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TMSIS Dataguide Medicaid.gov
Version 3.27.0

FUNDING-SOURCE-NONFEDERAL-SHARE

Data Element

DE Number

CLT077

System DE Number

CLT.002.077

File Name

CLT - CLAIM LONG-TERM CARE

File Segment Number

CLT00002

File Segment Name

CLAIM-HEADER-RECORD-LT

Last updated

Overview Valid Values Related Rules Related DQ Measures Other Instances
Definition

A code to indicate the type of non-federal share used by the state to finance its expenditure to the provider. In the event of two sources, states are to report the portion which represents the largest proportion not funded by the Federal government.
Size X(2)
FLF Start Position 434
FLF Stop Position 435
Segment Key Field Identifier Not Applicable
Coding Requirements

1. Value must be in Funding Source Non-Federal Share List (VVL)
2. Value must be 2 characters

3. Value must be populated if TYPE-OF-CLAIM <> ‘3', ‘C’, ‘W’, or '6’
4. Conditional
Valid Value Code Set Valid Value Code Valid Value Name Valid Value Description Effective Start Date Effective End Date
DE Number System DE Number DE Name File Segment Number File Segment Name
CIP127 CIP.002.127 FUNDING-SOURCE-NONFEDERAL-SHARE CIP00002 CLAIM-HEADER-RECORD-IP
COT063 COT.002.063 FUNDING-SOURCE-NONFEDERAL-SHARE COT00002 CLAIM-HEADER-RECORD-OT
CRX054 CRX.002.054 FUNDING-SOURCE-NONFEDERAL-SHARE CRX00002 CLAIM-HEADER-RECORD-RX