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Data Element
CIP214
CIP.002.214
Definition | A free-form text field to indicate the health home program that authorized payment for the service on the claim or to identify the health home SPA in which an individual is enrolled. The name entered should be the name that the state uses to uniquely identify the team. A "Health Home 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). Because an identification numbering schema has not been established, the entities' names are being used instead. |
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Size | X(50) |
FLF Start Position | 1263 |
FLF Stop Position | 1312 |
Segment Key Field Identifier | Not Applicable |
Coding Requirements | 1. Value must not contain a pipe or asterisk symbols 2. Value must 50 characters or less 3. Conditional |
Valid Value Code Set | Valid Value Code | Valid Value Name | Valid Value Description | Effective Start Date | Effective End Date |
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DE Number | System DE Number | DE Name | File Segment Number | File Segment Name |
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CLT161 | CLT.002.161 | HEALTH-HOME-ENTITY-NAME | CLT00002 | CLAIM-HEADER-RECORD-LT |
COT138 | COT.002.138 | HEALTH-HOME-ENTITY-NAME | COT00002 | CLAIM-HEADER-RECORD-OT |
CRX096 | CRX.002.096 | HEALTH-HOME-ENTITY-NAME | CRX00002 | CLAIM-HEADER-RECORD-RX |
ELG108 | ELG.006.108 | HEALTH-HOME-ENTITY-NAME | ELG00006 | HEALTH-HOME-SPA-PARTICIPATION-INFORMATION |
ELG119 | ELG.007.119 | HEALTH-HOME-ENTITY-NAME | ELG00007 | HEALTH-HOME-SPA-PROVIDERS |