E5 Drug Utilization Professional Service Code List DE 440-E5: Dosing evaluation/determination 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E5 Drug Utilization Professional Service Code List FE 440-E5: Formulary enforcement 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E5 Drug Utilization Professional Service Code List GP 440-E5: Generic product selection 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E5 Drug Utilization Professional Service Code List M0 440-E5: Prescriber consulted 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E5 Drug Utilization Professional Service Code List MA 440-E5: Medication administration 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E5 Drug Utilization Professional Service Code List MR 440-E5: Medication review 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E5 Drug Utilization Professional Service Code List P0 440-E5: Patient consulted 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E5 Drug Utilization Professional Service Code List PE 440-E5: Patient education/instruction 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E5 Drug Utilization Professional Service Code List PH 440-E5: Patient medication history 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E5 Drug Utilization Professional Service Code List PM 440-E5: Patient monitoring 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E5 Drug Utilization Professional Service Code List PT 440-E5: Perform laboratory test 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E5 Drug Utilization Professional Service Code List R0 440-E5: Pharmacist consulted other source 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E5 Drug Utilization Professional Service Code List RT 440-E5: Recommend laboratory test 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E5 Drug Utilization Professional Service Code List SC 440-E5: Self-care consultation 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E5 Drug Utilization Professional Service Code List SW 440-E5: Literature search/review 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E5 Drug Utilization Professional Service Code List TC 440-E5: Payer/processor consulted 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E5 Drug Utilization Professional Service Code List TH 440-E5: Therapeutic product interchange 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E6 Drug Utilization Result of Service Code List 00 441-E6: Not Specified 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E6 Drug Utilization Result of Service Code List 1A 441-E6: Filled As Is 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E6 Drug Utilization Result of Service Code List 1B 441-E6: Filled Prescription As Is 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E6 Drug Utilization Result of Service Code List 1C 441-E6: Filled 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E6 Drug Utilization Result of Service Code List 1D 441-E6: Filled 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E6 Drug Utilization Result of Service Code List 1E 441-E6: Filled 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E6 Drug Utilization Result of Service Code List 1F 441-E6: Filled 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E6 Drug Utilization Result of Service Code List 1G 441-E6: Filled 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E6 Drug Utilization Result of Service Code List 1H 441-E6: Brand-to-Generic Change 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E6 Drug Utilization Result of Service Code List 1J 441-E6: Rx-to-OTC Change 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E6 Drug Utilization Result of Service Code List 1K 441-E6: Filled with Different Dosage Form 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E6 Drug Utilization Result of Service Code List 2A 441-E6: Prescription Not Filled 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E6 Drug Utilization Result of Service Code List 2B 441-E6: Not Filled 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E6 Drug Utilization Result of Service Code List 3A 441-E6: Recommendation Accepted 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E6 Drug Utilization Result of Service Code List 3B 441-E6: Recommendation Not Accepted 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E6 Drug Utilization Result of Service Code List 3C 441-E6: Discontinued Drug 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E6 Drug Utilization Result of Service Code List 3D 441-E6: Regimen Changed 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E6 Drug Utilization Result of Service Code List 3E 441-E6: Therapy Changed 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E6 Drug Utilization Result of Service Code List 3F 441-E6: Therapy Changed-cost increased acknowledged 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E6 Drug Utilization Result of Service Code List 3G 441-E6: Drug Therapy Unchanged 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E6 Drug Utilization Result of Service Code List 3H 441-E6: Follow-Up/Report 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E6 Drug Utilization Result of Service Code List 3J 441-E6: Patient Referral 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E6 Drug Utilization Result of Service Code List 3K 441-E6: Instructions Understood 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E6 Drug Utilization Result of Service Code List 3M 441-E6: Compliance Aid Provided 01/01/0001 12/31/9999
DRUG-UTILIZATION-CODE-E6 Drug Utilization Result of Service Code List 3N 441-E6: Medication Administered 01/01/0001 12/31/9999
DUAL-ELIGIBLE-CODE Dual Eligible Code List 00 Eligible is not a Medicare beneficiary 01/01/0001 12/31/9999
DUAL-ELIGIBLE-CODE Dual Eligible Code List 01 Eligible is entitled to Medicare- QMB only 01/01/0001 12/31/9999
DUAL-ELIGIBLE-CODE Dual Eligible Code List 02 Eligible is entitled to Medicare- QMB AND Medicaid coverage 01/01/0001 12/31/9999
DUAL-ELIGIBLE-CODE Dual Eligible Code List 03 Eligible is entitled to Medicare- SLMB only 01/01/0001 12/31/9999
DUAL-ELIGIBLE-CODE Dual Eligible Code List 04 Eligible is entitled to Medicare- SLMB AND Medicaid coverage 01/01/0001 12/31/9999
DUAL-ELIGIBLE-CODE Dual Eligible Code List 05 Eligible is entitled to Medicare- QDWI 01/01/0001 12/31/9999
DUAL-ELIGIBLE-CODE Dual Eligible Code List 06 Eligible is entitled to Medicare- Qualifying individuals 01/01/0001 12/31/9999
DUAL-ELIGIBLE-CODE Dual Eligible Code List 08 Eligible is entitled to Medicare- Other Dual Eligibles (Non QMB, SLMB, QDWI or QI) 01/01/0001 12/31/9999
DUAL-ELIGIBLE-CODE Dual Eligible Code List 09 Eligible is entitled to Medicare - Other (This code is to be used only with specific CMS approval.) 01/01/0001 12/31/9999
DUAL-ELIGIBLE-CODE Dual Eligible Code List 10 Separate CHIP Eligible is entitled to Medicare 01/01/0001 12/31/9999
ELG-IDENTIFIER-TYPE Eligible Identifier Type List 1 Medicaid Card ID 01/01/0001 12/31/9999
ELG-IDENTIFIER-TYPE Eligible Identifier Type List 2 Old MSIS Identification Number 01/01/0001 12/31/9999
ELIGIBILITY-EXTENSION-CODE Eligibility Extension Code List 001 60-day extended postpartum coverage (mandatory per SSA 1902(e)(5) and 2112(d)(2)(A)) 01/01/0001 12/31/9999
ELIGIBILITY-EXTENSION-CODE Eligibility Extension Code List 002 12-month extended postpartum coverage (optional per SSA 1902(e)(16) or 2107(e)(1)(J)) 01/01/0001 12/31/9999
ELIGIBILITY-EXTENSION-CODE Eligibility Extension Code List 003 1115 waiver for extended postpartum coverage 01/01/0001 12/31/9999
ELIGIBILITY-EXTENSION-CODE Eligibility Extension Code List 995 Other 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 01 Parents and Other Caretaker Relatives 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 02 Transitional Medical Assistance 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 03 Extended Medicaid due to Earnings 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 04 Extended Medicaid due to Spousal Support Collections 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 05 Pregnant Women 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 06 Deemed Newborns 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 07 Infants and Children under Age 19 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 08 Children with Title IV-E Adoption Assistance, Foster Care or Guardianship Care 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 09 Former Foster Care Children 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 11 Individuals Receiving SSI 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 12 Aged, Blind and Disabled Individuals in 209(b) States 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 13 Individuals Receiving Mandatory State Supplements 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 14 Individuals Who Are Essential Spouses 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 15 Institutionalized Individuals Continuously Eligible Since 1973 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 16 Blind or Disabled Individuals Eligible in 1973 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 17 Individuals Who Lost Eligibility for SSI/SSP Due to an Increase in OASDI Benefits in 1972 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 18 Individuals Who Would be Eligible for SSI/SSP but for OASDI COLA increases since April, 1977 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 19 Disabled Widows and Widowers Ineligible for SSI due to Increase in OASDI 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 20 Disabled Widows and Widowers Ineligible for SSI due to Early Receipt of Social Security 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 21 Working Disabled under 1619(b) 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 22 Disabled Adult Children 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 23 Qualified Medicare Beneficiaries 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 24 Qualified Disabled and Working Individuals 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 25 Specified Low Income Medicare Beneficiaries 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 26 Qualifying Individuals 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 27 Optional Coverage of Parents and Other Caretaker Relatives 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 28 Reasonable Classifications of Individuals under Age 21 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 29 Children with Non-IV-E Adoption Assistance 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 30 Independent Foster Care Adolescents 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 31 Optional Targeted Low Income Children 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 32 Individuals Electing COBRA Continuation Coverage 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 33 Individuals above 133% FPL under Age 65 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 34 Certain Individuals Needing Treatment for Breast or Cervical Cancer 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 35 Individuals Eligible for Family Planning Services 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 36 Individuals with Tuberculosis 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 37 Aged, Blind or Disabled Individuals Eligible for but Not Receiving Cash Assistance 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 38 Individuals Eligible for Cash Assistance except for Institutionalization 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 39 Individuals Receiving Home and Community Based Services under Institutional Rules 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 40 Optional State Supplement Recipients - 1634 States, and SSI Criteria States with 1616 Agreements 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 41 Optional State Supplement Recipients - 209(b) States, and SSI Criteria States without 1616 Agreements 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 42 Institutionalized Individuals Eligible under a Special Income Level 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 43 Individuals participating in a PACE Program under Institutional Rules 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 44 Individuals Receiving Hospice Care 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 45 Qualified Disabled Children under Age 19 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 46 Poverty Level Aged or Disabled 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 47 Work Incentives Eligibility Group 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 48 Ticket to Work Basic Group 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 49 Ticket to Work Medical Improvements Group 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 50 Family Opportunity Act Children with Disabilities 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 51 Individuals Eligible for Home and Community-Based Services 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 52 Individuals Eligible for Home and Community-Based Services - Special Income Level 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 53 Medically Needy Pregnant Women 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 54 Medically Needy Children under Age 18 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 55 Medically Needy Children Age 18 through 20 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 56 Medically Needy Parents and Other Caretakers 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 59 Medically Needy Aged, Blind or Disabled 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 60 Medically Needy Blind or Disabled Individuals Eligible in 1973 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 61 Targeted Low-Income Children 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 62 Deemed Newborn 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 63 Children Ineligible for Medicaid Due to Loss of Income Disregards 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 64 Coverage from Conception to Birth 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 65 Children with Access to Public Employee Coverage 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 66 Children Eligible for Dental Only Supplemental Coverage 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 67 Targeted Low-Income Pregnant Women 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 68 Pregnant Women with Access to Public Employee Coverage 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 69 Individuals with Mental Health Conditions (expansion group) 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 70 Family Planning Participants (expansion group) 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 71 Other expansion group 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 72 Adult Group - Individuals at or below 133% FPL Age 19 through 64 - newly eligible for all states 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 73 Adult Group - Individuals at or below 133% FPL Age 19 through 64- not newly eligible for non 1905z(3) states 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 74 Adult Group - Individuals at or below 133% FPL Age 19 through 64 - not newly eligible parent/ caretaker-relative(s) in 1905z(3) states 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 75 Adult Group - Individuals at or below 133% FPL Age 19 through 64- not newly eligible non-parent/ caretaker-relative(s) in 1905z(3) states 01/01/0001 12/31/9999
ELIGIBILITY-GROUP Eligibility Group List 76 Uninsured Individual eligible for COVID-19 testing 03/18/2020 12/31/9999
ELIGIBILITY-TERMINATION-REASON Eligibility Termination Reason List 01 Income Requirement not met - do not use for changes in household composition 01/01/0001 12/31/9999
ELIGIBILITY-TERMINATION-REASON Eligibility Termination Reason List 02 Asset requirement not met - do not use for changes in household composition 01/01/0001 12/31/9999
ELIGIBILITY-TERMINATION-REASON Eligibility Termination Reason List 03 Income reduced - (do not use - typically not a reason for termination) 01/01/0001 12/31/9999
ELIGIBILITY-TERMINATION-REASON Eligibility Termination Reason List 04 Aged out of program 01/01/0001 12/31/9999
ELIGIBILITY-TERMINATION-REASON Eligibility Termination Reason List 05 No longer in the foster care system - (do not use - typically not a reason for termination) 01/01/0001 12/31/9999
ELIGIBILITY-TERMINATION-REASON Eligibility Termination Reason List 06 Death 01/01/0001 12/31/9999
ELIGIBILITY-TERMINATION-REASON Eligibility Termination Reason List 07 No longer disabled 01/01/0001 12/31/9999
ELIGIBILITY-TERMINATION-REASON Eligibility Termination Reason List 08 No longer institutionalized 01/01/0001 12/31/9999
ELIGIBILITY-TERMINATION-REASON Eligibility Termination Reason List 09 No longer in need of long-term care services 01/01/0001 12/31/9999
ELIGIBILITY-TERMINATION-REASON Eligibility Termination Reason List 10 Obtained employer sponsored insurance (ESI) 01/01/0001 12/31/9999
ELIGIBILITY-TERMINATION-REASON Eligibility Termination Reason List 11 Gained access to public employees health plan 01/01/0001 12/31/9999
ELIGIBILITY-TERMINATION-REASON Eligibility Termination Reason List 12 Obtained other coverage (not ESI or public employees health plan) 01/01/0001 12/31/9999
ELIGIBILITY-TERMINATION-REASON Eligibility Termination Reason List 13 Failure to respond 01/01/0001 12/31/9999
ELIGIBILITY-TERMINATION-REASON Eligibility Termination Reason List 14 Failure to pay premium or enrollment fees 01/01/0001 12/31/9999
ELIGIBILITY-TERMINATION-REASON Eligibility Termination Reason List 15 Residency requirement not met (e.g., individual moved to a different state, individual has entered or been discharged from an otherwise unspecified facility or institution) 01/01/0001 12/31/9999
ELIGIBILITY-TERMINATION-REASON Eligibility Termination Reason List 16 Voluntary request for termination 01/01/0001 12/31/9999
ELIGIBILITY-TERMINATION-REASON Eligibility Termination Reason List 17 Lack of verifications (e.g., unable to successfully verify citizenship status, immigration status, income, or other information from an application; if unverifiable due to non-response, document as "Failure to respond) 01/01/0001 12/31/9999
ELIGIBILITY-TERMINATION-REASON Eligibility Termination Reason List 18 Fraud 01/01/0001 12/31/9999
ELIGIBILITY-TERMINATION-REASON Eligibility Termination Reason List 19 Suspension/termination due to incarceration - use when the state is able to distinguish a more granular reason than just residency requirement not met 01/01/0001 12/31/9999
ELIGIBILITY-TERMINATION-REASON Eligibility Termination Reason List 20 Disqualification for residence in an Institution for Mental Disease (IMD) - use when the state is able to distinguish a more granular reason than just residency requirement not met 01/01/0001 12/31/9999
ELIGIBILITY-TERMINATION-REASON Eligibility Termination Reason List 21 Suspension/Termination with reason unknown 01/01/0001 12/31/9999
ELIGIBILITY-TERMINATION-REASON Eligibility Termination Reason List 22 Other 01/01/0001 12/31/9999
ELIGIBILITY-TERMINATION-REASON Eligibility Termination Reason List 23 Terminated due to Incorrect Granting of Eligibility (e.g., someone is given eligibility in error and then eligibility has to be retracted/terminated) 01/01/0001 12/31/9999
ELIGIBILITY-TERMINATION-REASON Eligibility Termination Reason List 24 Household or family composition criteria not met (e.g., someone was incorrectly included or excluded from the household or family composition) - do not use for changes in income 01/01/0001 12/31/9999
ELIGIBILITY-TERMINATION-REASON Eligibility Termination Reason List 25 Non-financial program requirements not met (e.g. child support not paid, failure of drug tests, failure to apply for SSN, etc.) 01/01/0001 12/31/9999
ELIGIBILITY-TERMINATION-REASON Eligibility Termination Reason List 26 No longer meets categorical eligibility requirements. 01/01/0001 12/31/9999
ELIGIBILITY-TERMINATION-REASON Eligibility Termination Reason List 27 End of pregnancy/postpartum coverage period - should only be used if the beneficiary did not obtain coverage through another coverage group like parent/caretaker relative 01/01/0001 12/31/9999
ELIGIBILITY-TERMINATION-REASON Eligibility Termination Reason List 28 Time limited eligibility expired (e.g., Transitional Medical Assistance (TMA) 01/01/0001 12/31/9999
ELIGIBILITY-TERMINATION-REASON Eligibility Termination Reason List 29 Closed as duplicate 01/01/0001 12/31/9999
ELIGIBILITY-TERMINATION-REASON Eligibility Termination Reason List 30 Medical/health status or condition or level of care requirements no longer met - for reasons other than no longer being institutionalized or no longer meeting disability requirements (e.g., completed breast and/or cervical cancer treatment, incarcerated individual no longer requires temporary inpatient level of care) 01/01/0001 12/31/9999
ELIGIBILITY-TERMINATION-REASON Eligibility Termination Reason List 31 Change in federal or state law or policy (e.g., a state or federal program is completely discontinued and not replaced by an equivalent or transitional program; unwinding of the Families First Coronavirus Response Act coverage of COVID testing for otherwise uninsured individuals who would have otherwise continued to be eligible if they had been re-determined eligible for at least the same program had the program not been terminated) 01/01/0001 12/31/9999
ELIGIBLE-ADDR-TYPE Eligible Address Type List 01 Primary home address and contact information, used for the eligibility determination process 01/01/0001 12/31/9999
ELIGIBLE-ADDR-TYPE Eligible Address Type List 02 Primary work address and contact information 01/01/0001 12/31/9999
ELIGIBLE-ADDR-TYPE Eligible Address Type List 03 Secondary residence and contact information 01/01/0001 12/31/9999
ELIGIBLE-ADDR-TYPE Eligible Address Type List 04 Secondary work address and contact information 01/01/0001 12/31/9999
ELIGIBLE-ADDR-TYPE Eligible Address Type List 05 Other category of address and contact information 01/01/0001 12/31/9999
ELIGIBLE-ADDR-TYPE Eligible Address Type List 06 Eligible person's official mailing address 01/01/0001 12/31/9999
ENGL-PROF-CODE Engl Prof List 0 Very Well 01/01/0001 12/31/9999
ENGL-PROF-CODE Engl Prof List 1 Well 01/01/0001 12/31/9999
ENGL-PROF-CODE Engl Prof List 2 Not well 01/01/0001 12/31/9999
ENGL-PROF-CODE Engl Prof List 3 No spoken proficiency 01/01/0001 12/31/9999
ENROLLMENT-TYPE Enrollment Type List 1 Medicaid 01/01/0001 12/31/9999
ENROLLMENT-TYPE Enrollment Type List 2 CHIP 01/01/0001 12/31/9999
ETHNICITY-CODE Ethnicity Code List 0 Not of Hispanic or, Latino/a, or Spanish origin 01/01/0001 12/31/9999
ETHNICITY-CODE Ethnicity Code List 1 Mexican, Mexican American, Chicano/a 01/01/0001 12/31/9999
ETHNICITY-CODE Ethnicity Code List 2 Puerto Rican 01/01/0001 12/31/9999
ETHNICITY-CODE Ethnicity Code List 3 Cuban 01/01/0001 12/31/9999
ETHNICITY-CODE Ethnicity Code List 4 Another Hispanic, Latino, or Spanish origin 01/01/0001 12/31/9999
ETHNICITY-CODE Ethnicity Code List 5 Hispanic or Latino Unknown 01/01/0001 12/31/9999
ETHNICITY-CODE Ethnicity Code List 6 Ethnicity Unspecified 01/01/0001 12/31/9999
EXPENDITURE-AUTHORITY-TYPE Expenditure Authority Type List 01 1115 01/01/0001 12/31/9999
EXPENDITURE-AUTHORITY-TYPE Expenditure Authority Type List 95 Other 01/01/0001 12/31/9999
FACILITY-GROUP-INDIVIDUAL-CODE Facility Group Individual Code List 01 Facility - The entity identified by the associated SUBMITTING-STATE-PROV-ID is a facility. 01/01/0001 12/31/9999
FACILITY-GROUP-INDIVIDUAL-CODE Facility Group Individual Code List 02 Group - The entity identified by the associated SUBMITTING-STATE-PROV-ID is a group of individual practitioners. 01/01/0001 12/31/9999
FACILITY-GROUP-INDIVIDUAL-CODE Facility Group Individual Code List 03 Individual - The entity identified by the associated SUBMITTING-STATE-PROV-ID is an individual practitioner. 01/01/0001 12/31/9999
FILE-ENCODING-SPECIFICATION File Encoding Specification List FLF The file follows a fixed length format. 01/01/0001 12/31/9999
FILE-ENCODING-SPECIFICATION File Encoding Specification List PSV The file follows a pipe-delimited format. 01/01/0001 12/31/9999
FILE-NAME T-MSIS File Type List CLAIM-IP Inpatient Claim/Encounters File 01/01/0001 12/31/9999
FILE-NAME T-MSIS File Type List CLAIM-LT Long Term Care Claims/Encounters File 01/01/0001 12/31/9999
FILE-NAME T-MSIS File Type List CLAIM-OT Other Claims/Encounters File 01/01/0001 12/31/9999
FILE-NAME T-MSIS File Type List CLAIM-RX Pharmacy Claims/Encounters File 01/01/0001 12/31/9999
FILE-NAME T-MSIS File Type List ELIGIBLE Eligible File 01/01/0001 12/31/9999
FILE-NAME T-MSIS File Type List FINTRANS Financial Transaction File 01/01/0001 12/31/9999
FILE-NAME T-MSIS File Type List MNGDCARE Managed Care Plan Information File 01/01/0001 12/31/9999
FILE-NAME T-MSIS File Type List PROVIDER Provider File 01/01/0001 12/31/9999
FILE-NAME T-MSIS File Type List TPL-FILE Third Party Liability File 01/01/0001 12/31/9999
FILE-STATUS-INDICATOR File Status Indicator List P Production File 01/01/0001 12/31/9999
FILE-STATUS-INDICATOR File Status Indicator List T Test File 01/01/0001 12/31/9999
FILE-SUBMISSION-METHOD File Submission Method List 01 True Full File Refresh (TFFR) 01/01/0001 12/31/9999
FILE-SUBMISSION-METHOD File Submission Method List 02 Rolling History File Refresh (RHFR) 01/01/0001 12/31/9999
FILE-SUBMISSION-METHOD File Submission Method List 03 Incremental Timespan (IT) - One month incremental Create files 01/01/0001 12/31/9999
FILE-SUBMISSION-METHOD File Submission Method List 04 Change-Segment Only (CSO) 01/01/0001 12/31/9999
FILE-SUBMISSION-METHOD File Submission Method List 05 Incremental Timespan (IT) - Multi-month incremental Create files 01/01/0001 12/31/9999
FIXED-PAYMENT-IND Fixed Payment Indicator List 0 Not Fixed Payment 01/01/0001 12/31/9999
FIXED-PAYMENT-IND Fixed Payment Indicator List 1 FFS Fixed Payment 01/01/0001 12/31/9999
FORCED-CLAIM-IND Forced Claim Indicator List 0 No 01/01/0001 12/31/9999
FORCED-CLAIM-IND Forced Claim Indicator List 1 Yes 01/01/0001 12/31/9999
FUNDING-CODE Funding Code List A Medicaid Agency 01/01/0001 12/31/9999
FUNDING-CODE Funding Code List B CHIP Agency 01/01/0001 12/31/9999
FUNDING-CODE Funding Code List C Mental Health Service Agency 01/01/0001 12/31/9999
FUNDING-CODE Funding Code List D Education Agency 01/01/0001 12/31/9999
FUNDING-CODE Funding Code List E Child and Family Services Agency 01/01/0001 12/31/9999
FUNDING-CODE Funding Code List F County 01/01/0001 12/31/9999
FUNDING-CODE Funding Code List G City 01/01/0001 12/31/9999
FUNDING-CODE Funding Code List H Providers 01/01/0001 12/31/9999
FUNDING-CODE Funding Code List I Other 01/01/0001 12/31/9999
FUNDING-SOURCE-NONFEDERAL-SHARE Funding Source Non-Federal Share List 01 State appropriations to the Medicaid agency 01/01/0001 12/31/9999
FUNDING-SOURCE-NONFEDERAL-SHARE Funding Source Non-Federal Share List 02 Intergovernmental transfers (IGT) 01/01/0001 12/31/9999
FUNDING-SOURCE-NONFEDERAL-SHARE Funding Source Non-Federal Share List 03 Certified public expenditures (CPE) 01/01/0001 12/31/9999
FUNDING-SOURCE-NONFEDERAL-SHARE Funding Source Non-Federal Share List 04 Provider taxes 01/01/0001 12/31/9999
FUNDING-SOURCE-NONFEDERAL-SHARE Funding Source Non-Federal Share List 05 Donations 01/01/0001 12/31/9999
FUNDING-SOURCE-NONFEDERAL-SHARE Funding Source Non-Federal Share List 06 State appropriations to the CHIP agency 01/01/0001 12/31/9999
GENDER-IDENTITY Gender Identity List 1 Female 01/01/0001 12/31/9999
GENDER-IDENTITY Gender Identity List 2 Male 01/01/0001 12/31/9999
GENDER-IDENTITY Gender Identity List 3 Transgender female 01/01/0001 12/31/9999
GENDER-IDENTITY Gender Identity List 4 Transgender male 01/01/0001 12/31/9999
GENDER-IDENTITY Gender Identity List 5 Not sure 01/01/0001 12/31/9999
GENDER-IDENTITY Gender Identity List 6 Prefer not to answer 01/01/0001 12/31/9999
GENDER-IDENTITY Gender Identity List 7 Other 01/01/0001 12/31/9999
HCBS-CHRONIC-CONDITION-NON-HEALTH-HOME-CODE HCBS Chronic Condition Non Health Home Code List 001 Aged 01/01/0001 12/31/9999
HCBS-CHRONIC-CONDITION-NON-HEALTH-HOME-CODE HCBS Chronic Condition Non Health Home Code List 002 Physical Disabilities 01/01/0001 12/31/9999
HCBS-CHRONIC-CONDITION-NON-HEALTH-HOME-CODE HCBS Chronic Condition Non Health Home Code List 003 Intellectual Disabilities 01/01/0001 12/31/9999
HCBS-CHRONIC-CONDITION-NON-HEALTH-HOME-CODE HCBS Chronic Condition Non Health Home Code List 004 Autism Spectrum Disorder 01/01/0001 12/31/9999
HCBS-CHRONIC-CONDITION-NON-HEALTH-HOME-CODE HCBS Chronic Condition Non Health Home Code List 005 Developmental Disabilities 01/01/0001 12/31/9999
HCBS-CHRONIC-CONDITION-NON-HEALTH-HOME-CODE HCBS Chronic Condition Non Health Home Code List 006 Mental Illness and/or Serious Emotional Disturbance 01/01/0001 12/31/9999
HCBS-CHRONIC-CONDITION-NON-HEALTH-HOME-CODE HCBS Chronic Condition Non Health Home Code List 007 Brain Injury 01/01/0001 12/31/9999
HCBS-CHRONIC-CONDITION-NON-HEALTH-HOME-CODE HCBS Chronic Condition Non Health Home Code List 008 HIV/AIDs 01/01/0001 12/31/9999
HCBS-CHRONIC-CONDITION-NON-HEALTH-HOME-CODE HCBS Chronic Condition Non Health Home Code List 009 Technology Dependent or Medically Fragile 01/01/0001 12/31/9999
HCBS-CHRONIC-CONDITION-NON-HEALTH-HOME-CODE HCBS Chronic Condition Non Health Home Code List 010 Disabled (other) 01/01/0001 12/31/9999
HCBS-SERVICE-CODE HCBS Service Code List 1 The HCBS service was provided under 1915(i) 01/01/0001 12/31/9999
HCBS-SERVICE-CODE HCBS Service Code List 2 The HCBS service was provided under 1915(j) 01/01/0001 12/31/9999
HCBS-SERVICE-CODE HCBS Service Code List 3 The HCBS service was provided under 1915(k) 01/01/0001 12/31/9999
HCBS-SERVICE-CODE HCBS Service Code List 4 The HCBS service was provided under a 1915(c) HCBS Waiver 01/01/0001 12/31/9999
HCBS-SERVICE-CODE HCBS Service Code List 5 The HCBS service was provided under an 1115 waiver 01/01/0001 12/31/9999
HCBS-SERVICE-CODE HCBS Service Code List 6 The HCBS service was not provided under the statutes identified above and was of an acute care nature 01/01/0001 12/31/9999
HCBS-SERVICE-CODE HCBS Service Code List 7 The HCBS service was not provided under the statutes identified above and was of a long term care nature 01/01/0001 12/31/9999
HCBS-TAXONOMY HCBS Taxonomy Code List 01010 Case Management 01/01/0001 12/31/9999
HCBS-TAXONOMY HCBS Taxonomy Code List 02011 Group Living, Residential Habilitation 01/01/0001 12/31/9999
HCBS-TAXONOMY HCBS Taxonomy Code List 02012 Group Living, Mental Health Services 01/01/0001 12/31/9999
HCBS-TAXONOMY HCBS Taxonomy Code List 02013 Group Living, Other 01/01/0001 12/31/9999
HCBS-TAXONOMY HCBS Taxonomy Code List 02021 Shared Living, Residential Habilitation 01/01/0001 12/31/9999
HCBS-TAXONOMY HCBS Taxonomy Code List 02022 Shared Living, Mental Health Services 01/01/0001 12/31/9999
HCBS-TAXONOMY HCBS Taxonomy Code List 02023 Shared Living, Other 01/01/0001 12/31/9999
HCBS-TAXONOMY HCBS Taxonomy Code List 02031 In-e Residential Habilitation 01/01/0001 12/31/9999
HCBS-TAXONOMY HCBS Taxonomy Code List 02032 In-Home Round-The-Clock Mental Health Services 01/01/0001 12/31/9999
HCBS-TAXONOMY HCBS Taxonomy Code List 02033 In-Home Round-The-Clock Services, Other 01/01/0001 12/31/9999
HCBS-TAXONOMY HCBS Taxonomy Code List 03010 Job Development 01/01/0001 12/31/9999
HCBS-TAXONOMY HCBS Taxonomy Code List 03021 Ongoing Supported Employment, Individual 01/01/0001 12/31/9999
HCBS-TAXONOMY HCBS Taxonomy Code List 03022 Ongoing Supported Employment, Group 01/01/0001 12/31/9999
HCBS-TAXONOMY HCBS Taxonomy Code List 03030 Career Planning 01/01/0001 12/31/9999
HCBS-TAXONOMY HCBS Taxonomy Code List 04010 Prevocational Services 01/01/0001 12/31/9999
HCBS-TAXONOMY HCBS Taxonomy Code List 04020 Day Habilitation 01/01/0001 12/31/9999
HCBS-TAXONOMY HCBS Taxonomy Code List 04030 Education Services 01/01/0001 12/31/9999
HCBS-TAXONOMY HCBS Taxonomy Code List 04040 Day Treatment/Partial Hospitalization 01/01/0001 12/31/9999
HCBS-TAXONOMY HCBS Taxonomy Code List 04050 Adult Day Health 01/01/0001 12/31/9999
HCBS-TAXONOMY HCBS Taxonomy Code List 04060 Adult Day Services (Social Model) 01/01/0001 12/31/9999
HCBS-TAXONOMY HCBS Taxonomy Code List 04070 Community Integration 01/01/0001 12/31/9999
HCBS-TAXONOMY HCBS Taxonomy Code List 04080 Medical Day Care for Children 01/01/0001 12/31/9999
HCBS-TAXONOMY HCBS Taxonomy Code List 05010 Private Duty Nursing 01/01/0001 12/31/9999
HCBS-TAXONOMY HCBS Taxonomy Code List 05020 Skilled Nursing 01/01/0001 12/31/9999
HCBS-TAXONOMY HCBS Taxonomy Code List 06010 Home Delivered Meals 01/01/0001 12/31/9999
HCBS-TAXONOMY HCBS Taxonomy Code List 07010 Rent and Food Expenses For Live-In Caregiver 01/01/0001 12/31/9999
HCBS-TAXONOMY HCBS Taxonomy Code List 08010 Home-Based Habilitation 01/01/0001 12/31/9999
HCBS-TAXONOMY HCBS Taxonomy Code List 08020 Home Health Aide 01/01/0001 12/31/9999
HCBS-TAXONOMY HCBS Taxonomy Code List 08030 Personal Care 01/01/0001 12/31/9999
HCBS-TAXONOMY HCBS Taxonomy Code List 08040 Companion 01/01/0001 12/31/9999
HCBS-TAXONOMY HCBS Taxonomy Code List 08050 Homemaker 01/01/0001 12/31/9999
HCBS-TAXONOMY HCBS Taxonomy Code List 08060 Chore 01/01/0001 12/31/9999
HCBS-TAXONOMY HCBS Taxonomy Code List 09011 Respite, Out-Of-Home 01/01/0001 12/31/9999
HCBS-TAXONOMY HCBS Taxonomy Code List 09012 Respite, In-Home 01/01/0001 12/31/9999
HCBS-TAXONOMY HCBS Taxonomy Code List 09020 Caregiver Counseling and/or Training 01/01/0001 12/31/9999
HCBS-TAXONOMY HCBS Taxonomy Code List 10010 Mental Health Assessment 01/01/0001 12/31/9999
HCBS-TAXONOMY HCBS Taxonomy Code List 10020 Assertive Community Treatment 01/01/0001 12/31/9999
HCBS-TAXONOMY HCBS Taxonomy Code List 10030 Crisis Intervention 01/01/0001 12/31/9999
HCBS-TAXONOMY HCBS Taxonomy Code List 10040 Behavior Support 01/01/0001 12/31/9999
HCBS-TAXONOMY HCBS Taxonomy Code List 10050 Peer Specialist 01/01/0001 12/31/9999
HCBS-TAXONOMY HCBS Taxonomy Code List 10060 Counseling 01/01/0001 12/31/9999
HCBS-TAXONOMY HCBS Taxonomy Code List 10070 Psychosocial Rehabilitation 01/01/0001 12/31/9999
HCBS-TAXONOMY HCBS Taxonomy Code List 10080 Clinic Services 01/01/0001 12/31/9999
HCBS-TAXONOMY HCBS Taxonomy Code List 10090 Other Mental Health and Behavioral Services 01/01/0001 12/31/9999
HCBS-TAXONOMY HCBS Taxonomy Code List 11010 Health Monitoring 01/01/0001 12/31/9999
HCBS-TAXONOMY HCBS Taxonomy Code List 11020 Health Assessment 01/01/0001 12/31/9999
HCBS-TAXONOMY HCBS Taxonomy Code List 11030 Medication Assessment and/or Management 01/01/0001 12/31/9999
HCBS-TAXONOMY HCBS Taxonomy Code List 11040 Nutrition Consultation 01/01/0001 12/31/9999
HCBS-TAXONOMY HCBS Taxonomy Code List 11050 Physician Services 01/01/0001 12/31/9999
HCBS-TAXONOMY HCBS Taxonomy Code List 11060 Prescription Drugs 01/01/0001 12/31/9999
HCBS-TAXONOMY HCBS Taxonomy Code List 11070 Dental Services 01/01/0001 12/31/9999
HCBS-TAXONOMY HCBS Taxonomy Code List 11080 Occupational Therapy 01/01/0001 12/31/9999
HCBS-TAXONOMY HCBS Taxonomy Code List 11090 Physical Therapy 01/01/0001 12/31/9999
HCBS-TAXONOMY HCBS Taxonomy Code List 11100 Speech, Hearing, And Language Therapy 01/01/0001 12/31/9999
HCBS-TAXONOMY HCBS Taxonomy Code List 11110 Respiratory Therapy 01/01/0001 12/31/9999
HCBS-TAXONOMY HCBS Taxonomy Code List 11120 Cognitive Rehabilitative Therapy 01/01/0001 12/31/9999
HCBS-TAXONOMY HCBS Taxonomy Code List 11130 Other Therapies 01/01/0001 12/31/9999
HCBS-TAXONOMY HCBS Taxonomy Code List 12010 Financial Management Services In Support Of Participant Direction 01/01/0001 12/31/9999
HCBS-TAXONOMY HCBS Taxonomy Code List 12020 Information and Assistance In Support Of Participant Direction 01/01/0001 12/31/9999
HCBS-TAXONOMY HCBS Taxonomy Code List 13010 Participant Training 01/01/0001 12/31/9999
HCBS-TAXONOMY HCBS Taxonomy Code List 14010 Personal Emergency Response System (Pers) 01/01/0001 12/31/9999
HCBS-TAXONOMY HCBS Taxonomy Code List 14020 Home and/or Vehicle Accessibility Adaptations 01/01/0001 12/31/9999
HCBS-TAXONOMY HCBS Taxonomy Code List 14031 Equipment and Technology 01/01/0001 12/31/9999
HCBS-TAXONOMY HCBS Taxonomy Code List 14032 Supplies 01/01/0001 12/31/9999
HCBS-TAXONOMY HCBS Taxonomy Code List 15010 Non-Medical Transportation 01/01/0001 12/31/9999
HCBS-TAXONOMY HCBS Taxonomy Code List 16010 Community Transition Services 01/01/0001 12/31/9999
HCBS-TAXONOMY HCBS Taxonomy Code List 17010 Goods and Services 01/01/0001 12/31/9999
HCBS-TAXONOMY HCBS Taxonomy Code List 17020 Interpreter 01/01/0001 12/31/9999
HCBS-TAXONOMY HCBS Taxonomy Code List 17030 Housing Consultation 01/01/0001 12/31/9999
HCBS-TAXONOMY HCBS Taxonomy Code List 17990 Other 01/01/0001 12/31/9999
HEALTH-CARE-ACQUIRED-CONDITION-IND Healthcare Acquired Condition Indicator List 0 No 01/01/0001 12/31/9999
HEALTH-CARE-ACQUIRED-CONDITION-IND Healthcare Acquired Condition Indicator List 1 Yes 01/01/0001 12/31/9999
HEALTH-HOME-CHRONIC-CONDITION Health Home Chronic Condition List A Mental health 01/01/0001 12/31/9999
HEALTH-HOME-CHRONIC-CONDITION Health Home Chronic Condition List B Substance abuse 01/01/0001 12/31/9999
HEALTH-HOME-CHRONIC-CONDITION Health Home Chronic Condition List C Asthma 01/01/0001 12/31/9999
HEALTH-HOME-CHRONIC-CONDITION Health Home Chronic Condition List D Diabetes 01/01/0001 12/31/9999
HEALTH-HOME-CHRONIC-CONDITION Health Home Chronic Condition List E Heart disease 01/01/0001 12/31/9999
HEALTH-HOME-CHRONIC-CONDITION Health Home Chronic Condition List F Overweight (BMI of >25) 01/01/0001 12/31/9999
HEALTH-HOME-CHRONIC-CONDITION Health Home Chronic Condition List G HIV/AIDS 01/01/0001 12/31/9999
HEALTH-HOME-CHRONIC-CONDITION Health Home Chronic Condition List H Other 01/01/0001 12/31/9999
HEALTH-HOME-PROV-IND Health Home Provider Indicator List 0 No 01/01/0001 12/31/9999
HEALTH-HOME-PROV-IND Health Home Provider Indicator List 1 Yes 01/01/0001 12/31/9999
HOUR Hour List 00 0:00-0:59 01/01/0001 12/31/9999
HOUR Hour List 01 1:00-1:59 01/01/0001 12/31/9999
HOUR Hour List 02 2:00-2:59 01/01/0001 12/31/9999
HOUR Hour List 03 3:00-3:59 01/01/0001 12/31/9999
HOUR Hour List 04 4:00-4:59 01/01/0001 12/31/9999
HOUR Hour List 05 5:00-5:59 01/01/0001 12/31/9999
HOUR Hour List 06 6:00-6:59 01/01/0001 12/31/9999
HOUR Hour List 07 7:00-7:59 01/01/0001 12/31/9999
HOUR Hour List 08 8:00-8:59 01/01/0001 12/31/9999
HOUR Hour List 09 9:00-9:59 01/01/0001 12/31/9999
HOUR Hour List 10 10:00-10:59 01/01/0001 12/31/9999
HOUR Hour List 11 11:00-11:59 01/01/0001 12/31/9999
HOUR Hour List 12 12:00-12:59 01/01/0001 12/31/9999
HOUR Hour List 13 13:00-13:59 01/01/0001 12/31/9999
HOUR Hour List 14 14:00-14:59 01/01/0001 12/31/9999
HOUR Hour List 15 15:00-15:59 01/01/0001 12/31/9999
HOUR Hour List 16 16:00-16:59 01/01/0001 12/31/9999
HOUR Hour List 17 17:00-17:59 01/01/0001 12/31/9999
HOUR Hour List 18 18:00-18:59 01/01/0001 12/31/9999
HOUR Hour List 19 19:00-19:59 01/01/0001 12/31/9999
HOUR Hour List 20 20:00-20:59 01/01/0001 12/31/9999
HOUR Hour List 21 21:00-21:59 01/01/0001 12/31/9999
HOUR Hour List 22 22:00-22:59 01/01/0001 12/31/9999
HOUR Hour List 23 23:00-23:59 01/01/0001 12/31/9999
HOUSEHOLD-SIZE Household Size List 01 1 person 01/01/0001 12/31/9999
HOUSEHOLD-SIZE Household Size List 02 2 people 01/01/0001 12/31/9999
HOUSEHOLD-SIZE Household Size List 03 3 people 01/01/0001 12/31/9999
HOUSEHOLD-SIZE Household Size List 04 4 people 01/01/0001 12/31/9999
HOUSEHOLD-SIZE Household Size List 05 5 people 01/01/0001 12/31/9999
HOUSEHOLD-SIZE Household Size List 06 6 people 01/01/0001 12/31/9999
HOUSEHOLD-SIZE Household Size List 07 7 people 01/01/0001 12/31/9999
HOUSEHOLD-SIZE Household Size List 08 8 or more people 01/01/0001 12/31/9999
IHS-SERVICE-IND IHS Service Indicator Code List 0 No 01/01/0001 12/31/9999
IHS-SERVICE-IND IHS Service Indicator Code List 1 Yes 01/01/0001 12/31/9999
IMMIGRATION-STATUS Immigration Status List 1 Qualified non-citizen 01/01/0001 12/31/9999
IMMIGRATION-STATUS Immigration Status List 2 Lawfully present under CHIPRA 214 01/01/0001 12/31/9999
IMMIGRATION-STATUS Immigration Status List 3 Eligible only for payment for emergency services 01/01/0001 12/31/9999
IMMIGRATION-STATUS Immigration Status List 8 Not Applicable (U.S. citizen or U.S. national) 01/01/0001 12/31/9999
IMMIGRATION-VERIFICATION-FLAG Immigration Verification Flag List 0 Immigration Status Verified 01/01/0001 12/31/9999
IMMIGRATION-VERIFICATION-FLAG Immigration Verification Flag List 1 Enrolled in Medicaid pending immigration verification 01/01/0001 12/31/9999
INCOME-CODE Income Code List 01 Individual's State-defined family income is from 0 to 100% of the FPL 01/01/0001 12/31/9999
INCOME-CODE Income Code List 02 Individual's State-defined family income is from 101 to 133% of the FPL 01/01/0001 12/31/9999
INCOME-CODE Income Code List 03 Individual's State-defined family income is from 134 to 150% of the FPL 01/01/0001 12/31/9999
INCOME-CODE Income Code List 04 Individual's State-defined family income is from 151 to 200% of the FPL 01/01/0001 12/31/9999
INCOME-CODE Income Code List 05 Individual's State-defined family income is from 201 to 255% of the FPL 01/01/0001 12/31/9999
INCOME-CODE Income Code List 06 Individual's State-defined family income is from 256 to 300% of the FPL 01/01/0001 12/31/9999
INCOME-CODE Income Code List 07 Individual's State-defined family income is from 301 to 400% of the FPL 01/01/0001 12/31/9999
INCOME-CODE Income Code List 08 Individual's State-defined family income is over 400% of the FPL 01/01/0001 12/31/9999
INCOME-STANDARD-CODE Income Standard Code List 01 MAGI 01/01/0001 12/31/9999
INCOME-STANDARD-CODE Income Standard Code List 02 Non-MAGI 01/01/0001 12/31/9999
INCOME-STANDARD-CODE Income Standard Code List 95 Other 01/01/0001 12/31/9999
INSURANCE-PLAN-TYPE Insurance Plan Type List 01 Medical or comprehensive health insurance plan (e.g. HMO) 01/01/0001 12/31/9999
INSURANCE-PLAN-TYPE Insurance Plan Type List 02 Dental health insurance plan 01/01/0001 12/31/9999
INSURANCE-PLAN-TYPE Insurance Plan Type List 03 Vision health insurance plan 01/01/0001 12/31/9999
INSURANCE-PLAN-TYPE Insurance Plan Type List 04 Prenatal/delivery health insurance plan 01/01/0001 12/31/9999
INSURANCE-PLAN-TYPE Insurance Plan Type List 05 Long term care health insurance plan (Long Term PIHP) 01/01/0001 12/31/9999
INSURANCE-PLAN-TYPE Insurance Plan Type List 06 Transportation health insurance plan (Transportation PAHP) 01/01/0001 12/31/9999
INSURANCE-PLAN-TYPE Insurance Plan Type List 07 A managed care plan 01/01/0001 12/31/9999
INSURANCE-PLAN-TYPE Insurance Plan Type List 08 Disease management health insurance plan (Disease Management PAHP) 01/01/0001 12/31/9999
INSURANCE-PLAN-TYPE Insurance Plan Type List 09 PAHP (Medical only) 01/01/0001 12/31/9999
INSURANCE-PLAN-TYPE Insurance Plan Type List 10 Comprehensive health insurance and Long Term Care (hybrid) 01/01/0001 12/31/9999
INSURANCE-PLAN-TYPE Insurance Plan Type List 11 Other health insurance plan 01/01/0001 12/31/9999
INSURANCE-PLAN-TYPE Insurance Plan Type List 12 Veterans Administration health benefits 01/01/0001 12/31/9999
INSURANCE-PLAN-TYPE Insurance Plan Type List 13 Indian Health Service Program health benefits 01/01/0001 12/31/9999
INSURANCE-PLAN-TYPE Insurance Plan Type List 14 TRICARE health benefits 01/01/0001 12/31/9999
INSURANCE-PLAN-TYPE Insurance Plan Type List 15 Eligible enrolled in private LTC insurance 01/01/0001 12/31/9999
INSURANCE-PLAN-TYPE Insurance Plan Type List 16 Fee-for-Service insurance 01/01/0001 12/31/9999
LEVEL-OF-CARE-STATUS Level of Care Status List 001 Hospital as defined in 42 CFR $440.10 01/01/0001 12/31/9999
LEVEL-OF-CARE-STATUS Level of Care Status List 002 Inpatient psychiatric facility for individuals under age 21 as provided in 42 CFR $440.160 01/01/0001 12/31/9999
LEVEL-OF-CARE-STATUS Level of Care Status List 003 Nursing Facility 01/01/0001 12/31/9999
LEVEL-OF-CARE-STATUS Level of Care Status List 004 ICF/IDD 01/01/0001 12/31/9999
LEVEL-OF-CARE-STATUS Level of Care Status List 005 Other Type of Facility 01/01/0001 12/31/9999
LEVEL-OF-CARE-STATUS Level of Care Status List 888 Not Applicable (Not in LTSS program) 01/01/0001 12/31/9999
LICENSE-TYPE License Type List 1 State, county, or municipality professional or business license 01/01/0001 12/31/9999
LICENSE-TYPE License Type List 2 DEA license 01/01/0001 12/31/9999
LICENSE-TYPE License Type List 3 Professional society accreditation 01/01/0001 12/31/9999
LICENSE-TYPE License Type List 4 CLIA accreditation 01/01/0001 12/31/9999
LICENSE-TYPE License Type List 5 Other 01/01/0001 12/31/9999
LINE-ADJUSTMENT-IND Line Adjustment Indicator List 0 Original Claim/Encounter/Payment - Indicates that this is the first (and, when applicable, only) fully adjudicated transaction in a claim family (one or more claims with the related ICN-ORIG and/or ICN-ADJ and typically the same MSIS ID and provider ID(s) also). 01/01/0001 12/31/9999
LINE-ADJUSTMENT-IND Line Adjustment Indicator List 1 Void/Reversal/Cancel of a prior submission Use this code to convey that the purpose of the transaction is to void/reverse/cancel a previously paid/approved claim/encounter/payment where the claim/encounter/payment is not being replaced by a new paid/approved version of the claim/encounter/payment. Typically, this would be the last claim/encounter/payment that would ever be associated with a given claim family. These records must have the same ICN-ORIG or ICN-ADJ as the claim/encounter being voided. CMS expects a void transaction to also have the same MSIS ID and provider ID(s) as the claim/encounter/payment being voided/reversed/cancelled. 01/01/0001 12/31/9999
LINE-ADJUSTMENT-IND Line Adjustment Indicator List 4 Replacement/Resubmission of a previously paid/approved claim/encounter/payment - Use when the purpose of the transaction is to replace a previously paid/approved claim/encounter/payment with a new paid/approved version of the claim/encounter/payment. These records must have the same ICN-ORIG or ICN-ADJ as the claim/encounter being replaced. CMS expects a replacement transaction to also have the same MSIS ID and provider ID(s) as the claim/encounter/payment being replaced/resubmitted. 01/01/0001 12/31/9999
LINE-ADJUSTMENT-IND Line Adjustment Indicator List 5 Credit Gross Adjustment - Use this code to indicate an aggregate provider-level recoupment of payments (e.g., not attributable to a single beneficiary). Amounts on these claims should be expressed as negative numbers. If a credit gross adjustment is reported with an ICN that is related to an ICN(s) of another gross adjustment (credit or debit) then CMS will interpret this to mean that the credit gross adjustment with the more recent adjudication date should completely replace the preceding related gross adjustment. If the ICNs of a credit gross adjustment are not related to any other gross adjustments (credit or debit) then the credit gross adjustment will always be treated as a distinct financial transaction. 01/01/0001 12/31/9999
LINE-ADJUSTMENT-IND Line Adjustment Indicator List 6 Debit Gross Adjustment - Use this code to indicate an aggregate provider-level payment to a provider (e.g., not attributable to a single beneficiary). Amounts on these claims should be expressed as positive numbers. If a debit gross adjustment is reported with an ICN that is related to an ICN(s) of another gross adjustment (credit or debit) then CMS will interpret this to mean that the credit gross adjustment with the more recent adjudication date should completely replace the preceding related gross adjustment. If the ICNs of a debit gross adjustment are not related to any other gross adjustments (credit or debit) then the debit gross adjustment will always be treated as a distinct financial transaction. 01/01/0001 12/31/9999
LINE-ADJUSTMENT-REASON-CODE Line Adjustment Reason Code List See "VVL_Code_Description" field This data element's valid value code set is maintained by a Code Set Maintenance Organization (CSMO), the official licensing organization for specific valid value code sets. The CSMO is the system of record for those specific valid value code sets. While T-MSIS endeavors to be in-sync with CMSO's updates, minor delays may occur but that shouldn't block T-MSIS data submissions using the CSMO's latest version.

For background and context, see https://x12.org/codes/claim-adjustment-reason-codes		 N/A N/A
LTSS-LEVEL-CARE LTSS Level of Care List 1 Skilled Care 01/01/0001 12/31/9999
LTSS-LEVEL-CARE LTSS Level of Care List 2 Intermediate Care 01/01/0001 12/31/9999
LTSS-LEVEL-CARE LTSS Level of Care List 3 Custodial Care 01/01/0001 12/31/9999
MANAGED-CARE-ADDR-TYPE Managed Care Address Type List 1 MCOs corporate address and contact information 01/01/0001 12/31/9999
MANAGED-CARE-ADDR-TYPE Managed Care Address Type List 2 MCOs mailing address 01/01/0001 12/31/9999
MANAGED-CARE-ADDR-TYPE Managed Care Address Type List 3 MCOs service location address 01/01/0001 12/31/9999
MANAGED-CARE-ADDR-TYPE Managed Care Address Type List 4 MCOs Billing address and contact information 01/01/0001 12/31/9999
MANAGED-CARE-ADDR-TYPE Managed Care Address Type List 5 CEO's address and contact information 01/01/0001 12/31/9999
MANAGED-CARE-ADDR-TYPE Managed Care Address Type List 6 CFO's address and contact information 01/01/0001 12/31/9999
MANAGED-CARE-ADDR-TYPE Managed Care Address Type List 7 Other 01/01/0001 12/31/9999
MANAGED-CARE-PLAN-OTHER-ID-TYPE Managed Care Plan Other ID Type List 01 Federal Tax ID 01/01/0001 12/31/9999
MANAGED-CARE-PLAN-OTHER-ID-TYPE Managed Care Plan Other ID Type List 02 State Tax ID 01/01/0001 12/31/9999
MANAGED-CARE-PLAN-TYPE Managed Care Plan Type List 01 Comprehensive MCO 01/01/0001 12/31/9999
MANAGED-CARE-PLAN-TYPE Managed Care Plan Type List 02 Traditional PCCM Provider 01/01/0001 12/31/9999
MANAGED-CARE-PLAN-TYPE Managed Care Plan Type List 03 Enhanced PCCM Provider 01/01/0001 12/31/9999
MANAGED-CARE-PLAN-TYPE Managed Care Plan Type List 04 HIO 01/01/0001 12/31/9999
MANAGED-CARE-PLAN-TYPE Managed Care Plan Type List 05 Medical-only PIHP (risk or non-risk/non-comprehensive/with inpatient hospital or institutional services) 01/01/0001 12/31/9999
MANAGED-CARE-PLAN-TYPE Managed Care Plan Type List 06 Medical-only PAHP (risk or non-risk/non-comprehensive/no inpatient hospital or institutional services) 01/01/0001 12/31/9999
MANAGED-CARE-PLAN-TYPE Managed Care Plan Type List 07 Long Term Care (LTC) PIHP 01/01/0001 12/31/9999
MANAGED-CARE-PLAN-TYPE Managed Care Plan Type List 08 Mental Health (MH) PIHP 01/01/0001 12/31/9999
MANAGED-CARE-PLAN-TYPE Managed Care Plan Type List 09 Mental Health (MH) PAHP 01/01/0001 12/31/9999
MANAGED-CARE-PLAN-TYPE Managed Care Plan Type List 10 Substance Use Disorders (SUD) PIHP 01/01/0001 12/31/9999
MANAGED-CARE-PLAN-TYPE Managed Care Plan Type List 11 Substance Use Disorders (SUD) PAHP 01/01/0001 12/31/9999
MANAGED-CARE-PLAN-TYPE Managed Care Plan Type List 12 Mental Health (MH) and Substance Use Disorders (SUD) PIHP 01/01/0001 12/31/9999
MANAGED-CARE-PLAN-TYPE Managed Care Plan Type List 13 Mental Health (MH) and Substance Use Disorders (SUD) PAHP 01/01/0001 12/31/9999
MANAGED-CARE-PLAN-TYPE Managed Care Plan Type List 14 Dental PAHP 01/01/0001 12/31/9999
MANAGED-CARE-PLAN-TYPE Managed Care Plan Type List 15 Transportation PAHP 01/01/0001 12/31/9999
MANAGED-CARE-PLAN-TYPE Managed Care Plan Type List 16 Disease Management PAHP 01/01/0001 12/31/9999
MANAGED-CARE-PLAN-TYPE Managed Care Plan Type List 17 PACE 01/01/0001 12/31/9999
MANAGED-CARE-PLAN-TYPE Managed Care Plan Type List 18 Pharmacy PAHP 01/01/0001 12/31/9999
MANAGED-CARE-PLAN-TYPE Managed Care Plan Type List 19 Individual is enrolled in Long-Term Services & Supports (LTSS) and Mental Health (MH) PIHP 01/01/0001 12/31/9999
MANAGED-CARE-PLAN-TYPE Managed Care Plan Type List 20 Other 01/01/0001 12/31/9999
MANAGED-CARE-PLAN-TYPE Managed Care Plan Type List 60 Accountable Care Organization 01/01/0001 12/31/9999
MANAGED-CARE-PLAN-TYPE Managed Care Plan Type List 70 Health/Medical Home 01/01/0001 09/30/2020
MANAGED-CARE-PLAN-TYPE Managed Care Plan Type List 80 Integrated Care For Dual Eligibles 01/01/0001 12/31/9999
MANAGED-CARE-PROFIT-STATUS Managed Care Profit Status List 01 501(C)(3) NON-PROFIT 01/01/0001 12/31/9999
MANAGED-CARE-PROFIT-STATUS Managed Care Profit Status List 02 FOR-PROFIT, CLOSELY HELD 01/01/0001 12/31/9999
MANAGED-CARE-PROFIT-STATUS Managed Care Profit Status List 03 FOR-PROFIT, PUBLICLY TRADED 01/01/0001 12/31/9999
MANAGED-CARE-PROFIT-STATUS Managed Care Profit Status List 04 OTHER 01/01/0001 12/31/9999
MANAGED-CARE-PROGRAM Managed Care Program List 1 Medicaid State Plan 01/01/0001 12/31/9999
MANAGED-CARE-PROGRAM Managed Care Program List 2 CHIP State Plan 01/01/0001 12/31/9999
MANAGED-CARE-PROGRAM Managed Care Program List 3 Both Medicaid and CHIP 01/01/0001 12/31/9999
MANAGED-CARE-SERVICE-AREA Managed Care Service Area List 1 Statewide - The managed care entity provides services to beneficiaries throughout the entire state. 01/01/0001 12/31/9999
MANAGED-CARE-SERVICE-AREA Managed Care Service Area List 2 County - The managed care entity provides services to beneficiaries in specified counties. 01/01/0001 12/31/9999
MANAGED-CARE-SERVICE-AREA Managed Care Service Area List 3 City - The managed care entity provides services to beneficiaries in specified cities. 01/01/0001 12/31/9999
MANAGED-CARE-SERVICE-AREA Managed Care Service Area List 4 Region - The managed care entity provides services to beneficiaries in specified regions, not defined by individual counties within the state ("region" is state-defined). 01/01/0001 12/31/9999
MANAGED-CARE-SERVICE-AREA Managed Care Service Area List 5 Zip Code - The managed care entity program provides services to beneficiaries in specified zip codes. 01/01/0001 12/31/9999
MANAGED-CARE-SERVICE-AREA Managed Care Service Area List 6 Other - The managed care entity provides services to beneficiaries in "other" area(s), not Statewide, County, City, or Region. 01/01/0001 12/31/9999
MANAGED-CARE-SERVICE-AREA-NAME Managed Care Service Area Name List See "VVL_Code_Description" field This data element's valid value code set is maintained by a Code Set Maintenance Organization (CSMO), the official licensing organization for specific valid value code sets. The CSMO is the system of record for those specific valid value code sets. While T-MSIS endeavors to be in-sync with CMSO's updates, minor delays may occur but that shouldn't block T-MSIS data submissions using the CSMO's latest version.

For background and context, see https://www.census.gov/library/reference/code-lists/ansi.html		 N/A N/A
MARITAL-STATUS Marital Status List 01 Legally Married (to opposite sex), spouse present 01/01/0001 12/31/9999
MARITAL-STATUS Marital Status List 02 Legally Married (to opposite sex), spouse absent 01/01/0001 12/31/9999
MARITAL-STATUS Marital Status List 03 Legally Married (to same sex), spouse present 01/01/0001 12/31/9999
MARITAL-STATUS Marital Status List 04 Legally Married (to same sex), spouse absent 01/01/0001 12/31/9999
MARITAL-STATUS Marital Status List 05 Partnered or in Civil Union (to opposite sex), spouse present 01/01/0001 12/31/9999
MARITAL-STATUS Marital Status List 06 Partnered or in Civil Union (to opposite sex), spouse absent 01/01/0001 12/31/9999
MARITAL-STATUS Marital Status List 07 Partnered or in Civil Union (to same sex), spouse present 01/01/0001 12/31/9999
MARITAL-STATUS Marital Status List 08 Partnered or in Civil Union (to same sex), spouse absent 01/01/0001 12/31/9999
MARITAL-STATUS Marital Status List 09 Legally separated (and not married or partnered) 01/01/0001 12/31/9999
MARITAL-STATUS Marital Status List 10 Divorced (and not currently married or partnered) 01/01/0001 12/31/9999
MARITAL-STATUS Marital Status List 11 Separated (and not currently married or partnered) 01/01/0001 12/31/9999
MARITAL-STATUS Marital Status List 12 Widower/Widow (and not currently married or partnered) 01/01/0001 12/31/9999
MARITAL-STATUS Marital Status List 13 Never married/partnered 01/01/0001 12/31/9999
MARITAL-STATUS Marital Status List 14 Other 01/01/0001 12/31/9999
MARITAL-STATUS Marital Status List 15 Legally Married (to opposite sex) 01/01/0001 12/31/9999
MARITAL-STATUS Marital Status List 16 Legally Married (to same sex) 01/01/0001 12/31/9999
MARITAL-STATUS Marital Status List 17 Legally Married, spouse present 01/01/0001 12/31/9999
MARITAL-STATUS Marital Status List 18 Legally Married, spouse absent 01/01/0001 12/31/9999
MARITAL-STATUS Marital Status List 19 Legally Married 01/01/0001 12/31/9999
MARITAL-STATUS Marital Status List 20 Partnered or in Civil Union (to opposite sex) 01/01/0001 12/31/9999
MARITAL-STATUS Marital Status List 21 Partnered (Registered Domestic Partner) or in Civil Union (to same sex) 01/01/0001 12/31/9999
MARITAL-STATUS Marital Status List 22 Partnered (Registered Domestic Partner) or in Civil Union, spouse present 01/01/0001 12/31/9999
MARITAL-STATUS Marital Status List 23 Partnered (Registered Domestic Partner) or in Civil Union, spouse absent 01/01/0001 12/31/9999
MARITAL-STATUS Marital Status List 24 Partnered (Registered Domestic Partner) or in Civil Union 01/01/0001 12/31/9999
MARITAL-STATUS Marital Status List 25 Partnered (Registered Domestic Partner) 01/01/0001 12/31/9999
MARITAL-STATUS Marital Status List 26 Civil Union 01/01/0001 12/31/9999
MARITAL-STATUS Marital Status List 27 Legally Married, Partnered, or in Civil Union 01/01/0001 12/31/9999
MARITAL-STATUS Marital Status List 28 Legally separated (and still legally married) 01/01/0001 12/31/9999
MARITAL-STATUS Marital Status List 29 Legally separated 01/01/0001 12/31/9999
MARITAL-STATUS Marital Status List 30 Annulled (and not currently married or partnered) 01/01/0001 12/31/9999
MARITAL-STATUS Marital Status List 31 Separated (and currently married or partnered) 01/01/0001 12/31/9999
MARITAL-STATUS Marital Status List 32 Separated 01/01/0001 12/31/9999
MARITAL-STATUS Marital Status List 33 Single, widowed, or divorced 01/01/0001 12/31/9999
MBESCBES-FORM-GROUP MBESCBES Form Group List 1 The MBES/CBES form that this expenditure was or will be reported to is a form for Medicaid (but not Medicaid-expansion CHIP) expenditures or adjustments. 01/01/0001 12/31/9999
MBESCBES-FORM-GROUP MBESCBES Form Group List 2 The MBES/CBES form that this expenditure was or will be reported to is a form for Medicaid-expansion CHIP expenditures or adjustments. 01/01/0001 12/31/9999
MBESCBES-FORM-GROUP MBESCBES Form Group List 3 The MBES/CBES form that this expenditure was or will be reported to is a form for separate CHIP expenditures or adjustments. 01/01/0001 12/31/9999
MBESCBES-FORMGP-1 MBESCBES Form Group 1 List 64.10BASE Quarterly Expenditures for State & Local Administration 01/01/0001 12/31/9999
MBESCBES-FORMGP-1 MBESCBES Form Group 1 List 64.9A Third Party Liability Collections and Cost Avoidance 01/01/0001 12/31/9999
MBESCBES-FORMGP-1 MBESCBES Form Group 1 List 64.9BASE Medical Assistance Expenditures by Type of Service 01/01/0001 12/31/9999
MBESCBES-FORMGP-1 MBESCBES Form Group 1 List 64.9P Quarterly Medicaid Statement of Expenditures for the Medical Assistance Program, Prior Period Adjustment 01/01/0001 12/31/9999
MBESCBES-FORMGP-2 MBESCBES Form Group 2 List 64.21U Child Health Expenditures by Service 01/01/0001 12/31/9999
MBESCBES-FORMGP-2 MBESCBES Form Group 2 List 64.21UP Quarterly Medical Assistance Expenditures by Children’s Health Insurance Program expenditure categories 01/01/0001 12/31/9999
MBESCBES-FORMGP-3 MBESCBES Form Group 3 List 21BASE Children's Health Expenditures By Type of Service 01/01/0001 12/31/9999
MBESCBES-FORMGP-3 MBESCBES Form Group 3 List 21P Quarterly Children's Health Insurance Program 01/01/0001 12/31/9999
MEDICARE-COMB-DED-IND Medicare Combined Deductible Indicator List 0 Amount not combined with coinsurance amount 01/01/0001 12/31/9999
MEDICARE-COMB-DED-IND Medicare Combined Deductible Indicator List 1 Amount combined with coinsurance amount 01/01/0001 12/31/9999
MEDICARE-REIM-TYPE Medicare Reimbursement Type List 01 IPPS - Acute Inpatient PPS 01/01/0001 12/31/9999
MEDICARE-REIM-TYPE Medicare Reimbursement Type List 02 LTCHPPS - Long-term Care Hospital PPS 01/01/0001 12/31/9999
MEDICARE-REIM-TYPE Medicare Reimbursement Type List 03 SNFPPS - Skilled Nursing Facility PPS 01/01/0001 12/31/9999
MEDICARE-REIM-TYPE Medicare Reimbursement Type List 04 HHPPS - Home Health PPS 01/01/0001 12/31/9999
MEDICARE-REIM-TYPE Medicare Reimbursement Type List 05 IRFPPS - Inpatient Rehabilitation Facility PPS 01/01/0001 12/31/9999
MEDICARE-REIM-TYPE Medicare Reimbursement Type List 06 IPFPPS - Inpatient Psychiatric Facility PPS 01/01/0001 12/31/9999
MEDICARE-REIM-TYPE Medicare Reimbursement Type List 07 OPPS - Outpatient PPS 01/01/0001 12/31/9999
MEDICARE-REIM-TYPE Medicare Reimbursement Type List 08 Fee Schedules (for physicians, DME, ambulance, and clinical lab) 01/01/0001 12/31/9999
MEDICARE-REIM-TYPE Medicare Reimbursement Type List 09 Part C Hierarchical Condition Category Risk Assessment (CMS-HCC RA) Capitation Payment Model 01/01/0001 12/31/9999
MFP-LIVES-WITH-FAMILY MFP Lives with Family List 0 No 01/01/0001 12/31/9999
MFP-LIVES-WITH-FAMILY MFP Lives with Family List 1 Yes 01/01/0001 12/31/9999
MFP-LIVES-WITH-FAMILY MFP Lives with Family List 2 Non Participation 01/01/0001 12/31/9999
MFP-QUALIFIED-INSTITUTION MFP Qualified Institution List 00 Default- Non Participation 01/01/0001 12/31/9999
MFP-QUALIFIED-INSTITUTION MFP Qualified Institution List 01 Nursing Facility 01/01/0001 12/31/9999
MFP-QUALIFIED-INSTITUTION MFP Qualified Institution List 02 ICF/IID (Intermediate Care Facilities for individuals with Intellectual Disabilities) 01/01/0001 12/31/9999
MFP-QUALIFIED-INSTITUTION MFP Qualified Institution List 03 IMD (Institution for Mental Diseases) 01/01/0001 12/31/9999
MFP-QUALIFIED-INSTITUTION MFP Qualified Institution List 04 Hospital 01/01/0001 12/31/9999
MFP-QUALIFIED-INSTITUTION MFP Qualified Institution List 05 Other 01/01/0001 12/31/9999
MFP-QUALIFIED-RESIDENCE MFP Qualified Residence List 00 Default - Non Participation 01/01/0001 12/31/9999
MFP-QUALIFIED-RESIDENCE MFP Qualified Residence List 01 Home owned by participant 01/01/0001 12/31/9999
MFP-QUALIFIED-RESIDENCE MFP Qualified Residence List 02 Home owned by family member 01/01/0001 12/31/9999
MFP-QUALIFIED-RESIDENCE MFP Qualified Residence List 03 Apartment leased by participant, not assisted living 01/01/0001 12/31/9999
MFP-QUALIFIED-RESIDENCE MFP Qualified Residence List 04 Apartment leased by participant, assisted living 01/01/0001 12/31/9999
MFP-QUALIFIED-RESIDENCE MFP Qualified Residence List 05 Group home of no more than 4 people 01/01/0001 12/31/9999
MFP-REASON-PARTICIPATION-ENDED MFP Reason Participation Ended List 00 Default - No Participation 01/01/0001 12/31/9999
MFP-REASON-PARTICIPATION-ENDED MFP Reason Participation Ended List 01 Completed 365 days of participation 01/01/0001 12/31/9999
MFP-REASON-PARTICIPATION-ENDED MFP Reason Participation Ended List 02 Suspended eligibility 01/01/0001 12/31/9999
MFP-REASON-PARTICIPATION-ENDED MFP Reason Participation Ended List 03 Re-institutionalized 01/01/0001 12/31/9999
MFP-REASON-PARTICIPATION-ENDED MFP Reason Participation Ended List 04 Died 01/01/0001 12/31/9999
MFP-REASON-PARTICIPATION-ENDED MFP Reason Participation Ended List 05 Moved 01/01/0001 12/31/9999
MFP-REASON-PARTICIPATION-ENDED MFP Reason Participation Ended List 06 No longer needed services 01/01/0001 12/31/9999
MFP-REASON-PARTICIPATION-ENDED MFP Reason Participation Ended List 07 Other 01/01/0001 12/31/9999
MFP-REINSTITUTIONALIZED-REASON MFP Reinstitutionalized Reason List 00 Default- Non Participation 01/01/0001 12/31/9999
MFP-REINSTITUTIONALIZED-REASON MFP Reinstitutionalized Reason List 01 Acute care hospitalization followed by long term rehabilitation 01/01/0001 12/31/9999
MFP-REINSTITUTIONALIZED-REASON MFP Reinstitutionalized Reason List 02 Deterioration in cognitive functioning 01/01/0001 12/31/9999
MFP-REINSTITUTIONALIZED-REASON MFP Reinstitutionalized Reason List 03 Deterioration in health 01/01/0001 12/31/9999
MFP-REINSTITUTIONALIZED-REASON MFP Reinstitutionalized Reason List 04 Deterioration in mental health 01/01/0001 12/31/9999
MFP-REINSTITUTIONALIZED-REASON MFP Reinstitutionalized Reason List 05 Loss of housing 01/01/0001 12/31/9999
MFP-REINSTITUTIONALIZED-REASON MFP Reinstitutionalized Reason List 06 Loss of personal care giver 01/01/0001 12/31/9999
MFP-REINSTITUTIONALIZED-REASON MFP Reinstitutionalized Reason List 07 By request of participant or guardian 01/01/0001 12/31/9999
MFP-REINSTITUTIONALIZED-REASON MFP Reinstitutionalized Reason List 08 Lack of sufficient community services 01/01/0001 12/31/9999
NDC-UNIT-OF-MEASURE NDC Unit of Measure List F2 International Unit 01/01/0001 12/31/9999
NDC-UNIT-OF-MEASURE NDC Unit of Measure List GR Gram 01/01/0001 12/31/9999
NDC-UNIT-OF-MEASURE NDC Unit of Measure List ME Milligram 01/01/0001 12/31/9999
NDC-UNIT-OF-MEASURE NDC Unit of Measure List ML Milliliter 01/01/0001 12/31/9999
NDC-UNIT-OF-MEASURE NDC Unit of Measure List See "VVL_Code_Description" field This data element's valid value code set is maintained by a Code Set Maintenance Organization (CSMO), the official licensing organization for specific valid value code sets. The CSMO is the system of record for those specific valid value code sets. While T-MSIS endeavors to be in-sync with CMSO's updates, minor delays may occur but that shouldn't block T-MSIS data submissions using the CSMO's latest version.

For background and context, see https://www.x12.org/		 N/A N/A
NDC-UNIT-OF-MEASURE NDC Unit of Measure List UN Unit 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 00 New Prescription 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 01 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 02 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 03 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 04 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 05 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 06 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 07 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 08 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 09 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 10 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 11 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 12 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 13 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 14 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 15 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 16 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 17 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 18 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 19 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 20 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 21 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 22 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 23 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 24 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 25 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 26 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 27 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 28 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 29 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 30 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 31 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 32 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 33 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 34 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 35 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 36 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 37 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 38 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 39 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 40 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 41 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 42 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 43 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 44 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 45 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 46 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 47 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 48 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 49 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 50 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 51 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 52 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 53 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 54 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 55 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 56 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 57 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 58 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 59 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 60 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 61 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 62 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 63 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 64 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 65 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 66 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 67 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 68 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 69 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 70 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 71 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 72 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 73 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 74 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 75 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 76 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 77 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 78 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 79 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 80 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 81 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 82 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 83 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 84 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 85 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 86 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 87 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 88 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 89 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 90 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 91 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 92 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 93 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 94 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 95 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 96 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 97 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 98 Number of Refill(s) 01/01/0001 12/31/9999
NEW-REFILL-IND New Refill Indicator List 99 Number of Refill(s) 01/01/0001 12/31/9999
OCCURRENCE-CODE Occurrence Code List See "VVL_Code_Description" field This data element's valid value code set is maintained by a Code Set Maintenance Organization (CSMO), the official licensing organization for specific valid value code sets. The CSMO is the system of record for those specific valid value code sets. While T-MSIS endeavors to be in-sync with CMSO's updates, minor delays may occur but that shouldn't block T-MSIS data submissions using the CSMO's latest version.

For background and context, see https://www.nubc.org/license or https://med.noridianmedicare.com/web/jea/topics/claim-submission/occurrence-codes		 N/A N/A
OFFSET-TRANS-TYPE Offset Transaction Type List 1 Capitation 01/01/0001 12/31/9999
OFFSET-TRANS-TYPE Offset Transaction Type List 2 Individual Premium 01/01/0001 12/31/9999
OFFSET-TRANS-TYPE Offset Transaction Type List 3 Group Premium 01/01/0001 12/31/9999
OPERATING-AUTHORITY Operating Authority List 01 1115 demonstration waiver program - demonstration projects under which most provisions of Section 1902 of the Social Security Act are waived and/or expenditures that would not otherwise be eligible for FFP are authorized. States use these to expand eligibility, restructure Medicaid coverage and secure programmatic flexibility. 01/01/0001 12/31/9999
OPERATING-AUTHORITY Operating Authority List 02 1915(b) waiver program - waivers of most provisions of Section 1902 of the Social Security Act in order to limit beneficiaries' freedom of choice of provider; selectively contract with providers; or provide additional services to beneficiaries (State may include BBA special populations) 01/01/0001 12/31/9999
OPERATING-AUTHORITY Operating Authority List 03 1932(a) state plan option to use managed care for MCO and PCCM programs - mandatory managed care programs implemented through the state plan (State must exclude or permit voluntary enrollment of specific populations) 01/01/0001 12/31/9999
OPERATING-AUTHORITY Operating Authority List 04 1915(a) voluntary managed care program - an MCO managed care program in which enrollment is voluntary and therefore does not require a waiver. 01/01/0001 12/31/9999
OPERATING-AUTHORITY Operating Authority List 05 Concurrent 1915(b)/1915(c) waivers- programs, or portions thereof, operating under both 1915(b) managed care and 1915(c) home and community-based services waivers. 01/01/0001 12/31/9999
OPERATING-AUTHORITY Operating Authority List 06 Concurrent 1915(a)/1915(c) waivers- programs, or portions thereof, operating under both 1915(a) voluntary managed care and 1915(c) home and community-based services waiver 01/01/0001 12/31/9999
OPERATING-AUTHORITY Operating Authority List 07 Concurrent 1932(a)/1915(c) waivers - programs, or portions thereof, operating under both 1932(a) managed care and 1915(c) home and community-based services waiver. 01/01/0001 12/31/9999
OPERATING-AUTHORITY Operating Authority List 08 PACE - program that provides pre-paid, capitated comprehensive, health care services to the frail elderly. 01/01/0001 12/31/9999
OPERATING-AUTHORITY Operating Authority List 09 1905(t) voluntary PCCM program - A PCCM managed care program in which enrollment is voluntary and therefore does not require a waiver. 01/01/0001 12/31/9999
OPERATING-AUTHORITY Operating Authority List 10 1937benchmark benefit program-programs to provide benefits that differ from Medicaid state plan benefits using managed care and implemented through the state plan. 01/01/0001 12/31/9999
OPERATING-AUTHORITY Operating Authority List 11 1902(a)(70) non-emergency medical transportation program -non-emergency medical transportation brokerage programs implemented through the state plan which can vary scope of services, operate on a less-than-statewide basis, and limit freedom of choice 01/01/0001 12/31/9999
OPERATING-AUTHORITY Operating Authority List 12 Concurrent 1915(b)/1915(i) HCBS state plan services - the optional 1915(i) state plan Home and Community-Based Services (HCBS) benefit operated in conjunction with a 1915(b) managed care waiver program. 01/01/0001 12/31/9999
OPERATING-AUTHORITY Operating Authority List 13 Concurrent 1915(a)/ 1915(i) HCBS state plan services - the optional 1915(i) state plan Home and Community-Based Services (HCBS) benefit operated in conjunction with a 1915(a) voluntary managed care program. 01/01/0001 12/31/9999
OPERATING-AUTHORITY Operating Authority List 14 Concurrent 1932(a)/ 1915(i) HCBS state plan services - the optional 1915(i) state plan Home and Community-Based Services (HCBS) benefit operated in conjunction with a 1932(a) managed care state plan option. 01/01/0001 12/31/9999
OPERATING-AUTHORITY Operating Authority List 15 1945 Health Homes. 01/01/0001 12/31/9999
OPERATING-AUTHORITY Operating Authority List 16 Concurrent 1915(a)/1915(j) - programs, or portions thereof, operating under both 1915(a) and 1915(j) authorities 01/01/0001 12/31/9999
OPERATING-AUTHORITY Operating Authority List 17 Concurrent 1932(a)/1915(j) - programs, or portions thereof, operating under both 1932(a) and 1915(j) authorities 01/01/0001 12/31/9999
OPERATING-AUTHORITY Operating Authority List 18 Concurrent 1915(b)/1915(j) - programs, or portions thereof, operating under both 1915(b) and 1915(j) authorities 01/01/0001 12/31/9999
OPERATING-AUTHORITY Operating Authority List 19 Concurrent 1115/1915(j) - programs, or portions thereof, operating under both 1115 and 1915(j) authorities 01/01/0001 12/31/9999
OPERATING-AUTHORITY Operating Authority List 20 Concurrent 1915(a)/1915(k) - programs, or portions thereof, operating under both 1915(a) and 1915(k) authorities 01/01/0001 12/31/9999
OPERATING-AUTHORITY Operating Authority List 21 Concurrent 1932(a)/1915(k) - programs, or portions thereof, operating under both 1932(a) and 1915(k) authorities 01/01/0001 12/31/9999
OPERATING-AUTHORITY Operating Authority List 22 Concurrent 1915(b)/1915(k) - programs, or portions thereof, operating under both 1915(b) and 1915(k) authorities 01/01/0001 12/31/9999
OPERATING-AUTHORITY Operating Authority List 23 Concurrent 1115/1915(k) - programs, or portions thereof, operating under both 1115 and 1915(k) authorities 01/01/0001 12/31/9999
OTHER-INSURANCE-IND Other Insurance Indicator List 0 No 01/01/0001 12/31/9999
OTHER-INSURANCE-IND Other Insurance Indicator List 1 Yes 01/01/0001 12/31/9999
OTHER-TPL-COLLECTION Other TPL Collection List 000 Not Applicable 01/01/0001 12/31/9999
OTHER-TPL-COLLECTION Other TPL Collection List 001 Third Party Resource is Casualty/Tort 01/01/0001 12/31/9999
OTHER-TPL-COLLECTION Other TPL Collection List 002 Third Party Resource is Estate 01/01/0001 12/31/9999
OTHER-TPL-COLLECTION Other TPL Collection List 003 Third Party Resource is Lien (TEFRA) 01/01/0001 12/31/9999
OTHER-TPL-COLLECTION Other TPL Collection List 004 Third Party Resource is Lien (Other) 01/01/0001 12/31/9999
OTHER-TPL-COLLECTION Other TPL Collection List 005 Third Party Resource is Worker's Compensation 01/01/0001 12/31/9999
OTHER-TPL-COLLECTION Other TPL Collection List 006 Third Party Resource is Medical Malpractice 01/01/0001 12/31/9999
OTHER-TPL-COLLECTION Other TPL Collection List 007 Third Party Resource is Other 01/01/0001 12/31/9999
OUTLIER-CODE Outlier Code List 00 No Outlier 01/01/0001 12/31/9999
OUTLIER-CODE Outlier Code List 01 Day Outlier 01/01/0001 12/31/9999
OUTLIER-CODE Outlier Code List 02 Cost Outlier 01/01/0001 12/31/9999
OUTLIER-CODE Outlier Code List 06 Valid DRG Received from the intermediary 01/01/0001 12/31/9999
OUTLIER-CODE Outlier Code List 07 CMS Developed DRG 01/01/0001 12/31/9999
OUTLIER-CODE Outlier Code List 08 CMS Developed DRG Using Patient Status Code 01/01/0001 12/31/9999
OUTLIER-CODE Outlier Code List 09 Not Group able 01/01/0001 12/31/9999
OUTLIER-CODE Outlier Code List 10 Composite of cost outliers 01/01/0001 12/31/9999
OWNERSHIP-CODE Ownership Code List 01 Voluntary - Non-Profit - Religious Organizations 01/01/0001 12/31/9999
OWNERSHIP-CODE Ownership Code List 02 Voluntary - Non-Profit - Other 01/01/0001 12/31/9999
OWNERSHIP-CODE Ownership Code List 03 Voluntary - multiple owners 01/01/0001 12/31/9999
OWNERSHIP-CODE Ownership Code List 04 Proprietary - Individual 01/01/0001 12/31/9999
OWNERSHIP-CODE Ownership Code List 05 Proprietary - Corporation 01/01/0001 12/31/9999
OWNERSHIP-CODE Ownership Code List 06 Proprietary - Partnership 01/01/0001 12/31/9999
OWNERSHIP-CODE Ownership Code List 07 Proprietary - Other 01/01/0001 12/31/9999
OWNERSHIP-CODE Ownership Code List 08 Proprietary - multiple owners 01/01/0001 12/31/9999
OWNERSHIP-CODE Ownership Code List 09 Government - Federal 01/01/0001 12/31/9999
OWNERSHIP-CODE Ownership Code List 10 Government - State 01/01/0001 12/31/9999
OWNERSHIP-CODE Ownership Code List 11 Government - City 01/01/0001 12/31/9999
OWNERSHIP-CODE Ownership Code List 12 Government - County 01/01/0001 12/31/9999
OWNERSHIP-CODE Ownership Code List 13 Government - City-County 01/01/0001 12/31/9999
OWNERSHIP-CODE Ownership Code List 14 Government - Hospital District 01/01/0001 12/31/9999
OWNERSHIP-CODE Ownership Code List 15 Government - State and City/County 01/01/0001 12/31/9999
OWNERSHIP-CODE Ownership Code List 16 Government - other multiple owners 01/01/0001 12/31/9999
OWNERSHIP-CODE Ownership Code List 17 Voluntary /Proprietary 01/01/0001 12/31/9999
OWNERSHIP-CODE Ownership Code List 18 Proprietary/Government 01/01/0001 12/31/9999
OWNERSHIP-CODE Ownership Code List 19 Voluntary/Government 01/01/0001 12/31/9999
OWNERSHIP-CODE Ownership Code List 88 N/A - The individual only practices as part of a group, e.g., as an employee 01/01/0001 12/31/9999
PATIENT-STATUS Patient Status List See "VVL_Code_Description" field This data element's valid value code set is maintained by a Code Set Maintenance Organization (CSMO), the official licensing organization for specific valid value code sets. The CSMO is the system of record for those specific valid value code sets. While T-MSIS endeavors to be in-sync with CMSO's updates, minor delays may occur but that shouldn't block T-MSIS data submissions using the CSMO's latest version.

For background and context, see https://www.nubc.org/license		 N/A N/A
PAYEE-ID-TYPE Payee ID Type List 01 State 01/01/0001 12/31/9999
PAYEE-ID-TYPE Payee ID Type List 02 Capitated plan ID 01/01/0001 12/31/9999
PAYEE-ID-TYPE Payee ID Type List 03 Sub-capitated plan ID 01/01/0001 12/31/9999
PAYEE-ID-TYPE Payee ID Type List 04 Sub-capitated network provider ID 01/01/0001 12/31/9999
PAYEE-ID-TYPE Payee ID Type List 05 State contracted FFS provider ID assigned by state 01/01/0001 12/31/9999
PAYEE-ID-TYPE Payee ID Type List 06 State contracted FFS provider NPI 01/01/0001 12/31/9999
PAYEE-ID-TYPE Payee ID Type List 07 Insurance carrier 01/01/0001 12/31/9999
PAYEE-ID-TYPE Payee ID Type List 08 Beneficiary 01/01/0001 12/31/9999
PAYEE-ID-TYPE Payee ID Type List 09 Non-Medicaid eligible guardian 01/01/0001 12/31/9999
PAYEE-ID-TYPE Payee ID Type List 95 Other 01/01/0001 12/31/9999
PAYEE-TAX-ID-TYPE Payee Tax ID Type List 01 SSN 01/01/0001 12/31/9999
PAYEE-TAX-ID-TYPE Payee Tax ID Type List 02 EIN 01/01/0001 12/31/9999
PAYEE-TAX-ID-TYPE Payee Tax ID Type List 03 ITIN 01/01/0001 12/31/9999
PAYEE-TAX-ID-TYPE Payee Tax ID Type List 04 State Tax ID 01/01/0001 12/31/9999
PAYEE-TAX-ID-TYPE Payee Tax ID Type List 95 Other 01/01/0001 12/31/9999
PAYER-ID-TYPE Payer ID Type List 01 State 01/01/0001 12/31/9999
PAYER-ID-TYPE Payer ID Type List 02 Capitated plan ID 01/01/0001 12/31/9999
PAYER-ID-TYPE Payer ID Type List 03 Sub-capitated entity ID 01/01/0001 12/31/9999
PAYER-ID-TYPE Payer ID Type List 04 Sub-capitated network provider ID 01/01/0001 12/31/9999
PAYER-ID-TYPE Payer ID Type List 95 Other 01/01/0001 12/31/9999
PAYMENT-LEVEL-IND Payment Level Indicator List 1 Payment/allowed amount is not determined at the individual line level (e.g., DRG or outpatient PPS) 01/01/0001 12/31/9999
PAYMENT-LEVEL-IND Payment Level Indicator List 2 Payment/allowed amount is determined at the individual line level (e.g., RBRVS) and when applicable, cost-sharing and/or coordination of benefits were deducted from one or more specific line-level payment/allowed amount(s) 01/01/0001 12/31/9999
PAYMENT-LEVEL-IND Payment Level Indicator List 3 Payment/allowed amount is determined for each individual line (e.g., RBRVS) but then cost sharing or coordination of benefits was deducted from the total paid/allowed amount at the header only 01/01/0001 12/31/9999
PAYMENT-PERIOD-TYPE Payment Period Type List 01 Bene coverage period 01/01/0001 12/31/9999
PAYMENT-PERIOD-TYPE Payment Period Type List 02 Service coverage period 01/01/0001 12/31/9999
PAYMENT-PERIOD-TYPE Payment Period Type List 03 Provider coverage period 01/01/0001 12/31/9999
PAYMENT-PERIOD-TYPE Payment Period Type List 04 Fiscal period 01/01/0001 12/31/9999
PAYMENT-PERIOD-TYPE Payment Period Type List 05 Episode of care 01/01/0001 12/31/9999
PAYMENT-PERIOD-TYPE Payment Period Type List 95 Other 01/01/0001 12/31/9999
PLACE-OF-SERVICE Place of Service Code List See "VVL_Code_Description" field This data element's valid value code set is maintained by a Code Set Maintenance Organization (CSMO), the official licensing organization for specific valid value code sets. The CSMO is the system of record for those specific valid value code sets. While T-MSIS endeavors to be in-sync with CMSO's updates, minor delays may occur but that shouldn't block T-MSIS data submissions using the CSMO's latest version.

For background and context, see https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set		 N/A N/A
POLICY-OWNER-CODE Policy Owner Code List 01 Self 01/01/0001 12/31/9999
POLICY-OWNER-CODE Policy Owner Code List 02 Spouse 01/01/0001 12/31/9999
POLICY-OWNER-CODE Policy Owner Code List 03 Custodial Parent 01/01/0001 12/31/9999
POLICY-OWNER-CODE Policy Owner Code List 04 Noncustodial Parent (Child Support Enforcement in effect) 01/01/0001 12/31/9999
POLICY-OWNER-CODE Policy Owner Code List 05 Noncustodial Parent without child support enforcement in effect 01/01/0001 12/31/9999
POLICY-OWNER-CODE Policy Owner Code List 06 Grandparent 01/01/0001 12/31/9999
POLICY-OWNER-CODE Policy Owner Code List 07 Guardian 01/01/0001 12/31/9999
POLICY-OWNER-CODE Policy Owner Code List 08 Domestic Partner 01/01/0001 12/31/9999
POLICY-OWNER-CODE Policy Owner Code List 09 Other 01/01/0001 12/31/9999
PREFERRED-LANGUAGE-CODE Preferred Language Code List See "VVL_Code_Description" field This data element's valid value code set is maintained by a Code Set Maintenance Organization (CSMO), the official licensing organization for specific valid value code sets. The CSMO is the system of record for those specific valid value code sets. While T-MSIS endeavors to be in-sync with CMSO's updates, minor delays may occur but that shouldn't block T-MSIS data submissions using the CSMO's latest version.

For background and context, see https://en.wikipedia.org/wiki/List_of_ISO_639-2_codes		 N/A N/A
PREGNANCY-IND Pregnancy Indicator List 0 No 01/01/0001 12/31/9999
PREGNANCY-IND Pregnancy Indicator List 1 Yes 01/01/0001 12/31/9999
PRESCRIPTION-ORIGIN-CODE Prescription Origin Code List See "VVL_Code_Description" field This data element's valid value code set is maintained by a Code Set Maintenance Organization (CSMO), the official licensing organization for specific valid value code sets. The CSMO is the system of record for those specific valid value code sets. While T-MSIS endeavors to be in-sync with CMSO's updates, minor delays may occur but that shouldn't block T-MSIS data submissions using the CSMO's latest version.

For background and context, see https://www.ncpdp.org/ or https://www.ncpdp.org/NCPDP/media/pdf/VersionD-Questions.pdf		 N/A N/A
PRIMARY-ELIGIBILITY-GROUP-IND Primary Eligibility Group Indicator List 0 NO 01/01/0001 12/31/9999
PRIMARY-ELIGIBILITY-GROUP-IND Primary Eligibility Group Indicator List 1 YES 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 01 CPT 4 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 02 ICD-9 CM 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 06 HCPCS Level II and CDT 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 07 ICD-10 - PCS (Will be implemented on 10/1/2014) 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 10 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 11 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 12 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 13 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 14 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 15 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 16 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 17 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 18 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 19 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 20 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 21 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 22 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 23 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 24 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 25 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 26 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 27 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 28 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 29 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 30 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 31 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 32 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 33 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 34 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 35 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 36 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 37 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 38 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 39 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 40 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 41 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 42 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 43 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 44 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 45 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 46 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 47 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 48 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 49 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 50 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 51 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 52 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 53 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 54 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 55 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 56 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 57 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 58 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 59 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 60 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 61 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 62 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 63 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 64 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 65 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 66 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 67 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 68 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 69 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 70 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 71 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 72 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 73 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 74 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 75 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 76 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 77 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 78 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 79 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 80 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 81 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 82 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 83 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 84 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 85 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 86 Other Systems 01/01/0001 12/31/9999
PROCEDURE-CODE-FLAG Procedure Code Flag List 87 Other Systems 01/01/0001 12/31/9999
PROGRAM-TYPE Program Type List 00 No Special Program 01/01/0001 12/31/9999
PROGRAM-TYPE Program Type List 01 EPSDT 01/01/0001 12/31/9999
PROGRAM-TYPE Program Type List 02 Family Planning 01/01/0001 12/31/9999
PROGRAM-TYPE Program Type List 03 Rural Health Clinic 01/01/0001 12/31/9999
PROGRAM-TYPE Program Type List 04 Federally Qualified Health Centers (FQHC) 01/01/0001 12/31/9999
PROGRAM-TYPE Program Type List 05 Indian Health Services 01/01/0001 12/31/9999
PROGRAM-TYPE Program Type List 07 Home and Community Based Care Waiver Services 01/01/0001 12/31/9999
PROGRAM-TYPE Program Type List 08 Money Follows the Person (MFP) 01/01/0001 12/31/9999
PROGRAM-TYPE Program Type List 10 BIP - Balancing Incentive Payment 01/01/0001 12/31/9999
PROGRAM-TYPE Program Type List 11 Community First Choice (1915(k)) 01/01/0001 12/31/9999
PROGRAM-TYPE Program Type List 12 Medicaid Emergency Psychiatric Demonstration 01/01/0001 12/31/9999
PROGRAM-TYPE Program Type List 13 Home and Community Based Services (HCBS) State Plan Option (1915(i)) 01/01/0001 12/31/9999
PROGRAM-TYPE Program Type List 14 State Plan CHIP 01/01/0001 12/31/9999
PROGRAM-TYPE Program Type List 15 Psychiatric Residential Treatment Facilities Demonstration Grant Program (PRTF) 01/01/0001 12/31/9999
PROGRAM-TYPE Program Type List 16 1915(j) (Self- directed personal assistance services/personal care under State Plan or 1915(c) waiver) 01/01/0001 12/31/9999
PROGRAM-TYPE Program Type List 17 COVID-19 Testing Services (1905(a)(3) and 2103(c)) 03/18/2020 12/31/9999
PROV-ADDR-TYPE Provider Address Type List 1 Provider Billing 01/01/0001 12/31/9999
PROV-ADDR-TYPE Provider Address Type List 2 Provider Mailing 01/01/0001 12/31/9999
PROV-ADDR-TYPE Provider Address Type List 3 Provider Practice 01/01/0001 12/31/9999
PROV-ADDR-TYPE Provider Address Type List 4 Provider Service Location 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 001 Inpatient hospital services, other than services in an institution for mental diseases 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 002 Outpatient hospital services 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 003 Rural health clinic services 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 004 Other ambulatory services furnished by a rural health clinic 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 005 Professional laboratory services 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 006 Technical laboratory services 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 007 Professional radiological services 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 008 Technical radiological services 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 009 Nursing facility services for individuals age 21 or older (other than services in an institution for mental disease) 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 010 Early and periodic screening and diagnosis and treatment (EPSDT) services 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 011 Family planning services and supplies for individuals of child-bearing age 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 012 Physicians' services 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 013 Medical and surgical services of a dentist 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 014 Outpatient substance abuse treatment services. 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 015 Medical or other remedial care or services, other than physicians' services, provided by licensed practitioners within the scope of practice as defined under State law 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 016 Home health services - Nursing services 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 017 Home health services - Home health aide services 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 018 Home health services - Medical supplies, equipment, and appliances suitable for use in the home 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 019 Home health services - Physical therapy provided by a home health agency or by a facility licensed by the State to provide medical rehabilitation services 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 020 Home health services - Occupational therapy provided by a home health agency or by a facility licensed by the State to provide medical rehabilitation services 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 021 Home health services - Speech pathology and audiology services provided by a home health agency or by a facility licensed by the State to provide medical rehabilitation services 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 022 Private duty nursing services 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 023 Advanced practice nurse services 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 024 Pediatric nurse 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 025 Nurse-midwife service 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 026 Nurse practitioner services 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 027 Respiratory care for ventilator-dependent individuals 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 028 Clinic services 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 029 Dental services 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 030 Physical therapy services (when not provided under home health services) 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 031 Occupational therapy services (when not provided under home health services) 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 032 Speech, hearing, and language disorders services (when not provided under home health services) 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 033 Prescribed drugs 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 034 Over-the-counter medications. 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 035 Dentures 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 036 Prosthetic devices 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 037 Eyeglasses 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 038 Hearing Aids 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 039 Diagnostic services 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 040 Screening services 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 041 Preventive services 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 042 Well-baby and well-child care services as defined by the State. 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 043 Rehabilitative services 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 044 Inpatient hospital services for individuals age 65 or older in institutions for mental diseases 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 045 Nursing facility services for individuals age 65 or older in institutions for mental diseases 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 046 Intermediate care facility (ICF/IID) services 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 047 Nursing facility services, other than in institutions for mental diseases 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 048 Inpatient psychiatric services for individuals under age 21 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 049 Outpatient mental health services, other than Outpatient substance abuse treatment services. This TOS includes services furnished in a State-operated mental hospital and including community-based services. 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 050 Inpatient substance abuse treatment services and residential substance abuse treatment services. 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 051 Personal care services 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 052 Primary care case management services 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 053 Targeted case management services 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 054 Case Management services other than those that meet the definition of primary care case management services or targeted case management services 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 055 Care coordination services. 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 056 Transportation services 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 057 Enabling services 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 058 Services furnished in a religious nonmedical health care institution 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 059 Skilled nursing facility services for individuals under age 21 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 060 Emergency hospital services 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 061 Critical access hospital services 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 062 HCBS - Case management services 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 063 HCBS - Homemaker services 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 064 HCBS - Home health aide services 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 065 HCBS - Personal care services 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 066 HCBS - Adult day health services 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 067 HCBS - Habilitation services 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 068 HCBS - Respite care services 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 069 HCBS - Day treatment or other partial hospitalization services, psychosocial rehabilitation services and clinic services (whether or not furnished in a facility) for individuals with chronic mental illness 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 070 HCBS - Day Care 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 071 HCBS - Training for family members 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 072 HCBS - Minor modification to the home 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 073 HCBS - Other services requested by the agency and approved by CMS as cost effective and necessary to avoid institutionalization 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 074 HCBS - Expanded habilitation services - Prevocational services 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 075 HCBS - Expanded habilitation services - Educational services 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 076 HCBS - Expanded habilitation services - Supported employment services, which facilitate paid employment 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 077 HCBS-65-plus - Case management services 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 078 HCBS-65-plus - Homemaker services 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 079 HCBS-65-plus - Home health aide services 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 080 HCBS-65-plus - Personal care services 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 081 HCBS-65-plus - Adult day health services 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 082 HCBS-65-plus - Respite care services 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 083 HCBS-65-plus - Other medical and social services 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 084 Sterilizations 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 085 Prenatal care and pre-pregnancy family planning services and supplies. 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 086 Other Pregnancy-related Procedures 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 087 Hospice services 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 088 Any other health care services or items specified by the Secretary and not excluded under regulations. 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 089 Disposable medical supplies. 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 090 Critical access hospital services - IP 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 091 Skilled care - hospital residing 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 092 Exceptional care - hospital residing 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 093 Non-acute care - hospital residing 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 115 Residential care 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 120 Capitated payments for primary care case management (PCCM) 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 123 Disproportionate share hospital (DSH) payments 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 127 Indian Health Service (IHS) - Family Plan 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 132 Supplemental payment - inpatient 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 133 Supplemental payment - nursing 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 134 Supplemental payment - outpatient 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 135 EHR payments to provider 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 136 In vitro diagnostic products (as defined in section 809.3(a) of title 21, Code of Federal Regulations) administered during any portion of the emergency period defined in paragraph (1)(B) of section 1135(g) beginning on or after the date of the enactment of this subparagraph for the detection of SARS–CoV–2 or the diagnosis of the virus that causes COVID–19, and the administration of such in vitro diagnostic products 03/18/2020 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 137 COVID–19 testing-related services 03/18/2020 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 138 Per member per month (PMPM) payments for health home services 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 143 Per member per month (PMPM) payments for other payments 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 144 Payments to individuals for personal assistance services under 1915(j) 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 145 Medication Assisted Treatment (MAT) services and drugs for evidenced-based treatment of Opioid Use Disorder (OUD) in accordance with section 1905(a)(29) of the Social Security Act 10/01/2020 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 146 Inpatient Psychiatric Services for beneficiaries between the ages of 22 and 64 who receive services in an institution for mental disease (IMD) 01/01/0001 12/31/9999
PROV-CLASSIFICATION-CODE-TYPE-4 Provider Authorized Category of Service Code List 147 Residential Pediatric Recovery Center (RPRC): A center or facility that furnishes items and services for which medical assistance is available under the State plan to infants with the diagnosis of neonatal abstinence syndrome without any other significant medical risk factors. 01/01/0001 12/31/9999
PROV-CLASSIFICATION-TYPE Provider Classification Type List 1 Taxonomy code 01/01/0001 12/31/9999
PROV-CLASSIFICATION-TYPE Provider Classification Type List 2 Provider specialty code 01/01/0001 12/31/9999
PROV-CLASSIFICATION-TYPE Provider Classification Type List 3 Provider type code 01/01/0001 12/31/9999
PROV-CLASSIFICATION-TYPE Provider Classification Type List 4 Authorized category of service code 01/01/0001 12/31/9999
PROV-ENROLLMENT-METHOD Provider Enrollment Method 1 Enrolled through use of Medicare enrollment system (State did not require that provider submit application. Rather Provider is active Medicare provider and state Medicaid program accepted these credentials as sufficient to participate as state Medicaid provider.) 01/01/0001 12/31/9999
PROV-ENROLLMENT-METHOD Provider Enrollment Method 2 Enrolled through use of state-based provider application 01/01/0001 12/31/9999
PROV-ENROLLMENT-METHOD Provider Enrollment Method 3 Other? 01/01/0001 12/31/9999
PROV-FACILITY-TYPE Provider Facility Type 100000000 Individuals or Groups (of Individuals) 01/01/0001 12/31/9999
PROV-FACILITY-TYPE Provider Facility Type 170000000 Non-Individual - Other Service Providers 01/01/0001 12/31/9999
PROV-FACILITY-TYPE Provider Facility Type 250000000 Non-Individual - Agencies 01/01/0001 12/31/9999
PROV-FACILITY-TYPE Provider Facility Type 260000000 Non-Individual - Ambulatory Health Care Facilities 01/01/0001 12/31/9999
PROV-FACILITY-TYPE Provider Facility Type 270000000 Non-Individual - Hospital Units 01/01/0001 12/31/9999
PROV-FACILITY-TYPE Provider Facility Type 280000000 Non-Individual - Hospitals 01/01/0001 12/31/9999
PROV-FACILITY-TYPE Provider Facility Type 290000000 Non-Individual - Laboratories 01/01/0001 12/31/9999
PROV-FACILITY-TYPE Provider Facility Type 300000000 Non-Individual - Managed Care Organizations 01/01/0001 12/31/9999
PROV-FACILITY-TYPE Provider Facility Type 310000000 Non-Individual - Nursing & Custodial Care Facilities 01/01/0001 12/31/9999
PROV-FACILITY-TYPE Provider Facility Type 320000000 Non-Individual - Residential Treatment Facilities 01/01/0001 12/31/9999
PROV-FACILITY-TYPE Provider Facility Type 330000000 Non-Individual - Suppliers 01/01/0001 12/31/9999
PROV-FACILITY-TYPE Provider Facility Type 340000000 Non-Individual - Transportation Services 01/01/0001 12/31/9999
PROV-FACILITY-TYPE Provider Facility Type 380000000 Non-Individual - Respite Care Facility 01/01/0001 12/31/9999
PROV-FACILITY-TYPE Provider Facility Type See "VVL_Code_Description" field This data element's valid value code set is maintained by a Code Set Maintenance Organization (CSMO), the official licensing organization for specific valid value code sets. The CSMO is the system of record for those specific valid value code sets. While T-MSIS endeavors to be in-sync with CMSO's updates, minor delays may occur but that shouldn't block T-MSIS data submissions using the CSMO's latest version.

For background and context, see https://x12.org/codes/provider-taxonomy-codes		 N/A N/A
PROV-IDENTIFIER-TYPE Provider Identifier Type List 1 State-specific Medicaid Provider ID 01/01/0001 12/31/9999
PROV-IDENTIFIER-TYPE Provider Identifier Type List 2 NPI 01/01/0001 12/31/9999
PROV-IDENTIFIER-TYPE Provider Identifier Type List 3 Medicare ID 01/01/0001 12/31/9999
PROV-IDENTIFIER-TYPE Provider Identifier Type List 4 NCPDP ID 01/01/0001 12/31/9999
PROV-IDENTIFIER-TYPE Provider Identifier Type List 5 Federal Tax ID 01/01/0001 12/31/9999
PROV-IDENTIFIER-TYPE Provider Identifier Type List 6 State Tax ID 01/01/0001 12/31/9999
PROV-IDENTIFIER-TYPE Provider Identifier Type List 7 SSN 01/01/0001 12/31/9999
PROV-IDENTIFIER-TYPE Provider Identifier Type List 8 Other 01/01/0001 12/31/9999
PROV-IDENTIFIER-TYPE Provider Identifier Type List 9 Old State Provider ID 01/01/0001 12/31/9999
PROV-MEDICAID-ENROLLMENT-STATUS-CODE Provider Medicaid Enrollment Status Code List 01 Active - Active Do Not Pay 01/01/0001 12/31/9999
PROV-MEDICAID-ENROLLMENT-STATUS-CODE Provider Medicaid Enrollment Status Code List 02 Active - Active Reinstated 01/01/0001 12/31/9999
PROV-MEDICAID-ENROLLMENT-STATUS-CODE Provider Medicaid Enrollment Status Code List 03 Active - Active 01/01/0001 12/31/9999
PROV-MEDICAID-ENROLLMENT-STATUS-CODE Provider Medicaid Enrollment Status Code List 04 Active - Eligibility Verification 01/01/0001 12/31/9999
PROV-MEDICAID-ENROLLMENT-STATUS-CODE Provider Medicaid Enrollment Status Code List 05 Active - Encounter Only 01/01/0001 12/31/9999
PROV-MEDICAID-ENROLLMENT-STATUS-CODE Provider Medicaid Enrollment Status Code List 06 Active - Financial Trans Only 01/01/0001 12/31/9999
PROV-MEDICAID-ENROLLMENT-STATUS-CODE Provider Medicaid Enrollment Status Code List 20 Denied - Denied Two Provider Numbers 01/01/0001 12/31/9999
PROV-MEDICAID-ENROLLMENT-STATUS-CODE Provider Medicaid Enrollment Status Code List 21 Denied - For Other Reasons 01/01/0001 12/31/9999
PROV-MEDICAID-ENROLLMENT-STATUS-CODE Provider Medicaid Enrollment Status Code List 22 Denied - Invalid License 01/01/0001 12/31/9999
PROV-MEDICAID-ENROLLMENT-STATUS-CODE Provider Medicaid Enrollment Status Code List 23 Denied - Not Eligible 01/01/0001 12/31/9999
PROV-MEDICAID-ENROLLMENT-STATUS-CODE Provider Medicaid Enrollment Status Code List 24 Denied - Same Number Assigned 01/01/0001 12/31/9999
PROV-MEDICAID-ENROLLMENT-STATUS-CODE Provider Medicaid Enrollment Status Code List 40 Pending - Enrollment 01/01/0001 12/31/9999
PROV-MEDICAID-ENROLLMENT-STATUS-CODE Provider Medicaid Enrollment Status Code List 41 Pending - License/Cert Verification 01/01/0001 12/31/9999
PROV-MEDICAID-ENROLLMENT-STATUS-CODE Provider Medicaid Enrollment Status Code List 42 Pending - Missing Documentation 01/01/0001 12/31/9999
PROV-MEDICAID-ENROLLMENT-STATUS-CODE Provider Medicaid Enrollment Status Code List 43 Pending - No License/Temp License 01/01/0001 12/31/9999
PROV-MEDICAID-ENROLLMENT-STATUS-CODE Provider Medicaid Enrollment Status Code List 44 Pending - NPI Invalid 01/01/0001 12/31/9999
PROV-MEDICAID-ENROLLMENT-STATUS-CODE Provider Medicaid Enrollment Status Code List 45 Pending - Rate Determination 01/01/0001 12/31/9999
PROV-MEDICAID-ENROLLMENT-STATUS-CODE Provider Medicaid Enrollment Status Code List 46 Pending - Signed Agreement 01/01/0001 12/31/9999
PROV-MEDICAID-ENROLLMENT-STATUS-CODE Provider Medicaid Enrollment Status Code List 47 Pending - Status Approval 01/01/0001 12/31/9999
PROV-MEDICAID-ENROLLMENT-STATUS-CODE Provider Medicaid Enrollment Status Code List 48 Pending - W9 Missing or Incomplete 01/01/0001 12/31/9999
PROV-MEDICAID-ENROLLMENT-STATUS-CODE Provider Medicaid Enrollment Status Code List 60 Term - Abuse of billing privileges 01/01/0001 12/31/9999
PROV-MEDICAID-ENROLLMENT-STATUS-CODE Provider Medicaid Enrollment Status Code List 61 Term - Action Taken by Medicaid/CHIP 01/01/0001 12/31/9999
PROV-MEDICAID-ENROLLMENT-STATUS-CODE Provider Medicaid Enrollment Status Code List 62 Term - Action Taken by Medicare 01/01/0001 12/31/9999
PROV-MEDICAID-ENROLLMENT-STATUS-CODE Provider Medicaid Enrollment Status Code List 63 Term - Change of Ownership 01/01/0001 12/31/9999
PROV-MEDICAID-ENROLLMENT-STATUS-CODE Provider Medicaid Enrollment Status Code List 64 Term - Failure to report a change of address/ownership 01/01/0001 12/31/9999
PROV-MEDICAID-ENROLLMENT-STATUS-CODE Provider Medicaid Enrollment Status Code List 65 Term - False or misleading information 01/01/0001 12/31/9999
PROV-MEDICAID-ENROLLMENT-STATUS-CODE Provider Medicaid Enrollment Status Code List 66 Term - Federal exclusion/ debarment, etc. 01/01/0001 12/31/9999
PROV-MEDICAID-ENROLLMENT-STATUS-CODE Provider Medicaid Enrollment Status Code List 67 Term - Felony conviction 01/01/0001 12/31/9999
PROV-MEDICAID-ENROLLMENT-STATUS-CODE Provider Medicaid Enrollment Status Code List 68 Term - Involuntary Termination 01/01/0001 12/31/9999
PROV-MEDICAID-ENROLLMENT-STATUS-CODE Provider Medicaid Enrollment Status Code List 69 Term - License Expired 01/01/0001 12/31/9999
PROV-MEDICAID-ENROLLMENT-STATUS-CODE Provider Medicaid Enrollment Status Code List 70 Term - License Revoked 01/01/0001 12/31/9999
PROV-MEDICAID-ENROLLMENT-STATUS-CODE Provider Medicaid Enrollment Status Code List 71 Term - Loss of license or other State action 01/01/0001 12/31/9999
PROV-MEDICAID-ENROLLMENT-STATUS-CODE Provider Medicaid Enrollment Status Code List 72 Term - Medicare/Medicaid Exclusion 01/01/0001 12/31/9999
PROV-MEDICAID-ENROLLMENT-STATUS-CODE Provider Medicaid Enrollment Status Code List 73 Term - Medicaid Authority 01/01/0001 12/31/9999
PROV-MEDICAID-ENROLLMENT-STATUS-CODE Provider Medicaid Enrollment Status Code List 74 Term - Medicare Termination 01/01/0001 12/31/9999
PROV-MEDICAID-ENROLLMENT-STATUS-CODE Provider Medicaid Enrollment Status Code List 75 Term - Misuse of billing number 01/01/0001 12/31/9999
PROV-MEDICAID-ENROLLMENT-STATUS-CODE Provider Medicaid Enrollment Status Code List 76 Term - No Claims Activity 01/01/0001 12/31/9999
PROV-MEDICAID-ENROLLMENT-STATUS-CODE Provider Medicaid Enrollment Status Code List 77 Term - Non-Compliance 01/01/0001 12/31/9999
PROV-MEDICAID-ENROLLMENT-STATUS-CODE Provider Medicaid Enrollment Status Code List 78 Term - Onsite review/ Provider is no longer operational 01/01/0001 12/31/9999
PROV-MEDICAID-ENROLLMENT-STATUS-CODE Provider Medicaid Enrollment Status Code List 79 Term - Other 01/01/0001 12/31/9999
PROV-MEDICAID-ENROLLMENT-STATUS-CODE Provider Medicaid Enrollment Status Code List 80 Term - Provider Deceased 01/01/0001 12/31/9999
PROV-MEDICAID-ENROLLMENT-STATUS-CODE Provider Medicaid Enrollment Status Code List 81 Term - State exclusion/ debarment, etc. 01/01/0001 12/31/9999
PROV-MEDICAID-ENROLLMENT-STATUS-CODE Provider Medicaid Enrollment Status Code List 82 Term - Unknown 01/01/0001 12/31/9999
PROV-MEDICAID-ENROLLMENT-STATUS-CODE Provider Medicaid Enrollment Status Code List 83 Term - Voluntary Termination 01/01/0001 12/31/9999
PROV-PROFIT-STATUS Provider Profit Status List 01 501(C)(3) NON-PROFIT 01/01/0001 12/31/9999
PROV-PROFIT-STATUS Provider Profit Status List 02 FOR-PROFIT, CLOSELY HELD 01/01/0001 12/31/9999
PROV-PROFIT-STATUS Provider Profit Status List 03 FOR-PROFIT, PUBLICLY TRADED 01/01/0001 12/31/9999
PROV-PROFIT-STATUS Provider Profit Status List 04 OTHER 01/01/0001 12/31/9999
PROV-PROFIT-STATUS Provider Profit Status List 88 N/A - The individual only practices as part of a group 01/01/0001 12/31/9999
PROV-PROFIT-STATUS Provider Profit Status List 99 Unknown 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 01 General Practice 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 02 General Surgery 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 03 Allergy/Immunology 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 04 Otolaryngology 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 05 Anesthesiology 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 06 Cardiology 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 07 Dermatology 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 08 Family Practice 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 09 Interventional Pain Management 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 10 Gastroenterology 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 11 Internal Medicine 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 12 Osteopathic Manipulative Therapy 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 13 Neurology 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 14 Neurosurgery 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 15 Speech Language Pathologist 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 16 Obstetrics/Gynecology 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 17 Hospice and Palliative Care 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 18 Ophthalmology 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 19 Oral Surgery (dentists only) 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 20 Orthopedic Surgery 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 21 Cardiac Electrophysiology 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 22 Pathology 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 23 Sports Medicine 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 24 Plastic and Reconstructive Surgery 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 25 Physical Medicine and Rehabilitation 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 26 Psychiatry 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 27 Geriatric Psychiatry 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 28 Colorectal Surgery (formerly proctology) 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 29 Pulmonary Disease 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 30 Diagnostic Radiology 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 31 Cardiac Rehabilitation & Intensive Cardiac Rehabilitation 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 32 Anesthesiologist Assistant 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 33 Thoracic Surgery 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 34 Urology 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 35 Chiropractic 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 36 Nuclear Medicine 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 37 Pediatric Medicine 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 38 Geriatric Medicine 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 39 Nephrology 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 40 Hand Surgery 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 41 Optometry 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 42 Certified Nurse Midwife 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 43 Certified Registered Nurse Anesthetist (CRNA) 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 44 Infectious Disease 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 45 Mammography Center 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 46 Endocrinology 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 47 Independent Diagnostic Testing Facility (IDTF) 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 48 Podiatry 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 49 Ambulatory Surgical Center 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 50 Nurse Practitioner 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 51 Medical Supply Company with Orthotist 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 52 Medical Supply Company with Prosthetist 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 53 Medical Supply Company with Orthotist-Prosthetist 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 54 Other Medical Supply Company 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 55 Individual Certified Orthotist 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 56 Individual Certified Prosthetist 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 57 Individual Certified Orthotist-Prosthetist 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 58 Medical Supply Company with Pharmacist 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 59 Ambulance Service Provider 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 60 Public Health or Welfare Agency 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 61 Voluntary Health or Charitable Agency 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 62 Psychologist (Billing Independently) 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 63 Portable X-Ray Supplier 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 64 Audiologist 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 65 Physical Therapist in Private Practice 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 66 Rheumatology 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 67 Occupational Therapist in Private Practice 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 68 Clinical Psychologist 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 69 Clinical Laboratory 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 70 Single or Multispecialty Clinic or Group Practice 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 71 Registered Dietitian or Nutrition Professional 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 72 Pain Management 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 73 Mass Immunization Roster Biller 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 74 Radiation Therapy Center 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 75 Slide Preparation Facility 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 76 Peripheral Vascular Disease 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 77 Vascular Surgery 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 78 Cardiac Surgery 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 79 Addiction Medicine 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 80 Licensed Clinical Social Worker 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 81 Critical Care (Intensivists) 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 82 Hematology 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 83 Hematology/Oncology 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 84 Preventive Medicine 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 85 Maxillofacial Surgery 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 86 Neuropsychiatry 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 87 All Other Suppliers 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 88 Unknown Supplier/Provider Specialty 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 89 Certified Clinical Nurse Specialist 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 90 Medical Oncology 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 91 Surgical Oncology 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 92 Radiation Oncology 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 93 Emergency Medicine 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 94 Interventional Radiology 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 95 Advance Diagnostic Imaging 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 96 Optician 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 97 Physician Assistant 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 98 Gynecological/Oncology 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List 99 Undefined physician type (provider is an MD) 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List A0 Hospital-General 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List A1 Skilled Nursing Facility 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List A2 Intermediate Care Nursing Facility 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List A3 Other Nursing Facility 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List A4 Home Health Agency 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List A5 Pharmacy 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List A6 Medical Supply Company with Respiratory Therapist 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List A7 Department Store 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List A8 Grocery Store 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List A9 Indian Health Service facility 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List B1 Oxygen supplier 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List B2 Pedorthic personnel 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List B3 Medical supply company with pedorthic personnel 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List B4 Rehabilitation Agency 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List B5 Ocularist 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List C0 Sleep Medicine 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List C1 Centralized Flu 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List C2 Indirect Payment Procedure 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List C3 Interventional Cardiology 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List C4 Restricted Use 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List C5 Dentist 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List C6 Hospitalist 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List C7 Advanced Heart Failure and Transplant Cardiology 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List C8 Medical Toxicology 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List C9 Hematopoietic Cell Transplantation and Cellular Therapy 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List D1 Medicare Diabetes Preventive Program 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List D2 Restricted Use 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List D3 Medical Genetics and Genomics 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List D4 Undersea and Hyperbaric Medicine 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List D5 Opioid Treatment Program 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List D6 Home Infusion Therapy Services 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List D7 Micrographic Dermatologic Surgery 01/01/0001 12/31/9999
PROV-SPECIALTY Provider Specialty List D8 Adult Congenital Heart Disease 01/01/0001 12/31/9999
PROV-TAXONOMY Provider Taxonomy List See "VVL_Code_Description" field This data element's valid value code set is maintained by a Code Set Maintenance Organization (CSMO), the official licensing organization for specific valid value code sets. The CSMO is the system of record for those specific valid value code sets. While T-MSIS endeavors to be in-sync with CMSO's updates, minor delays may occur but that shouldn't block T-MSIS data submissions using the CSMO's latest version.

For background and context, see https://x12.org/codes/provider-taxonomy-codes		 N/A N/A
PROV-TYPE Provider Type Code List 01 Physician 01/01/0001 12/31/9999
PROV-TYPE Provider Type Code List 02 Speech Language Pathologist 01/01/0001 12/31/9999
PROV-TYPE Provider Type Code List 03 Oral Surgery (Dentist only) 01/01/0001 12/31/9999
PROV-TYPE Provider Type Code List 04 Cardiac Rehabilitation and Intensive Cardiac Rehabilitation 01/01/0001 12/31/9999
PROV-TYPE Provider Type Code List 05 Anesthesiology Assistant 01/01/0001 12/31/9999
PROV-TYPE Provider Type Code List 06 Chiropractic 01/01/0001 12/31/9999
PROV-TYPE Provider Type Code List 07 Optometry 01/01/0001 12/31/9999
PROV-TYPE Provider Type Code List 08 Certified Nurse Midwife 01/01/0001 12/31/9999
PROV-TYPE Provider Type Code List 09 Certified Registered Nurse Anesthetist (CRNA) 01/01/0001 12/31/9999
PROV-TYPE Provider Type Code List 10 Mammography Center 01/01/0001 12/31/9999
PROV-TYPE Provider Type Code List 11 Independent Diagnostic Testing Facility (IDTF) 01/01/0001 12/31/9999
PROV-TYPE Provider Type Code List 12 Podiatry 01/01/0001 12/31/9999
PROV-TYPE Provider Type Code List 13 Ambulatory Surgical Center 01/01/0001 12/31/9999
PROV-TYPE Provider Type Code List 14 Nurse Practitioner 01/01/0001 12/31/9999
PROV-TYPE Provider Type Code List 15 Medical Supply Company with Orthotist 01/01/0001 12/31/9999
PROV-TYPE Provider Type Code List 16 Medical Supply Company with Prosthetist 01/01/0001 12/31/9999
PROV-TYPE Provider Type Code List 17 Medical Supply Company with Orthotist-Prosthetist 01/01/0001 12/31/9999
PROV-TYPE Provider Type Code List 18 Other Medical Supply Company 01/01/0001 12/31/9999
PROV-TYPE Provider Type Code List 19 Individual Certified Orthotist 01/01/0001 12/31/9999
PROV-TYPE Provider Type Code List 20 Individual Certified Prosthetist 01/01/0001 12/31/9999
PROV-TYPE Provider Type Code List 21 Individual Certified Prosthetist-Orthotist 01/01/0001 12/31/9999
PROV-TYPE Provider Type Code List 22 Medical Supply Company with Pharmacist 01/01/0001 12/31/9999
PROV-TYPE Provider Type Code List 23 Ambulance Service Provider 01/01/0001 12/31/9999
PROV-TYPE Provider Type Code List 24 Public Health or Welfare Agency 01/01/0001 12/31/9999
PROV-TYPE Provider Type Code List 25 Voluntary Health or Charitable Agency 01/01/0001 12/31/9999
PROV-TYPE Provider Type Code List 26 Psychologist, Clinical 01/01/0001 12/31/9999
PROV-TYPE Provider Type Code List 27 Portable X-Ray Supplier 01/01/0001 12/31/9999
PROV-TYPE Provider Type Code List 28 Audiologist 01/01/0001 12/31/9999
PROV-TYPE Provider Type Code List 29 Physical Therapist in Private Practice 01/01/0001 12/31/9999
PROV-TYPE Provider Type Code List 30 Occupational Therapist in Private Practice 01/01/0001 12/31/9999
PROV-TYPE Provider Type Code List 31 Clinical Laboratory 01/01/0001 12/31/9999
PROV-TYPE Provider Type Code List 32 Clinic or Group Practice 01/01/0001 12/31/9999
PROV-TYPE Provider Type Code List 33 Registered Dietitian or Nutrition Professional 01/01/0001 12/31/9999
PROV-TYPE Provider Type Code List 34 Mass Immunizer Roster Biller 01/01/0001 12/31/9999
PROV-TYPE Provider Type Code List 35 Radiation Therapy Center 01/01/0001 12/31/9999
PROV-TYPE Provider Type Code List 36 Slide Preparation Facility 01/01/0001 12/31/9999
PROV-TYPE Provider Type Code List 37 Licensed Clinical Social Worker 01/01/0001 12/31/9999
PROV-TYPE Provider Type Code List 38 Certified Clinical Nurse Specialist 01/01/0001 12/31/9999
PROV-TYPE Provider Type Code List 39 Advance Diagnostic Imaging 01/01/0001 12/31/9999
PROV-TYPE Provider Type Code List 40 Optician 01/01/0001 12/31/9999
PROV-TYPE Provider Type Code List 41 Physician Assistant 01/01/0001 12/31/9999
PROV-TYPE Provider Type Code List 42 Hospital-General 01/01/0001 12/31/9999
PROV-TYPE Provider Type Code List 43 Skilled Nursing Facility 01/01/0001 12/31/9999
PROV-TYPE Provider Type Code List 44 Intermediate Care Nursing Facility 01/01/0001 12/31/9999
PROV-TYPE Provider Type Code List 45 Other Nursing Facility 01/01/0001 12/31/9999
PROV-TYPE Provider Type Code List 46 Home Health Agency 01/01/0001 12/31/9999
PROV-TYPE Provider Type Code List 47 Pharmacy 01/01/0001 12/31/9999
PROV-TYPE Provider Type Code List 48 Medical Supply Company with Respiratory Therapist 01/01/0001 12/31/9999
PROV-TYPE Provider Type Code List 49 Department Store 01/01/0001 12/31/9999
PROV-TYPE Provider Type Code List 50 Grocery Store 01/01/0001 12/31/9999
PROV-TYPE Provider Type Code List 51 Indian Health Service facility 01/01/0001 12/31/9999
PROV-TYPE Provider Type Code List 52 Oxygen supplier 01/01/0001 12/31/9999
PROV-TYPE Provider Type Code List 53 Pedorthic personnel 01/01/0001 12/31/9999
PROV-TYPE Provider Type Code List 54 Medical supply company with pedorthic personnel 01/01/0001 12/31/9999
PROV-TYPE Provider Type Code List 55 Rehabilitation Agency 01/01/0001 12/31/9999
PROV-TYPE Provider Type Code List 56 Ocularist 01/01/0001 12/31/9999
PROV-TYPE Provider Type Code List 57 All Other 01/01/0001 12/31/9999
PROV-TYPE Provider Type Code List 58 Institutions for Mental Disease 01/01/0001 12/31/9999
PROVIDER-CLAIM-FORM-CODE Provider Claim Form Code List 01 Institutional claim - any (837I format or UB-04 form) 01/01/0001 12/31/9999
PROVIDER-CLAIM-FORM-CODE Provider Claim Form Code List 02 Institutional claim - electronic (837I format) 01/01/0001 12/31/9999
PROVIDER-CLAIM-FORM-CODE Provider Claim Form Code List 03 Institutional claim (UB-04 form) 01/01/0001 12/31/9999
PROVIDER-CLAIM-FORM-CODE Provider Claim Form Code List 11 Professional claim - any (837P format or CMS-1500 form) 01/01/0001 12/31/9999
PROVIDER-CLAIM-FORM-CODE Provider Claim Form Code List 12 Professional claim - electronic (837P format) 01/01/0001 12/31/9999
PROVIDER-CLAIM-FORM-CODE Provider Claim Form Code List 13 Professional claim - paper (CMS-1500 form) 01/01/0001 12/31/9999
PROVIDER-CLAIM-FORM-CODE Provider Claim Form Code List 21 Dental claim - any (837D format or ADA Dental Claim Form) 01/01/0001 12/31/9999
PROVIDER-CLAIM-FORM-CODE Provider Claim Form Code List 22 Dental claim - electronic (837D format) 01/01/0001 12/31/9999
PROVIDER-CLAIM-FORM-CODE Provider Claim Form Code List 23 Dental claim - paper (ADA Dental Claim Form) 01/01/0001 12/31/9999
PROVIDER-CLAIM-FORM-CODE Provider Claim Form Code List 31 Pharmacy claim (NCPDP format) 01/01/0001 12/31/9999
PROVIDER-CLAIM-FORM-CODE Provider Claim Form Code List 95 Other claim form or format not listed above 01/01/0001 12/31/9999
RACE Race List 001 White 01/01/0001 12/31/9999
RACE Race List 002 Black or African American 01/01/0001 12/31/9999
RACE Race List 003 American Indian or Alaska Native 01/01/0001 12/31/9999
RACE Race List 004 Asian Indian 01/01/0001 12/31/9999
RACE Race List 005 Chinese 01/01/0001 12/31/9999
RACE Race List 006 Filipino 01/01/0001 12/31/9999
RACE Race List 007 Japanese 01/01/0001 12/31/9999
RACE Race List 008 Korean 01/01/0001 12/31/9999
RACE Race List 009 Vietnamese 01/01/0001 12/31/9999
RACE Race List 010 Other Asian 01/01/0001 12/31/9999
RACE Race List 011 Asian Unknown 01/01/0001 12/31/9999
RACE Race List 012 Native Hawaiian 01/01/0001 12/31/9999
RACE Race List 013 Guamanian or Chamorro 01/01/0001 12/31/9999
RACE Race List 014 Samoan 01/01/0001 12/31/9999
RACE Race List 015 Other Pacific Islander 01/01/0001 12/31/9999
RACE Race List 016 Native Hawaiian or Other Pacific Islander Unknown 01/01/0001 12/31/9999
RACE Race List 017 Unspecified 01/01/0001 12/31/9999
RACE Race List 018 Other 01/01/0001 12/31/9999
REASON-FOR-CHANGE Reason for Change List LSE Large System Enhancement 01/01/0001 12/31/9999
REASON-FOR-CHANGE Reason for Change List MERGE Merge Beneficiaries 01/01/0001 12/31/9999
REASON-FOR-CHANGE Reason for Change List TCAM Transition between CHIP and Medicaid 01/01/0001 12/31/9999
REASON-FOR-CHANGE Reason for Change List UNMERGE Unmerge Beneficiaries 01/01/0001 12/31/9999
REBATE-ELIGIBLE-INDICATOR Rebate Eligible Indicator List 0 NDC is not eligible for drug rebate program. (Manufacturer does not have a rebate agreement.) 01/01/0001 12/31/9999
REBATE-ELIGIBLE-INDICATOR Rebate Eligible Indicator List 1 NDC is eligible for drug rebate program 01/01/0001 12/31/9999
REBATE-ELIGIBLE-INDICATOR Rebate Eligible Indicator List 2 NDC is exempt from the drug rebate program (biological and medical devices) 01/01/0001 12/31/9999
RECORD-ID Record ID List CIP00001 FILE-HEADER-RECORD-IP 01/01/0001 12/31/9999
RECORD-ID Record ID List CIP00002 CLAIM-HEADER-RECORD-IP 01/01/0001 12/31/9999
RECORD-ID Record ID List CIP00003 CLAIM-LINE-RECORD-IP 01/01/0001 12/31/9999
RECORD-ID Record ID List CIP00004 CLAIM-DX-IP 01/01/0001 12/31/9999
RECORD-ID Record ID List CLT00001 FILE-HEADER-RECORD-LT 01/01/0001 12/31/9999
RECORD-ID Record ID List CLT00002 CLAIM-HEADER-RECORD-LT 01/01/0001 12/31/9999
RECORD-ID Record ID List CLT00003 CLAIM-LINE-RECORD-LT 01/01/0001 12/31/9999
RECORD-ID Record ID List CLT00004 CLAIM-DX-LT 01/01/0001 12/31/9999
RECORD-ID Record ID List COT00001 FILE-HEADER-RECORD-OT 01/01/0001 12/31/9999
RECORD-ID Record ID List COT00002 CLAIM-HEADER-RECORD-OT 01/01/0001 12/31/9999
RECORD-ID Record ID List COT00003 CLAIM-LINE-RECORD-OT 01/01/0001 12/31/9999
RECORD-ID Record ID List COT00004 CLAIM-DX-OT 01/01/0001 12/31/9999
RECORD-ID Record ID List CRX00001 FILE-HEADER-RECORD-RX 01/01/0001 12/31/9999
RECORD-ID Record ID List CRX00002 CLAIM-HEADER-RECORD-RX 01/01/0001 12/31/9999
RECORD-ID Record ID List CRX00003 CLAIM-LINE-RECORD-RX 01/01/0001 12/31/9999
RECORD-ID Record ID List CRX00004 CLAIM-DX-RX 01/01/0001 12/31/9999
RECORD-ID Record ID List ELG00001 FILE-HEADER-RECORD-ELIGIBILITY 01/01/0001 12/31/9999
RECORD-ID Record ID List ELG00002 PRIMARY-DEMOGRAPHICS-ELIGIBILITY 01/01/0001 12/31/9999
RECORD-ID Record ID List ELG00003 VARIABLE-DEMOGRAPHICS-ELIGIBILITY 01/01/0001 12/31/9999
RECORD-ID Record ID List ELG00004 ELIGIBLE-CONTACT-INFORMATION 01/01/0001 12/31/9999
RECORD-ID Record ID List ELG00005 ELIGIBILITY-DETERMINANTS 01/01/0001 12/31/9999
RECORD-ID Record ID List ELG00006 HEALTH-HOME-SPA-PARTICIPATION-INFORMATION 01/01/0001 12/31/9999
RECORD-ID Record ID List ELG00007 HEALTH-HOME-SPA-PROVIDERS 01/01/0001 12/31/9999
RECORD-ID Record ID List ELG00008 HEALTH-HOME-CHRONIC-CONDITIONS 01/01/0001 12/31/9999
RECORD-ID Record ID List ELG00009 LOCK-IN-INFORMATION 01/01/0001 12/31/9999
RECORD-ID Record ID List ELG00010 MFP-INFORMATION 01/01/0001 12/31/9999
RECORD-ID Record ID List ELG00011 STATE-PLAN-OPTION-PARTICIPATION 01/01/0001 12/31/9999
RECORD-ID Record ID List ELG00012 WAIVER-PARTICIPATION 01/01/0001 12/31/9999
RECORD-ID Record ID List ELG00013 LTSS-PARTICIPATION 01/01/0001 12/31/9999
RECORD-ID Record ID List ELG00014 LTSS-PARTICIPATION 01/01/0001 12/31/9999
RECORD-ID Record ID List ELG00015 ETHNICITY-INFORMATION 01/01/0001 12/31/9999
RECORD-ID Record ID List ELG00016 RACE-INFORMATION 01/01/0001 12/31/9999
RECORD-ID Record ID List ELG00017 DISABILITY-INFORMATION 01/01/0001 12/31/9999
RECORD-ID Record ID List ELG00018 1115A-DEMONSTRATION-INFORMATION 01/01/0001 12/31/9999
RECORD-ID Record ID List ELG00020 HCBS-CHRONIC-CONDITIONS-NON-HEALTH-HOME 01/01/0001 12/31/9999
RECORD-ID Record ID List ELG00021 ENROLLMENT-TIME-SPAN 01/01/0001 12/31/9999
RECORD-ID Record ID List ELG00022 ELG-IDENTIFIERS 01/01/0001 12/31/9999
RECORD-ID Record ID List ELG00023 SOGI 01/01/0001 12/31/9999
RECORD-ID Record ID List FTX00001 FILE-HEADER-RECORD-FTX 01/01/0001 12/31/9999
RECORD-ID Record ID List FTX00002 INDIVIDUAL-CAPITATION-PMPM 01/01/0001 12/31/9999
RECORD-ID Record ID List FTX00003 INDIVIDUAL-HEALTH-INSURANCE-PREMIUM-PAYMENT 01/01/0001 12/31/9999
RECORD-ID Record ID List FTX00004 GROUP-INSURANCE-PREMIUM-PAYMENT 01/01/0001 12/31/9999
RECORD-ID Record ID List FTX00005 COST-SHARING-OFFSET 01/01/0001 12/31/9999
RECORD-ID Record ID List FTX00006 VALUE-BASED-PAYMENT 01/01/0001 12/31/9999
RECORD-ID Record ID List FTX00007 STATE-DIRECTED-PAYMENT-SEPARATE-PAYMENT-TERM 01/01/0001 12/31/9999
RECORD-ID Record ID List FTX00008 COST-SETTLEMENT-PAYMENT 01/01/0001 12/31/9999
RECORD-ID Record ID List FTX00009 FQHC-WRAP-PAYMENT 01/01/0001 12/31/9999
RECORD-ID Record ID List FTX00095 MISCELLANEOUS-PAYMENT 01/01/0001 12/31/9999
RECORD-ID Record ID List MCR00001 FILE-HEADER-RECORD-MANAGED-CARE 01/01/0001 12/31/9999
RECORD-ID Record ID List MCR00002 MANAGED-CARE-MAIN 01/01/0001 12/31/9999
RECORD-ID Record ID List MCR00003 MANAGED-CARE-LOCATION-AND-CONTACT-INFO 01/01/0001 12/31/9999
RECORD-ID Record ID List MCR00004 MANAGED-CARE-SERVICE-AREA 01/01/0001 12/31/9999
RECORD-ID Record ID List MCR00005 MANAGED-CARE-OPERATING-AUTHORITY 01/01/0001 12/31/9999
RECORD-ID Record ID List MCR00006 MANAGED-CARE-PLAN-POPULATION-ENROLLED 01/01/0001 12/31/9999
RECORD-ID Record ID List MCR00007 MANAGED-CARE-ACCREDITATION-ORGANIZATION 01/01/0001 12/31/9999
RECORD-ID Record ID List MCR00008 NATIONAL-HEALTH-CARE-ENTITY-ID-INFO 01/01/0001 12/31/9999
RECORD-ID Record ID List MCR00009 CHPID-SHPID-RELATIONSHIP 01/01/0001 12/31/9999
RECORD-ID Record ID List MCR00010 MANAGED-CARE-ID 01/01/0001 12/31/9999
RECORD-ID Record ID List PRV00001 FILE-HEADER-RECORD-PROVIDER 01/01/0001 12/31/9999
RECORD-ID Record ID List PRV00002 PROV-ATTRIBUTES-MAIN 01/01/0001 12/31/9999
RECORD-ID Record ID List PRV00003 PROV-LOCATION-AND-CONTACT-INFO 01/01/0001 12/31/9999
RECORD-ID Record ID List PRV00004 PROV-LICENSING-INFO 01/01/0001 12/31/9999
RECORD-ID Record ID List PRV00005 PROV-IDENTIFIERS 01/01/0001 12/31/9999
RECORD-ID Record ID List PRV00006 PROV-TAXONOMY-CLASSIFICATION 01/01/0001 12/31/9999
RECORD-ID Record ID List PRV00007 PROV-MEDICAID-ENROLLMENT 01/01/0001 12/31/9999
RECORD-ID Record ID List PRV00008 PROV-AFFILIATED-GROUPS 01/01/0001 12/31/9999
RECORD-ID Record ID List PRV00009 PROV-AFFILIATED-PROGRAMS 01/01/0001 12/31/9999
RECORD-ID Record ID List PRV00010 PROV-BED-TYPE-INFO 01/01/0001 12/31/9999
RECORD-ID Record ID List TPL00001 FILE-HEADER-RECORD-TPL 01/01/0001 12/31/9999
RECORD-ID Record ID List TPL00002 TPL-MEDICAID-ELIGIBLE-PERSON-MAIN 01/01/0001 12/31/9999
RECORD-ID Record ID List TPL00003 TPL-MEDICAID-ELIGIBLE-PERSON-HEALTH-INSURANCE-COVERAGE-INFO 01/01/0001 12/31/9999
RECORD-ID Record ID List TPL00004 TPL-MEDICAID-ELIGIBLE-PERSON-HEALTH-INSURANCE-COVERAGE-CATEGORIES 01/01/0001 12/31/9999
RECORD-ID Record ID List TPL00005 TPL-MEDICAID-ELIGIBLE-OTHER-THIRD-PARTY-COVERAGE-INFORMATION 01/01/0001 12/31/9999
RECORD-ID Record ID List TPL00006 TPL-ENTITY-CONTACT-INFORMATION 01/01/0001 12/31/9999
REIMBURSEMENT-ARRANGEMENT Reimbursement Arrangement List 01 Risk-based Capitation, no incentives or risk-sharing 01/01/0001 12/31/9999
REIMBURSEMENT-ARRANGEMENT Reimbursement Arrangement List 02 Risk-based Capitation with Incentive Arrangements 01/01/0001 12/31/9999
REIMBURSEMENT-ARRANGEMENT Reimbursement Arrangement List 03 Risk-based Capitation with other risk-sharing Arrangements 01/01/0001 12/31/9999
REIMBURSEMENT-ARRANGEMENT Reimbursement Arrangement List 04 Non-Risk Capitation 01/01/0001 12/31/9999
REIMBURSEMENT-ARRANGEMENT Reimbursement Arrangement List 05 Fee-For-Service 01/01/0001 12/31/9999
REIMBURSEMENT-ARRANGEMENT Reimbursement Arrangement List 06 Primary Care Case Management Payment 01/01/0001 12/31/9999
REIMBURSEMENT-ARRANGEMENT Reimbursement Arrangement List 07 Other 01/01/0001 12/31/9999
REIMBURSEMENT-ARRANGEMENT Reimbursement Arrangement List 08 Primary Care Case Management Payment plus Fee-For-Service 01/01/0001 12/31/9999
RESTRICTED-BENEFITS-CODE Restricted Benefits Code List 0 Individual is not eligible for Medicaid or CHIP during the month. 01/01/0001 12/31/9999
RESTRICTED-BENEFITS-CODE Restricted Benefits Code List 1 Individual is eligible for Medicaid or CHIP and entitled to the full scope of Medicaid or CHIP benefits. 01/01/0001 12/31/9999
RESTRICTED-BENEFITS-CODE Restricted Benefits Code List 2 Individual is eligible for Medicaid or Medicaid-Expansion CHIP, but only entitled to restricted benefits based on alien status. 01/01/0001 12/31/9999
RESTRICTED-BENEFITS-CODE Restricted Benefits Code List 3 Individual is eligible for Medicaid but only entitled to restricted benefits based on Medicare dual-eligibility status (e.g., QMB, SLMB, QDWI, QI). 01/01/0001 12/31/9999
RESTRICTED-BENEFITS-CODE Restricted Benefits Code List 4 Individual is eligible for Medicaid or CHIP but is only entitled to restricted benefits for pregnancy-related services, including services that do and those that do not meet the Minimum Essential Coverage standard. 01/01/0001 12/31/9999
RESTRICTED-BENEFITS-CODE Restricted Benefits Code List 5 Individual is eligible for Medicaid or Medicaid-Expansion CHIP, but for reasons other than alien, dual-eligibility, or pregnancy-related status, is only entitled to restricted benefits (e.g., restricted benefits based upon substance abuse, medically needy, or other criteria) that meet the standard for Minimum Essential Coverage. 01/01/0001 12/31/9999
RESTRICTED-BENEFITS-CODE Restricted Benefits Code List 6 Individual is eligible for Medicaid or Medicaid-Expansion CHIP but only entitled to restricted benefits for family planning services. 01/01/0001 12/31/9999
RESTRICTED-BENEFITS-CODE Restricted Benefits Code List 7 Individual is eligible for Medicaid and entitled to Medicaid benefits under an alternative package of benchmark-equivalent coverage, as enacted by the Deficit Reduction Act of 2005. 01/01/0001 12/31/9999
RESTRICTED-BENEFITS-CODE Restricted Benefits Code List A Individual is eligible for Medicaid and entitled to benefits under the Psychiatric Residential Treatment Facilities Demonstration Grant Program (PRTF), as enacted by the Deficit Reduction Act of 2005. 01/01/0001 12/31/9999
RESTRICTED-BENEFITS-CODE Restricted Benefits Code List B Individual is eligible for Medicaid and entitled to Medicaid benefits using a Health Opportunity Account (HOA). 01/01/0001 12/31/9999
RESTRICTED-BENEFITS-CODE Restricted Benefits Code List C Individual is eligible for S-separate CHIP dental coverage (supplemental dental wraparound benefit to employer-sponsored insurance). 01/01/0001 12/31/9999
RESTRICTED-BENEFITS-CODE Restricted Benefits Code List D Individual is eligible for Medicaid and entitled to benefits under a ""Money Follows the Person"" (MFP) rebalancing demonstration, as enacted by the Deficit Reduction Act of 2005, to allow States to develop community based long term care opportunities. 01/01/0001 12/31/9999
RESTRICTED-BENEFITS-CODE Restricted Benefits Code List E Individual is eligible for Medicaid or Medicaid-Expansion CHIP, but for reasons other than alien, dual-eligibility, or pregnancy-related status, is only entitled to restricted benefits (e.g., restricted benefits based on substance abuse, medically needy, or other criteria) that do not meet the standard for Minimum Essential Coverage. 01/01/0001 12/31/9999
RESTRICTED-BENEFITS-CODE Restricted Benefits Code List F Individual is eligible for Medicaid but is only entitled to restricted benefits for medical assistance for COVID-19 diagnostic products and any visit described as a COVID–19 testing-related service for which payment may be made under the State plan during any portion of the public health emergency period, beginning March 18, 2020 as described in Sections 1902(a)(10)(A)(ii)(XXIII), 1902(ss) and clause XVIII in the matter following 1902(a)(10)(G) of the Social Security Act. 03/18/2020 12/31/9999
RESTRICTED-BENEFITS-CODE Restricted Benefits Code List G Individual is eligible for Medicaid but only entitled to restricted benefits based on Medicare dual-eligibility status Medicare Part B-ID ESRD Benefit. 01/01/2023 12/31/9999
REVENUE-CODE Revenue Code List See "VVL_Code_Description" field This data element's valid value code set is maintained by a Code Set Maintenance Organization (CSMO), the official licensing organization for specific valid value code sets. The CSMO is the system of record for those specific valid value code sets. While T-MSIS endeavors to be in-sync with CMSO's updates, minor delays may occur but that shouldn't block T-MSIS data submissions using the CSMO's latest version.

For background and context, see https://www.nubc.org/		 N/A N/A
SDP-IND State Directed Payment Indicator List 0 No, not an SDP 01/01/0001 12/31/9999
SDP-IND State Directed Payment Indicator List 1 Yes, SDP 01/01/0001 12/31/9999
SELF-DIRECTION-TYPE Self Direction Type List 000 Not Applicable 01/01/0001 12/31/9999
SELF-DIRECTION-TYPE Self Direction Type List 001 Hiring Authority 01/01/0001 12/31/9999
SELF-DIRECTION-TYPE Self Direction Type List 002 Budget Authority 01/01/0001 12/31/9999
SELF-DIRECTION-TYPE Self Direction Type List 003 Hiring and Budget Authority 01/01/0001 12/31/9999
SEX Sex List F Female 01/01/0001 12/31/9999
SEX Sex List M Male 01/01/0001 12/31/9999
SEX Sex List U Unknown 01/01/0001 12/31/9999
SEX-ASSIGNED-AT-BIRTH Sex Assigned at Birth List 1 Female 01/01/0001 12/31/9999
SEX-ASSIGNED-AT-BIRTH Sex Assigned at Birth List 2 Male 01/01/0001 12/31/9999
SEX-ASSIGNED-AT-BIRTH Sex Assigned at Birth List 3 Not sure 01/01/0001 12/31/9999
SEX-ASSIGNED-AT-BIRTH Sex Assigned at Birth List 4 Prefer not to answer 01/01/0001 12/31/9999
SEX-ASSIGNED-AT-BIRTH Sex Assigned at Birth List 5 Other 01/01/0001 12/31/9999
SEXUAL-ORIENTATION Sexual Orientation List 1 Lesbian or gay 01/01/0001 12/31/9999
SEXUAL-ORIENTATION Sexual Orientation List 2 Straight 01/01/0001 12/31/9999
SEXUAL-ORIENTATION Sexual Orientation List 3 Bisexual 01/01/0001 12/31/9999
SEXUAL-ORIENTATION Sexual Orientation List 4 Not sure 01/01/0001 12/31/9999
SEXUAL-ORIENTATION Sexual Orientation List 5 Prefer not to answer 01/01/0001 12/31/9999
SEXUAL-ORIENTATION Sexual Orientation List 6 Other 01/01/0001 12/31/9999
SOURCE-LOCATION Source Location List 01 MMIS 01/01/0001 12/31/9999
SOURCE-LOCATION Source Location List 02 Non-MMIS CHIP Payment System 01/01/0001 12/31/9999
SOURCE-LOCATION Source Location List 03 Pharmacy Benefits Manager (PBM) Vendor 01/01/0001 12/31/9999
SOURCE-LOCATION Source Location List 04 Dental Benefits Manager Vendor 01/01/0001 12/31/9999
SOURCE-LOCATION Source Location List 05 Transportation Provider System 01/01/0001 12/31/9999
SOURCE-LOCATION Source Location List 06 Mental Health Claims Payment System 01/01/0001 12/31/9999
SOURCE-LOCATION Source Location List 07 Financial Transaction/Accounting System 01/01/0001 12/31/9999
SOURCE-LOCATION Source Location List 08 Other State Agency Claims Payment System 01/01/0001 12/31/9999
SOURCE-LOCATION Source Location List 09 County/Local Government Claims Payment System 01/01/0001 12/31/9999
SOURCE-LOCATION Source Location List 10 Other Vendor/Other Claims Payment System 01/01/0001 12/31/9999
SOURCE-LOCATION Source Location List 20 Managed Care Organization (MCO) 01/01/0001 12/31/9999
SOURCE-LOCATION Source Location List 22 Sub-contracted entity 01/01/0001 12/31/9999
SOURCE-LOCATION Source Location List 23 Sub-capitated network provider 01/01/0001 12/31/9999
SPLIT-CLAIM-IND Split Claim Indicator List 0 No 01/01/0001 12/31/9999
SPLIT-CLAIM-IND Split Claim Indicator List 1 Yes 01/01/0001 12/31/9999
SSDI-IND SSDI Indicator List 0 No 01/01/0001 12/31/9999
SSDI-IND SSDI Indicator List 1 Yes 01/01/0001 12/31/9999
SSI-IND SSI Indicator List 0 No 01/01/0001 12/31/9999
SSI-IND SSI Indicator List 1 Yes 01/01/0001 12/31/9999
SSI-STATE-SUPPLEMENT-STATUS-CODE SSI State Supplement Code List 000 Not Applicable 01/01/0001 12/31/9999
SSI-STATE-SUPPLEMENT-STATUS-CODE SSI State Supplement Code List 001 Mandatory 01/01/0001 12/31/9999
SSI-STATE-SUPPLEMENT-STATUS-CODE SSI State Supplement Code List 002 Optional 01/01/0001 12/31/9999
SSI-STATUS SSI Status List 000 Not Applicable 01/01/0001 12/31/9999
SSI-STATUS SSI Status List 001 SSI 01/01/0001 12/31/9999
SSI-STATUS SSI Status List 002 SSI Eligible Spouse 01/01/0001 12/31/9999
SSI-STATUS SSI Status List 003 SSI Pending a Final Determination of Disposal of Resources Exceeding SSI Dollar Limits 01/01/0001 12/31/9999
SSN-INDICATOR SSN Indicator List 0 State does not use SSN as MSIS-IDENTIFICATION-NUMBER 01/01/0001 12/31/9999
SSN-INDICATOR SSN Indicator List 1 State uses SSN as MSIS-IDENTIFICATION-NUMBER 01/01/0001 12/31/9999
SSN-VERIFICATION-FLAG SSN Verification Flag List 0 SSN not verified 01/01/0001 12/31/9999
SSN-VERIFICATION-FLAG SSN Verification Flag List 1 SSN successfully verified by SSA 01/01/0001 12/31/9999
SSN-VERIFICATION-FLAG SSN Verification Flag List 2 SSN is pending SSA verification 01/01/0001 12/31/9999
STATE State Code List 01 Alabama 01/01/0001 12/31/9999
STATE State Code List 02 Alaska 01/01/0001 12/31/9999
STATE State Code List 04 Arizona 01/01/0001 12/31/9999
STATE State Code List 05 Arkansas 01/01/0001 12/31/9999
STATE State Code List 06 California 01/01/0001 12/31/9999
STATE State Code List 08 Colorado 01/01/0001 12/31/9999
STATE State Code List 09 Connecticut 01/01/0001 12/31/9999
STATE State Code List 10 Delaware 01/01/0001 12/31/9999
STATE State Code List 11 District of Columbia 01/01/0001 12/31/9999
STATE State Code List 12 Florida 01/01/0001 12/31/9999
STATE State Code List 13 Georgia 01/01/0001 12/31/9999
STATE State Code List 15 Hawaii 01/01/0001 12/31/9999
STATE State Code List 16 Idaho 01/01/0001 12/31/9999
STATE State Code List 17 Illinois 01/01/0001 12/31/9999
STATE State Code List 18 Indiana 01/01/0001 12/31/9999
STATE State Code List 19 Iowa (Medicaid) 01/01/0001 12/31/9999
STATE State Code List 20 Kansas 01/01/0001 12/31/9999
STATE State Code List 21 Kentucky 01/01/0001 12/31/9999
STATE State Code List 22 Louisiana 01/01/0001 12/31/9999
STATE State Code List 23 Maine 01/01/0001 12/31/9999
STATE State Code List 24 Maryland 01/01/0001 12/31/9999
STATE State Code List 25 Massachusetts 01/01/0001 12/31/9999
STATE State Code List 26 Michigan 01/01/0001 12/31/9999
STATE State Code List 27 Minnesota 01/01/0001 12/31/9999
STATE State Code List 28 Mississippi 01/01/0001 12/31/9999
STATE State Code List 29 Missouri 01/01/0001 12/31/9999
STATE State Code List 30 Montana 01/01/0001 12/31/9999
STATE State Code List 31 Nebraska 01/01/0001 12/31/9999
STATE State Code List 32 Nevada 01/01/0001 12/31/9999
STATE State Code List 33 New Hampshire 01/01/0001 12/31/9999
STATE State Code List 34 New Jersey 01/01/0001 12/31/9999
STATE State Code List 35 New Mexico 01/01/0001 12/31/9999
STATE State Code List 36 New York 01/01/0001 12/31/9999
STATE State Code List 37 North Carolina 01/01/0001 12/31/9999
STATE State Code List 38 North Dakota 01/01/0001 12/31/9999
STATE State Code List 39 Ohio 01/01/0001 12/31/9999
STATE State Code List 40 Oklahoma 01/01/0001 12/31/9999
STATE State Code List 41 Oregon 01/01/0001 12/31/9999
STATE State Code List 42 Pennsylvania 01/01/0001 12/31/9999
STATE State Code List 44 Rhode Island 01/01/0001 12/31/9999
STATE State Code List 45 South Carolina 01/01/0001 12/31/9999
STATE State Code List 46 South Dakota 01/01/0001 12/31/9999
STATE State Code List 47 Tennessee 01/01/0001 12/31/9999
STATE State Code List 48 Texas 01/01/0001 12/31/9999
STATE State Code List 49 Utah 01/01/0001 12/31/9999
STATE State Code List 50 Vermont 01/01/0001 12/31/9999
STATE State Code List 51 Virginia 01/01/0001 12/31/9999
STATE State Code List 53 Washington 01/01/0001 12/31/9999
STATE State Code List 54 West Virginia 01/01/0001 12/31/9999
STATE State Code List 55 Wisconsin 01/01/0001 12/31/9999
STATE State Code List 56 Wyoming 01/01/0001 12/31/9999
STATE State Code List 60 American Samoa 01/01/0001 12/31/9999
STATE State Code List 64 Federated States of Micronesia 01/01/0001 12/31/9999
STATE State Code List 66 Guam 01/01/0001 12/31/9999
STATE State Code List 67 Johnston Atoll 01/01/0001 12/31/9999
STATE State Code List 68 Marshall Islands 01/01/0001 12/31/9999
STATE State Code List 69 Commonwealth of the Northern Mariana Islands 01/01/0001 12/31/9999
STATE State Code List 70 Palau 01/01/0001 12/31/9999
STATE State Code List 71 Midway Islands 01/01/0001 12/31/9999
STATE State Code List 72 Puerto Rico 01/01/0001 12/31/9999
STATE State Code List 74 U.S. Minor Outlying Islands 01/01/0001 12/31/9999
STATE State Code List 76 Navassa Island 01/01/0001 12/31/9999
STATE State Code List 78 U.S. Virgin Islands 01/01/0001 12/31/9999
STATE State Code List 79 Wake Island 01/01/0001 12/31/9999
STATE State Code List 81 Baker Island 01/01/0001 12/31/9999
STATE State Code List 84 Howland Island 01/01/0001 12/31/9999
STATE State Code List 86 Jarvis Island 01/01/0001 12/31/9999
STATE State Code List 89 Kingman Reef 01/01/0001 12/31/9999
STATE State Code List 93 WYOMING CHIP 01/01/0001 12/31/9999
STATE State Code List 94 MONTANA TPA 01/01/0001 12/31/9999
STATE State Code List 95 Palmyra Atoll 01/01/0001 12/31/9999
STATE State Code List 96 Iowa (CHIP) - I4 01/01/0001 12/31/9999
STATE State Code List 97 Pennsylvania (CHIP) - P1 01/01/0001 12/31/9999
STATE State Code List 99 Test State 01/01/0001 12/31/9999
STATE State Code List See "VVL_Code_Description" field This data element's valid value code set is maintained by a Code Set Maintenance Organization (CSMO), the official licensing organization for specific valid value code sets. The CSMO is the system of record for those specific valid value code sets. While T-MSIS endeavors to be in-sync with CMSO's updates, minor delays may occur but that shouldn't block T-MSIS data submissions using the CSMO's latest version.

For background and context, see https://www.census.gov/library/reference/code-lists/ansi.html#par_textimage_3		 N/A N/A
STATE-PLAN-ENROLLMENT State Plan Enrollment List 1 Medicaid 01/01/0001 12/31/9999
STATE-PLAN-ENROLLMENT State Plan Enrollment List 2 CHIP 01/01/0001 12/31/9999
STATE-PLAN-ENROLLMENT State Plan Enrollment List 3 Both Medicaid and CHIP 01/01/0001 12/31/9999
STATE-PLAN-ENROLLMENT State Plan Enrollment List 4 Not state plan affiliated 01/01/0001 12/31/9999
STATE-PLAN-OPTION-TYPE State Plan Option Type List 00 Not Applicable 01/01/0001 12/31/9999
STATE-PLAN-OPTION-TYPE State Plan Option Type List 01 Community First Choice 01/01/0001 12/31/9999
STATE-PLAN-OPTION-TYPE State Plan Option Type List 02 1915(i) 01/01/0001 12/31/9999
STATE-PLAN-OPTION-TYPE State Plan Option Type List 03 1915(j) 01/01/0001 12/31/9999
STATE-PLAN-OPTION-TYPE State Plan Option Type List 04 1932(a) 01/01/0001 12/31/9999
STATE-PLAN-OPTION-TYPE State Plan Option Type List 05 1915(a) 01/01/0001 12/31/9999
STATE-PLAN-OPTION-TYPE State Plan Option Type List 06 1937 (Alternative Benefit Plans) 01/01/0001 12/31/9999
SUBCAPITATION-IND Subcapitation Indicator List 1 No, transaction is not a sub-capitation payment or recoupment 01/01/0001 12/31/9999
SUBCAPITATION-IND Subcapitation Indicator List 2 Yes, transaction is a sub-capitation or recoupment 01/01/0001 12/31/9999
SUBMISSION-TRANSACTION-TYPE Submission Transaction Type List C Create File-a file that contains a complete set of transactions/changes processed since the last Create file submission. States may submit only one valid Create file per reporting period and data file type. 01/01/0001 12/31/9999
SUBMISSION-TRANSACTION-TYPE Submission Transaction Type List R Replacement File-a Replacement submission is a replacement of the month's data. It will completely replace the immediate prior submission. If a later replacement entry is received, it will overwrite the previous replacement, as well as a prior Create or Update submission for the same data type and reporting period. 01/01/0001 12/31/9999
SUBMISSION-TRANSACTION-TYPE Submission Transaction Type List U Update File-a file that contains T-MSIS record segments created in response to business rule rejects. Note: The records in an Update file are not generated as a result of a change processed in the state's Medicaid or Medicaid-related systems during the current reporting month. These Update file record segments may be unchanged from the ones submitted previously for various reasons (for example, the state may be unable to process a change record in their Medicaid / Medicaid-related systems to correct the issue because the state is simply passing through to T-MSIS data that originated outside of the state's systems).[1] Conversely, the records may be different from those previously submitted, but the change is the result of a fix whose root cause problem was an issue in the T-MSIS file-creation or replacement process at CMS. Regardless, the record was not generated from a change that occurred in the state's source data. 01/01/0001 12/31/9999
TANF-CASH-CODE TANF Cash Code List 0 Individual was not eligible for Medicaid. 01/01/0001 12/31/9999
TANF-CASH-CODE TANF Cash Code List 1 Individual did not receive TANF benefits 01/01/0001 12/31/9999
TANF-CASH-CODE TANF Cash Code List 2 Individual did receive TANF benefits (States should only use this value if they can accurately separate eligible receiving TANF benefits from other 1931 eligible reported into MAS 1) 01/01/0001 12/31/9999
TEACHING-IND Teaching Indicator List 0 No 01/01/0001 12/31/9999
TEACHING-IND Teaching Indicator List 1 Yes 01/01/0001 12/31/9999
TOOTH-DESIGNATION-SYSTEM Tooth Designation System List JO ANSI/ADA/ISO Specification No. 3950 01/01/0001 12/31/9999
TOOTH-DESIGNATION-SYSTEM Tooth Designation System List JP ADA's Universal/National Tooth Designation system 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List 1 Upper Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List 2 Upper Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List 3 Upper Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List 4 Upper Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List 5 Upper Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List 6 Upper Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List 7 Upper Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List 8 Upper Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List 9 Upper Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List 10 Upper Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List 11 Upper Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List 12 Upper Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List 13 Upper Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List 14 Upper Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List 15 Upper Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List 16 Upper Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List 17 Lower Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List 18 Lower Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List 19 Lower Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List 20 Lower Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List 21 Lower Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List 22 Lower Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List 23 Lower Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List 24 Lower Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List 25 Lower Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List 26 Lower Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List 27 Lower Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List 28 Lower Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List 29 Lower Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List 30 Lower Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List 31 Lower Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List 32 Lower Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List 51 Upper Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List 52 Upper Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List 53 Upper Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List 54 Upper Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List 55 Upper Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List 56 Upper Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List 57 Upper Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List 58 Upper Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List 59 Upper Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List 60 Upper Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List 61 Upper Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List 62 Upper Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List 63 Upper Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List 64 Upper Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List 65 Upper Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List 66 Upper Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List 67 Lower Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List 68 Lower Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List 69 Lower Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List 70 Lower Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List 71 Lower Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List 72 Lower Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List 73 Lower Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List 74 Lower Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List 75 Lower Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List 76 Lower Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List 77 Lower Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List 78 Lower Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List 79 Lower Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List 80 Lower Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List 81 Lower Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List 82 Lower Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List A Upper Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List AS Upper Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List B Upper Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List BS Upper Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List C Upper Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List CS Upper Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List D Upper Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List DS Upper Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List E Upper Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List ES Upper Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List F Upper Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List FS Upper Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List G Upper Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List GS Upper Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List H Upper Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List HS Upper Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List I Upper Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List IS Upper Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List J Upper Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List JS Upper Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List K Lower Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List KS Lower Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List L Lower Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List LS Lower Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List M Lower Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List MS Lower Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List N Lower Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List NS Lower Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List O Lower Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List OS Lower Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List P Lower Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List PS Lower Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List Q Lower Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List QS Lower Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List R Lower Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List RS Lower Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List S Lower Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List See "VVL_Code_Description" field This data element's valid value code set is maintained by a Code Set Maintenance Organization (CSMO), the official licensing organization for specific valid value code sets. The CSMO is the system of record for those specific valid value code sets. While T-MSIS endeavors to be in-sync with CMSO's updates, minor delays may occur but that shouldn't block T-MSIS data submissions using the CSMO's latest version.

For background and context, see https://www.ada.org/-/media/project/ada-organization/ada/ada-org/files/publications/cdt/ada_utds_value_set_v1_2022_aug.pdf		 N/A N/A
TOOTH-NUM Tooth Number List SS Lower Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List T Lower Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-NUM Tooth Number List TS Lower Arch (commencing in the Upper right quadrant and rotating counterclockwise) 01/01/0001 12/31/9999
TOOTH-QUAD-CODE Tooth Quad Code List 00 Entire Oral Cavity 01/01/0001 12/31/9999
TOOTH-QUAD-CODE Tooth Quad Code List 01 Maxillary Area 01/01/0001 12/31/9999
TOOTH-QUAD-CODE Tooth Quad Code List 02 Mandibular Area 01/01/0001 12/31/9999
TOOTH-QUAD-CODE Tooth Quad Code List 03 Upper Right Sextant 01/01/0001 12/31/9999
TOOTH-QUAD-CODE Tooth Quad Code List 04 Upper Anterior Sextant 01/01/0001 12/31/9999
TOOTH-QUAD-CODE Tooth Quad Code List 05 Upper Left Sextant 01/01/0001 12/31/9999
TOOTH-QUAD-CODE Tooth Quad Code List 06 Lower Left Sextant 01/01/0001 12/31/9999
TOOTH-QUAD-CODE Tooth Quad Code List 07 Lower Anterior Sextant 01/01/0001 12/31/9999
TOOTH-QUAD-CODE Tooth Quad Code List 08 Lower Right Sextant 01/01/0001 12/31/9999
TOOTH-QUAD-CODE Tooth Quad Code List 09 Other Area of Oral Cavity (An area specified in an annexed document or further explanation available.) 01/01/0001 12/31/9999
TOOTH-QUAD-CODE Tooth Quad Code List 10 Upper Right Quadrant (Right Refers to the oral and skeletal structures on the right side.) 01/01/0001 12/31/9999
TOOTH-QUAD-CODE Tooth Quad Code List 20 Upper Left Quadrant (Left Refers to the oral and skeletal structures on the left side.) 01/01/0001 12/31/9999
TOOTH-QUAD-CODE Tooth Quad Code List 30 Lower Left Quadrant 01/01/0001 12/31/9999
TOOTH-QUAD-CODE Tooth Quad Code List 40 Lower Right Quadrant 01/01/0001 12/31/9999
TOOTH-QUAD-CODE Tooth Quad Code List See "VVL_Code_Description" field This data element's valid value code set is maintained by a Code Set Maintenance Organization (CSMO), the official licensing organization for specific valid value code sets. The CSMO is the system of record for those specific valid value code sets. While T-MSIS endeavors to be in-sync with CMSO's updates, minor delays may occur but that shouldn't block T-MSIS data submissions using the CSMO's latest version.

For background and context, see https://www.ada.org/-/media/project/ada-organization/ada/ada-org/files/publications/cdt/areaoftheoralcavityandtoothanatomybycdtcode_2022jan.pdf		 N/A N/A
TOOTH-SURFACE-CODE Tooth Surface Code List B Buccal - The surface of the tooth which is closest to the cheek. 01/01/0001 12/31/9999
TOOTH-SURFACE-CODE Tooth Surface Code List D Distal - The surface of the tooth facing away from an invisible line drawn vertically through the center of the face. 01/01/0001 12/31/9999
TOOTH-SURFACE-CODE Tooth Surface Code List F Facial - The surface of a tooth that is directed towards the face. 01/01/0001 12/31/9999
TOOTH-SURFACE-CODE Tooth Surface Code List I Incisal - The cutting edges of the anterior teeth. 01/01/0001 12/31/9999
TOOTH-SURFACE-CODE Tooth Surface Code List L Lingual - The surface of the tooth that is directed towards the tongue. 01/01/0001 12/31/9999
TOOTH-SURFACE-CODE Tooth Surface Code List M Mesial - The surface of a tooth which faces toward an invisible line drawn vertically through the center of the face. 01/01/0001 12/31/9999
TOOTH-SURFACE-CODE Tooth Surface Code List O Occlusal - The surfaces of the posterior (back) teeth which provides the chewing function. 01/01/0001 12/31/9999
TOOTH-SURFACE-CODE Tooth Surface Code List See "VVL_Code_Description" field This data element's valid value code set is maintained by a Code Set Maintenance Organization (CSMO), the official licensing organization for specific valid value code sets. The CSMO is the system of record for those specific valid value code sets. While T-MSIS endeavors to be in-sync with CMSO's updates, minor delays may occur but that shouldn't block T-MSIS data submissions using the CSMO's latest version.

For background and context, see https://www.ada.org/-/media/project/ada-organization/ada/ada-org/files/publications/cdt/ada_utds_value_set_v1_2022_aug.pdf		 N/A N/A
TPL-ENTITY-ADDR-TYPE TPL Entity Address Type List 06 TPL-Entity Corporate Location 01/01/0001 12/31/9999
TPL-ENTITY-ADDR-TYPE TPL Entity Address Type List 07 TPL-Entity Mailing 01/01/0001 12/31/9999
TPL-ENTITY-ADDR-TYPE TPL Entity Address Type List 08 TPL-Entity Satellite Location 01/01/0001 12/31/9999
TPL-ENTITY-ADDR-TYPE TPL Entity Address Type List 09 TPL-Entity Billing 01/01/0001 12/31/9999
TPL-ENTITY-ADDR-TYPE TPL Entity Address Type List 10 TPL-Entity Correspondence 01/01/0001 12/31/9999
TPL-ENTITY-ADDR-TYPE TPL Entity Address Type List 11 TPL-Other 01/01/0001 12/31/9999
TPL-HEALTH-INSURANCE-COVERAGE-IND TPL Health Insurance Coverage Indicator List 0 Eligible individual has no TPL insurance coverage. 01/01/0001 12/31/9999
TPL-HEALTH-INSURANCE-COVERAGE-IND TPL Health Insurance Coverage Indicator List 1 Eligible individual does have TPL insurance coverage. 01/01/0001 12/31/9999
TPL-OTHER-COVERAGE-IND TPL Other Coverage Indicator List 0 Eligible individual has no other TPL funding available. 01/01/0001 12/31/9999
TPL-OTHER-COVERAGE-IND TPL Other Coverage Indicator List 1 Eligible individual does have other TPL funding available. 01/01/0001 12/31/9999
TRANSACTION-TYPE Transaction Type List 01 Kick payment 01/01/0001 12/31/9999
TRANSACTION-TYPE Transaction Type List 02 Provider retainer payment 01/01/0001 12/31/9999
TRANSACTION-TYPE Transaction Type List 03 Direct reimbursement to Bene for retroactive period cost (e.g. 42 CFR 447.25) 01/01/0001 12/31/9999
TRANSACTION-TYPE Transaction Type List 04 Direct reimbursement to Bene for non-emergency transportation 01/01/0001 12/31/9999
TRANSACTION-TYPE Transaction Type List 95 Other 01/01/0001 12/31/9999
TYPE-OF-BILL Type of Bill List See "VVL_Code_Description" field This data element's valid value code set is maintained by a Code Set Maintenance Organization (CSMO), the official licensing organization for specific valid value code sets. The CSMO is the system of record for those specific valid value code sets. While T-MSIS endeavors to be in-sync with CMSO's updates, minor delays may occur but that shouldn't block T-MSIS data submissions using the CSMO's latest version.

For background and context, see https://www.nubc.org/license		 N/A N/A
TYPE-OF-BILL-2-FACILITY-TYPE Type of Bill List (2nd position; Facility Type) 1 Hospital 01/01/0001 12/31/9999
TYPE-OF-BILL-2-FACILITY-TYPE Type of Bill List (2nd position; Facility Type) 2 Skilled Nursing 01/01/0001 12/31/9999
TYPE-OF-BILL-2-FACILITY-TYPE Type of Bill List (2nd position; Facility Type) 3 Home Health 01/01/0001 12/31/9999
TYPE-OF-BILL-2-FACILITY-TYPE Type of Bill List (2nd position; Facility Type) 4 Religious Nonmedical (Hospital) 01/01/0001 12/31/9999
TYPE-OF-BILL-2-FACILITY-TYPE Type of Bill List (2nd position; Facility Type) 5 Reserved for national assignment (discontinued effective 10/1/05). 01/01/0001 10/01/2005
TYPE-OF-BILL-2-FACILITY-TYPE Type of Bill List (2nd position; Facility Type) 6 Intermediate Care 01/01/0001 12/31/9999
TYPE-OF-BILL-2-FACILITY-TYPE Type of Bill List (2nd position; Facility Type) 7 Clinic or Hospital Based Renal Dialysis Facility (requires special information in second digit below). 01/01/0001 12/31/9999
TYPE-OF-BILL-2-FACILITY-TYPE Type of Bill List (2nd position; Facility Type) 8 Special facility or hospital ASC surgery (requires special information in second digit below). 01/01/0001 12/31/9999
TYPE-OF-BILL-2-FACILITY-TYPE Type of Bill List (2nd position; Facility Type) 9 Reserved for National Assignment 01/01/0001 12/31/9999
TYPE-OF-BILL-3-BILL-CLASSIFICATION-CLINICS Type of Bill List (3rd position; Facility Type: Clinics; Type of Care) 1 Rural Health Clinic (RHC) 01/01/0001 12/31/9999
TYPE-OF-BILL-3-BILL-CLASSIFICATION-CLINICS Type of Bill List (3rd position; Facility Type: Clinics; Type of Care) 2 Hospital Based or Independent Renal Dialysis Facility 01/01/0001 12/31/9999
TYPE-OF-BILL-3-BILL-CLASSIFICATION-CLINICS Type of Bill List (3rd position; Facility Type: Clinics; Type of Care) 3 Free Standing Provider-Based Federally Qualified Health Center (FQHC) 01/01/0001 12/31/9999
TYPE-OF-BILL-3-BILL-CLASSIFICATION-CLINICS Type of Bill List (3rd position; Facility Type: Clinics; Type of Care) 4 Other Rehabilitation Facility (ORF) 01/01/0001 12/31/9999
TYPE-OF-BILL-3-BILL-CLASSIFICATION-CLINICS Type of Bill List (3rd position; Facility Type: Clinics; Type of Care) 5 Comprehensive Outpatient Rehabilitation Facility (CORF) 01/01/0001 12/31/9999
TYPE-OF-BILL-3-BILL-CLASSIFICATION-CLINICS Type of Bill List (3rd position; Facility Type: Clinics; Type of Care) 6 Community Mental Health Center (CMHC) 01/01/0001 12/31/9999
TYPE-OF-BILL-3-BILL-CLASSIFICATION-CLINICS Type of Bill List (3rd position; Facility Type: Clinics; Type of Care) 7 Federally Qualified Health Center (FQHC) (Effective 4/1/10) 04/01/2010 12/31/9999
TYPE-OF-BILL-3-BILL-CLASSIFICATION-CLINICS Type of Bill List (3rd position; Facility Type: Clinics; Type of Care) 8 Licensed Freestanding Emergency Medical Facility (Effective 4/1/12) 04/01/2012 12/31/9999
TYPE-OF-BILL-3-BILL-CLASSIFICATION-CLINICS Type of Bill List (3rd position; Facility Type: Clinics; Type of Care) 9 OTHER 01/01/0001 12/31/9999
TYPE-OF-BILL-3-BILL-CLASSIFICATION-FACILITY Type of Bill List (3rd position; Facility Type: Facilities; Type of Care) 1 Hospice (Nonhospital Based) 01/01/0001 12/31/9999
TYPE-OF-BILL-3-BILL-CLASSIFICATION-FACILITY Type of Bill List (3rd position; Facility Type: Facilities; Type of Care) 2 Hospice (Hospital Based) 01/01/0001 12/31/9999
TYPE-OF-BILL-3-BILL-CLASSIFICATION-FACILITY Type of Bill List (3rd position; Facility Type: Facilities; Type of Care) 3 Ambulatory Surgical Center Services to Hospital Outpatients 01/01/0001 12/31/9999
TYPE-OF-BILL-3-BILL-CLASSIFICATION-FACILITY Type of Bill List (3rd position; Facility Type: Facilities; Type of Care) 4 Free Standing Birthing Center 01/01/0001 12/31/9999
TYPE-OF-BILL-3-BILL-CLASSIFICATION-FACILITY Type of Bill List (3rd position; Facility Type: Facilities; Type of Care) 5 Critical Access Hospital 01/01/0001 12/31/9999
TYPE-OF-BILL-3-BILL-CLASSIFICATION-FACILITY Type of Bill List (3rd position; Facility Type: Facilities; Type of Care) 6 Residential Facility 01/01/0001 12/31/9999
TYPE-OF-BILL-3-BILL-CLASSIFICATION-FACILITY Type of Bill List (3rd position; Facility Type: Facilities; Type of Care) 7 Freestanding Non-residential Opioid Treatment Program (Effective 1/1/21) 01/01/2021 12/31/9999
TYPE-OF-BILL-3-BILL-CLASSIFICATION-FACILITY Type of Bill List (3rd position; Facility Type: Facilities; Type of Care) 8 Reserved for National Assignment 01/01/0001 12/31/9999
TYPE-OF-BILL-3-BILL-CLASSIFICATION-FACILITY Type of Bill List (3rd position; Facility Type: Facilities; Type of Care) 9 OTHER 01/01/0001 12/31/9999
TYPE-OF-BILL-3-BILL-CLASSIFICATION-OTHER Type of Bill List (3rd position; Facility Type: Other; Type of Care) 1 Inpatient 01/01/0001 12/31/9999
TYPE-OF-BILL-3-BILL-CLASSIFICATION-OTHER Type of Bill List (3rd position; Facility Type: Other; Type of Care) 2 Inpatient 01/01/0001 12/31/9999
TYPE-OF-BILL-3-BILL-CLASSIFICATION-OTHER Type of Bill List (3rd position; Facility Type: Other; Type of Care) 3 Outpatient 01/01/0001 12/31/9999
TYPE-OF-BILL-3-BILL-CLASSIFICATION-OTHER Type of Bill List (3rd position; Facility Type: Other; Type of Care) 4 Other 01/01/0001 12/31/9999
TYPE-OF-BILL-3-BILL-CLASSIFICATION-OTHER Type of Bill List (3rd position; Facility Type: Other; Type of Care) 5 Intermediate Care - Level I 01/01/0001 12/31/9999
TYPE-OF-BILL-3-BILL-CLASSIFICATION-OTHER Type of Bill List (3rd position; Facility Type: Other; Type of Care) 6 Intermediate Care - Level II 01/01/0001 12/31/9999
TYPE-OF-BILL-3-BILL-CLASSIFICATION-OTHER Type of Bill List (3rd position; Facility Type: Other; Type of Care) 7 Reserved for national assignment (discontinued effective 10/1/05). 01/01/0001 10/01/2005
TYPE-OF-BILL-3-BILL-CLASSIFICATION-OTHER Type of Bill List (3rd position; Facility Type: Other; Type of Care) 8 Swing Bed (may be used to indicate billing for SNF level of care in a hospital with an approved swing bed agreement). 01/01/0001 12/31/9999
TYPE-OF-BILL-3-BILL-CLASSIFICATION-OTHER Type of Bill List (3rd position; Facility Type: Other; Type of Care) 9 Reserved for National Assignment 01/01/0001 12/31/9999
TYPE-OF-BILL-4-FREQUENCY Type of Bill list (4th position; Frequency) 0 Nonpayment/Zero Claims 01/01/0001 12/31/9999
TYPE-OF-BILL-4-FREQUENCY Type of Bill list (4th position; Frequency) 1 Admit Through Discharge Claim 01/01/0001 12/31/9999
TYPE-OF-BILL-4-FREQUENCY Type of Bill list (4th position; Frequency) 2 Interim-First Claim 01/01/0001 12/31/9999
TYPE-OF-BILL-4-FREQUENCY Type of Bill list (4th position; Frequency) 3 Interim-Continuing Claims (Not valid for PPS Bills) 01/01/0001 12/31/9999
TYPE-OF-BILL-4-FREQUENCY Type of Bill list (4th position; Frequency) A Admission/Election Notice 01/01/0001 12/31/9999
TYPE-OF-BILL-4-FREQUENCY Type of Bill list (4th position; Frequency) B Hospice/Medicare Coordinated Care Demonstration/Religious Nonmedical Health Care Institution Termination/Revocation Notice 01/01/0001 12/31/9999
TYPE-OF-BILL-4-FREQUENCY Type of Bill list (4th position; Frequency) C Hospice Change of Provider Notice 01/01/0001 12/31/9999
TYPE-OF-BILL-4-FREQUENCY Type of Bill list (4th position; Frequency) D Hospice/Medicare Coordinated Care Demonstration/Religious Nonmedical Health Care Institution Void/Cancel 01/01/0001 12/31/9999
TYPE-OF-BILL-4-FREQUENCY Type of Bill list (4th position; Frequency) E Hospice Change of Ownership 01/01/0001 12/31/9999
TYPE-OF-BILL-4-FREQUENCY Type of Bill list (4th position; Frequency) F Beneficiary Initiated Adjustment Claim 01/01/0001 12/31/9999
TYPE-OF-BILL-4-FREQUENCY Type of Bill list (4th position; Frequency) G CWF Initiated Adjustment Claim 01/01/0001 12/31/9999
TYPE-OF-BILL-4-FREQUENCY Type of Bill list (4th position; Frequency) H CMS Initiated Adjustment Claim 01/01/0001 12/31/9999
TYPE-OF-BILL-4-FREQUENCY Type of Bill list (4th position; Frequency) I FI Adjustment Claim (Other than QIO or Provider 01/01/0001 12/31/9999
TYPE-OF-BILL-4-FREQUENCY Type of Bill list (4th position; Frequency) J Initiated Adjustment Claim-Other 01/01/0001 12/31/9999
TYPE-OF-BILL-4-FREQUENCY Type of Bill list (4th position; Frequency) K OIG Initiated Adjustment Claim 01/01/0001 12/31/9999
TYPE-OF-BILL-4-FREQUENCY Type of Bill list (4th position; Frequency) M MSP Initiated Adjustment Claim 01/01/0001 12/31/9999
TYPE-OF-BILL-4-FREQUENCY Type of Bill list (4th position; Frequency) P QIO Adjustment Claim 01/01/0001 12/31/9999
TYPE-OF-CLAIM Type of Claim List 1 A Fee-For-Service Medicaid or Medicaid-expansion Claim 01/01/0001 12/31/9999
TYPE-OF-CLAIM Type of Claim List 3 Medicaid or Medicaid-expansion Managed Care Encounter (a.k.a. ""Dummy"") record that simulates a bill for a service rendered to a patient covered under some form of Capitation Plan. This includes billing records submitted by providers to non-state entities (e.g., MCOs, health plans) for which the State has no financial liability since the at risk entity has already received a capitated payment from the State. 01/01/0001 12/31/9999
TYPE-OF-CLAIM Type of Claim List A Separate CHIP (Title XXI) claim: A Fee-for-Service Claim 01/01/0001 12/31/9999
TYPE-OF-CLAIM Type of Claim List C Separate CHIP (Title XXI) encounter record that simulates a bill for a service or items rendered to a patient covered under some form of Capitation Plan. This includes billing records submitted by providers to non-State entities (e.g., MCOs, health plans) for which a state has no financial liability as the at-risk entity has already received a capitated payment from the state 01/01/0001 12/31/9999
TYPE-OF-CLAIM Type of Claim List U Other FFS claim 01/01/0001 12/31/9999
TYPE-OF-CLAIM Type of Claim List W Other Managed Care Encounter 01/01/0001 12/31/9999
TYPE-OF-CLAIM Type of Claim List Z Denied claims 01/01/0001 06/30/2020
TYPE-OF-HOSPITAL Type of Hospital List 00 Not a hospital 01/01/0001 12/31/9999
TYPE-OF-HOSPITAL Type of Hospital List 01 Inpatient Hospital 01/01/0001 12/31/9999
TYPE-OF-HOSPITAL Type of Hospital List 02 Outpatient Hospital 01/01/0001 12/31/9999
TYPE-OF-HOSPITAL Type of Hospital List 03 Critical Access Hospital 01/01/0001 12/31/9999
TYPE-OF-HOSPITAL Type of Hospital List 04 Swing Bed Hospital 01/01/0001 12/31/9999
TYPE-OF-HOSPITAL Type of Hospital List 05 Inpatient Psychiatric Hospital 01/01/0001 12/31/9999
TYPE-OF-HOSPITAL Type of Hospital List 06 IHS Hospital 01/01/0001 12/31/9999
TYPE-OF-HOSPITAL Type of Hospital List 07 Children's Hospital 01/01/0001 12/31/9999
TYPE-OF-HOSPITAL Type of Hospital List 08 Other 01/01/0001 12/31/9999
TYPE-OF-OTHER-THIRD-PARTY-LIABILITY Type of Other Third-Party Liability List 1 Tort/Casualty Claim 01/01/0001 12/31/9999
TYPE-OF-OTHER-THIRD-PARTY-LIABILITY Type of Other Third-Party Liability List 2 Medical Malpractice 01/01/0001 12/31/9999
TYPE-OF-OTHER-THIRD-PARTY-LIABILITY Type of Other Third-Party Liability List 3 Estate (an estate, annuity or designated trust) 01/01/0001 12/31/9999
TYPE-OF-OTHER-THIRD-PARTY-LIABILITY Type of Other Third-Party Liability List 4 Liens 01/01/0001 12/31/9999
TYPE-OF-OTHER-THIRD-PARTY-LIABILITY Type of Other Third-Party Liability List 5 Worker's Compensation 01/01/0001 12/31/9999
TYPE-OF-OTHER-THIRD-PARTY-LIABILITY Type of Other Third-Party Liability List 6 Payments from an individual or group who has either voluntarily or been assigned legal responsibility for the health care of one or more Medicaid recipients; fraternal groups; unions 01/01/0001 12/31/9999
TYPE-OF-OTHER-THIRD-PARTY-LIABILITY Type of Other Third-Party Liability List 7 Other - unidentified 01/01/0001 12/31/9999
TYPE-OF-SERVICE-IP Type of Service IP List 001 Inpatient hospital services, other than services in an institution for mental diseases 01/01/0001 12/31/9999
TYPE-OF-SERVICE-IP Type of Service IP List 058 Services furnished in a religious nonmedical health care institution 01/01/0001 12/31/9999
TYPE-OF-SERVICE-IP Type of Service IP List 060 Emergency hospital services 01/01/0001 12/31/9999
TYPE-OF-SERVICE-IP Type of Service IP List 084 Sterilizations 01/01/0001 12/31/9999
TYPE-OF-SERVICE-IP Type of Service IP List 086 Other Pregnancy-related Procedures 01/01/0001 12/31/9999
TYPE-OF-SERVICE-IP Type of Service IP List 090 Critical access hospital services - IP 01/01/0001 12/31/9999
TYPE-OF-SERVICE-IP Type of Service IP List 091 Skilled care - hospital residing 01/01/0001 12/31/9999
TYPE-OF-SERVICE-IP Type of Service IP List 092 Exceptional care - hospital residing 01/01/0001 12/31/9999
TYPE-OF-SERVICE-IP Type of Service IP List 093 Non-acute care - hospital residing 01/01/0001 12/31/9999
TYPE-OF-SERVICE-IP Type of Service IP List 136 In vitro diagnostic products (as defined in section 809.3(a) of title 21, Code of Federal Regulations) administered during any portion of the emergency period defined in paragraph (1)(B) of section 1135(g) beginning on or after the date of the enactment of this subparagraph for the detection of SARS–CoV–2 or the diagnosis of the virus that causes COVID–19, and the administration of such in vitro diagnostic products 03/18/2020 12/31/9999
TYPE-OF-SERVICE-IP Type of Service IP List 137 COVID–19 testing-related services 03/18/2020 12/31/9999
TYPE-OF-SERVICE-LT Type of Service LT List 009 Nursing facility services for individuals age 21 or older (other than services in an institution for mental disease) 01/01/0001 12/31/9999
TYPE-OF-SERVICE-LT Type of Service LT List 044 Inpatient hospital services for individuals age 65 or older in institutions for mental diseases 01/01/0001 12/31/9999
TYPE-OF-SERVICE-LT Type of Service LT List 045 Nursing facility services for individuals age 65 or older in institutions for mental diseases 01/01/0001 12/31/9999
TYPE-OF-SERVICE-LT Type of Service LT List 046 ICF/IID (Intermediate Care Facilities for individuals with Intellectual Disabilities) 01/01/0001 12/31/9999
TYPE-OF-SERVICE-LT Type of Service LT List 047 Nursing facility services, other than in institutions for mental diseases 01/01/0001 12/31/9999
TYPE-OF-SERVICE-LT Type of Service LT List 048 Inpatient psychiatric services for individuals under age 21 01/01/0001 12/31/9999
TYPE-OF-SERVICE-LT Type of Service LT List 050 Inpatient substance abuse treatment services and residential substance abuse treatment services. 01/01/0001 12/31/9999
TYPE-OF-SERVICE-LT Type of Service LT List 059 Skilled nursing facility services for individuals under age 21 01/01/0001 12/31/9999
TYPE-OF-SERVICE-LT Type of Service LT List 136 In vitro diagnostic products (as defined in section 809.3(a) of title 21, Code of Federal Regulations) administered during any portion of the emergency period defined in paragraph (1)(B) of section 1135(g) beginning on or after the date of the enactment of this subparagraph for the detection of SARS–CoV–2 or the diagnosis of the virus that causes COVID–19, and the administration of such in vitro diagnostic products 03/18/2020 12/31/9999
TYPE-OF-SERVICE-LT Type of Service LT List 137 COVID–19 testing-related services 03/18/2020 12/31/9999
TYPE-OF-SERVICE-LT Type of Service LT List 146 Inpatient Psychiatric Services for beneficiaries between the ages of 22 and 64 who receive services in an institution for mental disease (IMD) 01/01/0001 12/31/9999
TYPE-OF-SERVICE-LT Type of Service LT List 147 Residential Pediatric Recovery Center (RPRC): A center or facility that furnishes items and services for which medical assistance is available under the State plan to infants with the diagnosis of neonatal abstinence syndrome without any other significant medical risk factors. 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 002 Outpatient hospital services 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 003 Rural health clinic services 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 004 Other ambulatory services furnished by a rural health clinic 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 005 Professional laboratory services, Technical laboratory services 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 006 Technical laboratory services 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 007 Professional radiological services 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 008 Technical radiological services 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 010 Early and periodic screening and diagnosis and treatment (EPSDT) services 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 011 Family planning services and supplies for individuals of child-bearing age 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 012 Physicians' services 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 013 Medical and surgical services of a dentist 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 014 Outpatient substance abuse treatment services. 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 015 Medical or other remedial care or services, other than physicians' services, provided by licensed practitioners within the scope of practice as defined under State law 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 016 Home health services - Nursing services 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 017 Home health services - Home health aide services 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 018 Home health services - Medical supplies, equipment, and appliances suitable for use in the home 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 019 Home health services - Physical therapy provided by a home health agency or by a facility licensed by the State to provide medical rehabilitation services 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 020 Home health services - Occupational therapy provided by a home health agency or by a facility licensed by the State to provide medical rehabilitation services 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 021 Home health services - Speech pathology and audiology services provided by a home health agency or by a facility licensed by the State to provide medical rehabilitation services 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 022 Private duty nursing services 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 023 Advanced practice nurse services 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 024 Pediatric nurse 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 025 Nurse-midwife service 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 026 Nurse practitioner services 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 027 Respiratory care for ventilator-dependent individuals 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 028 Clinic services 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 029 Dental services 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 030 Physical therapy services (when not provided under home health services) 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 031 Occupational therapy services (when not provided under home health services) 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 032 Speech, hearing, and language disorders services (when not provided under home health services) 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 035 Dentures 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 036 Medical equipment/prosthetic devices 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 037 Eyeglasses 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 038 Hearing Aids 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 039 Diagnostic services 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 040 Screening services 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 041 Preventive services 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 042 Well-baby and well-child care services as defined by the State. 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 043 Rehabilitative services 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 049 Outpatient mental health services, other than Outpatient substance abuse treatment services. This TOS includes services furnished in a State-operated mental hospital and including community-based services. 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 050 Inpatient substance abuse treatment services and residential substance abuse treatment services. 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 051 Personal care services 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 052 Primary care case management services 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 053 Targeted case management services 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 054 Case Management services other than those that meet the definition of primary care case management services or targeted case management services 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 055 Care coordination services 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 056 Transportation services 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 057 Enabling services 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 058 Services furnished in a religious nonmedical health care institution 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 060 Emergency hospital services 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 061 Critical access hospital services - OT 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 062 HCBS - Case management services 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 063 HCBS - Homemaker services 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 064 HCBS - Home health aide services 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 065 HCBS - Personal care services 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 066 HCBS - Adult day health services 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 067 HCBS - Habilitation services 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 068 HCBS - Respite care services 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 069 HCBS - Day treatment or other partial hospitalization services, psychosocial rehabilitation services and clinic services (whether or not furnished in a facility) for individuals with chronic mental illness 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 070 HCBS - Day Care 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 071 HCBS - Training for family members 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 072 HCBS - Minor modification to the home 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 073 HCBS - Other services requested by the agency and approved by CMS as cost effective and necessary to avoid institutionalization 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 074 HCBS - Expanded habilitation services - Prevocational services 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 075 HCBS - Expanded habilitation services - Educational services 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 076 HCBS - Expanded habilitation services - Supported employment services, which facilitate paid employment 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 077 HCBS-65-plus - Case management services 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 078 HCBS-65-plus - Homemaker services 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 079 HCBS-65-plus - Home health aide services 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 080 HCBS-65-plus - Personal care services 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 081 HCBS-65-plus - Adult day health services 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 082 HCBS-65-plus - Respite care services 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 083 HCBS-65-plus - Other medical and social services 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 084 Sterilizations 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 085 Prenatal care and pre-pregnancy family planning services and supplies. 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 086 Other Pregnancy-related Procedures 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 087 Hospice services 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 088 Any other health care services or items specified by the Secretary and not excluded under regulations. 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 089 Disposable medical supplies. 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 115 Residential care 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 127 Indian Health Service (IHS) - Family Plan 01/01/0001 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 136 In vitro diagnostic products (as defined in section 809.3(a) of title 21, Code of Federal Regulations) administered during any portion of the emergency period defined in paragraph (1)(B) of section 1135(g) beginning on or after the date of the enactment of this subparagraph for the detection of SARS–CoV–2 or the diagnosis of the virus that causes COVID–19, and the administration of such in vitro diagnostic products 03/18/2020 12/31/9999
TYPE-OF-SERVICE-OT Type of Service OT List 137 COVID–19 testing-related services 03/18/2020 12/31/9999
TYPE-OF-SERVICE-RX Type of Service RX List 011 Family planning services and supplies for individuals of child-bearing age 01/01/0001 12/31/9999
TYPE-OF-SERVICE-RX Type of Service RX List 018 Home health services - Medical supplies, equipment, and appliances suitable for use in the home 01/01/0001 12/31/9999
TYPE-OF-SERVICE-RX Type of Service RX List 033 Prescribed drugs 01/01/0001 12/31/9999
TYPE-OF-SERVICE-RX Type of Service RX List 034 Over-the-counter medications. 01/01/0001 12/31/9999
TYPE-OF-SERVICE-RX Type of Service RX List 036 Medical equipment/prosthetic devices 01/01/0001 12/31/9999
TYPE-OF-SERVICE-RX Type of Service RX List 085 Prenatal care and pre-pregnancy family planning services and supplies. 01/01/0001 12/31/9999
TYPE-OF-SERVICE-RX Type of Service RX List 089 Disposable medical supplies. 01/01/0001 12/31/9999
TYPE-OF-SERVICE-RX Type of Service RX List 127 Indian Health Service (IHS) - Family Plan 01/01/0001 12/31/9999
TYPE-OF-SERVICE-RX Type of Service RX List 136 In vitro diagnostic products (as defined in section 809.3(a) of title 21, Code of Federal Regulations) administered during any portion of the emergency period defined in paragraph (1)(B) of section 1135(g) beginning on or after the date of the enactment of this subparagraph for the detection of SARS–CoV–2 or the diagnosis of the virus that causes COVID–19, and the administration of such in vitro diagnostic products 03/18/2020 12/31/9999
TYPE-OF-SERVICE-RX Type of Service RX List 137 COVID–19 testing-related services 03/18/2020 12/31/9999
TYPE-OF-SERVICE-RX Type of Service RX List 145 Medication Assisted Treatment (MAT) services and drugs for evidenced-based treatment of Opioid Use Disorder (OUD) in accordance with section 1905(a)(29) of the Social Security Act 10/01/2020 12/31/9999
UNIT-OF-MEASURE Unit of Measure List EA Each 01/01/0001 12/31/9999
UNIT-OF-MEASURE Unit of Measure List F2 International Unit 01/01/0001 12/31/9999
UNIT-OF-MEASURE Unit of Measure List GM Grams 01/01/0001 12/31/9999
UNIT-OF-MEASURE Unit of Measure List GR Gram 01/01/0001 12/31/9999
UNIT-OF-MEASURE Unit of Measure List ME Milligram 01/01/0001 12/31/9999
UNIT-OF-MEASURE Unit of Measure List ML Milliliter 01/01/0001 12/31/9999
UNIT-OF-MEASURE Unit of Measure List See "VVL_Code_Description" field This data element's valid value code set is maintained by a Code Set Maintenance Organization (CSMO), the official licensing organization for specific valid value code sets. The CSMO is the system of record for those specific valid value code sets. While T-MSIS endeavors to be in-sync with CMSO's updates, minor delays may occur but that shouldn't block T-MSIS data submissions using the CSMO's latest version.

For background and context, see https://www.ncpdp.org/		 N/A N/A
UNIT-OF-MEASURE NDC Unit of Measure List UN Unit 01/01/0001 12/31/9999
VALUE-BASED-PAYMENT-MODEL-TYPE Value Based Payment Model Type List 2A FFS/Q&V Foundational payments for infrastructure and operations 01/01/0001 12/31/9999
VALUE-BASED-PAYMENT-MODEL-TYPE Value Based Payment Model Type List 2B FFS/Q&V Pay for reporting 01/01/0001 12/31/9999
VALUE-BASED-PAYMENT-MODEL-TYPE Value Based Payment Model Type List 2C FFS/Q&V Pay for performance 01/01/0001 12/31/9999
VALUE-BASED-PAYMENT-MODEL-TYPE Value Based Payment Model Type List 3A APM/FFS APMs with Shared savings 01/01/0001 12/31/9999
VALUE-BASED-PAYMENT-MODEL-TYPE Value Based Payment Model Type List 3B APM/FFS APMs with shared savings and downside risk 01/01/0001 12/31/9999
VALUE-BASED-PAYMENT-MODEL-TYPE Value Based Payment Model Type List 3N APM/FFS Risk based payments NOT linked to quality 01/01/0001 12/31/9999
VALUE-BASED-PAYMENT-MODEL-TYPE Value Based Payment Model Type List 4A POP/PAY Condition-specific population-based payment 01/01/0001 12/31/9999
VALUE-BASED-PAYMENT-MODEL-TYPE Value Based Payment Model Type List 4B POP/PAY Comprehensive population-based payment 01/01/0001 12/31/9999
VALUE-BASED-PAYMENT-MODEL-TYPE Value Based Payment Model Type List 4C POP/PAY Integrated finance and delivery system 01/01/0001 12/31/9999
VALUE-BASED-PAYMENT-MODEL-TYPE Value Based Payment Model Type List 4N POP/PAY Capitated payments NOT linked to quality 01/01/0001 12/31/9999
VETERAN-IND Veteran Indicator List 0 No 01/01/0001 12/31/9999
VETERAN-IND Veteran Indicator List 1 Yes 01/01/0001 12/31/9999
WAIVER-TYPE Waiver Type List 01 1115 Other demonstration 01/01/0001 12/31/9999
WAIVER-TYPE Waiver Type List 02 1915(b)(1) - These waivers permit freedom-of-choice or mandatory managed care with some voluntary managed care. 01/01/0001 12/31/9999
WAIVER-TYPE Waiver Type List 03 1915(b)(2) - These waivers allow states to use enrollment brokers. 01/01/0001 12/31/9999
WAIVER-TYPE Waiver Type List 04 1915(b)(3) - These waivers allow states to use savings to provide additional services that are not in the State Plan. 01/01/0001 12/31/9999
WAIVER-TYPE Waiver Type List 05 1915(b)(4) - These waivers allow fee for service selective contracting. 01/01/0001 12/31/9999
WAIVER-TYPE Waiver Type List 06 1915(c)-Aged and Disabled 01/01/0001 12/31/9999
WAIVER-TYPE Waiver Type List 07 1915(c)-Aged 01/01/0001 12/31/9999
WAIVER-TYPE Waiver Type List 08 1915(c)-Physical Disabilities 01/01/0001 12/31/9999
WAIVER-TYPE Waiver Type List 09 1915(c)-Intellectual Disabilities 01/01/0001 12/31/9999
WAIVER-TYPE Waiver Type List 10 1915(c)-Intellectual and Developmental Disabilities 01/01/0001 12/31/9999
WAIVER-TYPE Waiver Type List 11 1915(c)-Brain Injury 01/01/0001 12/31/9999
WAIVER-TYPE Waiver Type List 12 1915(c)-HIV/AIDS 01/01/0001 12/31/9999
WAIVER-TYPE Waiver Type List 13 1915(c)-Technology Dependent or Medically Fragile 01/01/0001 12/31/9999
WAIVER-TYPE Waiver Type List 14 1915(c)-Disabled (other) 01/01/0001 12/31/9999
WAIVER-TYPE Waiver Type List 15 1915(c)-Enrolled in 1915(c) waiver for unspecified or unknown populations 01/01/0001 12/31/9999
WAIVER-TYPE Waiver Type List 16 1915(c)-Autism/Autism spectrum disorder 01/01/0001 12/31/9999
WAIVER-TYPE Waiver Type List 17 1915(c)-Developmental Disabilities 01/01/0001 12/31/9999
WAIVER-TYPE Waiver Type List 18 1915(c)-Mental Illness-Age 18 or Older 01/01/0001 12/31/9999
WAIVER-TYPE Waiver Type List 19 1915(c)-Mental Illness-Under Age 18 01/01/0001 12/31/9999
WAIVER-TYPE Waiver Type List 20 1915(c) waiver concurrent with an 1115 or 1915(b) managed care authority 01/01/0001 12/31/9999
WAIVER-TYPE Waiver Type List 21 1115 HIFA Waiver - The associated Waiver-ID is for a HIFA (Health Insurance and Flexibility and Accountability) waiver. May also be called demonstration waiver or refer to the eligibility expansion. 01/01/0001 12/31/9999
WAIVER-TYPE Waiver Type List 22 1115 Pharmacy demonstration 01/01/0001 12/31/9999
WAIVER-TYPE Waiver Type List 23 1115 Disaster-related demonstration 01/01/0001 12/31/9999
WAIVER-TYPE Waiver Type List 24 1115 Family planning demonstration 01/01/0001 12/31/9999
WAIVER-TYPE Waiver Type List 25 1115 Substance use demonstration 01/01/0001 12/31/9999
WAIVER-TYPE Waiver Type List 26 1115 Premium Assistance demonstration 01/01/0001 12/31/9999
WAIVER-TYPE Waiver Type List 27 1115 Beneficiary engagement demonstration 01/01/0001 12/31/9999
WAIVER-TYPE Waiver Type List 28 1115 Former foster care youth from another state 01/01/0001 12/31/9999
WAIVER-TYPE Waiver Type List 29 1115 Managed long term services and support 01/01/0001 12/31/9999
WAIVER-TYPE Waiver Type List 30 1115 Delivery system reform 01/01/0001 12/31/9999
WAIVER-TYPE Waiver Type List 31 1332 Demonstration 01/01/0001 12/31/9999
WAIVER-TYPE Waiver Type List 32 1915(b) waiver 01/01/0001 12/31/9999
WAIVER-TYPE Waiver Type List 33 1915(c) waiver 01/01/0001 12/31/9999
ZIP-CODE Zip Code List See "VVL_Code_Description" field This data element's valid value code set is maintained by a Code Set Maintenance Organization (CSMO), the official licensing organization for specific valid value code sets. The CSMO is the system of record for those specific valid value code sets. While T-MSIS endeavors to be in-sync with CMSO's updates, minor delays may occur but that shouldn't block T-MSIS data submissions using the CSMO's latest version.

For background and context,
https://tools.usps.com/zip-code-lookup.htm?bycitystate		 N/A N/A
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