CLT.002.157

An official website of the United States government

Official websites use .gov
A .gov website belongs to an official government organization in the United States.

Secure .gov websites use HTTPS
A lock () or https:// means you've safely connected to the .gov website. Share sensitive information only on official, secure websites.

TMSIS Dataguide

Medicaid.gov

Version 3.36.0

TOT-BENEFICIARY-DEDUCTIBLE-PAID-AMOUNT

Data Element

DE Number

CLT157

System DE Number

CLT.002.157

File Name

CLT - CLAIM LONG-TERM CARE

File Segment Number

File Segment Name

CLAIM-HEADER-RECORD-LT

Last updated

Overview Valid Values Related Rules Related DQ Measures Other Instances

Definition	The amount the beneficiary or his or her representative (e.g., their guardian) paid towards their copayment for the covered services on the claim. Do not include copayment payments made by a third party/ies on behalf of the beneficiary.
Size	S9(11)V99
FLF Start Position	994
FLF Stop Position	1006
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value must be between -99999999999.99 and 99999999999.99 2. Value must be expressed as a number with 2-digit precision (e.g. 100.50) 3. Conditional

Valid Value Code Set	Valid Value Code	Valid Value Name	Valid Value Description	Effective Start Date	Effective End Date

RULE ID	RULE Definition
RULE-1164	If a claim is a non-denied claim from an LT file, then the total beneficiary deductible paid amount value reported must be compatible with specified T-MSIS picture format: S9(11)V99.

Measure ID	Measure Name
MIS-4-006-6	% missing: TOT-BENEFICIARY-DEDUCTIBLE-PAID-AMOUNT (CLT00002)
MIS-23-006-6	% missing: TOT-BENEFICIARY-DEDUCTIBLE-PAID-AMOUNT (CLT00002)
MIS-81-006-6	% missing: TOT-BENEFICIARY-DEDUCTIBLE-PAID-AMOUNT (CLT00002)

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
CIP210	CIP.002.210	TOT-BENEFICIARY-DEDUCTIBLE-PAID-AMOUNT	CIP00002	CLAIM-HEADER-RECORD-IP
COT134	COT.002.134	TOT-BENEFICIARY-DEDUCTIBLE-PAID-AMOUNT	COT00002	CLAIM-HEADER-RECORD-OT
CRX092	CRX.002.092	TOT-BENEFICIARY-DEDUCTIBLE-PAID-AMOUNT	CRX00002	CLAIM-HEADER-RECORD-RX

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
09/12/2024	3.29.0	CLT.002.157	UPDATE	Coding requirement	1. Value must be between -99999999999.99 and 99999999999.992. Value must be expressed as a number with 2-digit precision (e.g. 100.50 )3. Conditional	1. Value must be between -99999999999.99 and 99999999999.992. Value must be expressed as a number with 2-digit precision (e.g. 100.50)3. Conditional
09/07/2023	3.12.0	CLT.002.157	UPDATE	Definition	The amount the beneficiary or his or her representative (e.g., their guardian) paid towards their copayment for the covered services on the claim. Do not include copayment payments made by a third party/s on behalf of the beneficiary.	The amount the beneficiary or his or her representative (e.g., their guardian) paid towards their copayment for the covered services on the claim. Do not include copayment payments made by a third party/ies on behalf of the beneficiary.
06/24/2022	3.0.0	CLT157/ TOT-BENEFICIARY-DEDUCTIBLE-PAID-AMOUNT	Rename DE	Data Dictionary - Record Layout	DE No\|Data Element Name CLT157\|BENEFICIARY-DEDUCTIBLE-AMOUNT	DE No\|Data Element Name CLT157\|TOT-BENEFICIARY-DEDUCTIBLE-PAID-AMOUNT
06/24/2022	3.0.0	CLT157	UPDATE	Data Dictionary	\|DE NO\| DATA ELEMENT NAME\|DEFINITION CLT157\|BENEFICIARY-DEDUCTIBLE-AMOUNT\|The amount of money the beneficiary paid towards an annual deductible.	\|DE NO\| DATA ELEMENT NAME\|DEFINITION CLT157\|TOT-BENEFICIARY-DEDUCTIBLE-PAID-AMOUNT\|The amount the beneficiary or his or her representative (e.g., their guardian) paid towards their deductible for the covered services on the claim. Do not include deductible payments made by a third party/ies on behalf of the beneficiary.