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TMSIS Dataguide Medicaid.gov
Version 3.27.0

TOT-BENEFICIARY-COPAYMENT-LIABLE-AMOUNT

Data Element

DE Number

CLT239

System DE Number

CLT.002.239

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 The total copayment amount on a claim that the beneficiary is obligated to pay for covered services. This is the total Medicaid or contract negotiated beneficiary copayment liability for covered service on the claim. Do not subtract out any payments made toward the copayment.
Size S9(11)V99
FLF Start Position 1707
FLF Stop Position 1719
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
DE Number System DE Number DE Name File Segment Number File Segment Name
CIP292 CIP.002.292 TOT-BENEFICIARY-COPAYMENT-LIABLE-AMOUNT CIP00002 CLAIM-HEADER-RECORD-IP
COT230 COT.002.230 TOT-BENEFICIARY-COPAYMENT-LIABLE-AMOUNT COT00002 CLAIM-HEADER-RECORD-OT
CRX163 CRX.002.163 TOT-BENEFICIARY-COPAYMENT-LIABLE-AMOUNT CRX00002 CLAIM-HEADER-RECORD-RX