CLT.003.215

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 3.27.0

SERVICING-PROV-TYPE

Data Element

DE Number

CLT215

System DE Number

CLT.003.215

File Name

CLT - CLAIM LONG-TERM CARE

File Segment Number

File Segment Name

CLAIM-LINE-RECORD-LT

Last updated

No Updates

Overview Valid Values Related Rules Related DQ Measures Other Instances

Definition	A code to describe the type of provider being reported.
Size	X(2)
FLF Start Position	330
FLF Stop Position	331
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value must be in Provider Type Code List (VVL). 2. Value must be 2 characters 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-1251	If the servicing provider type is populated on a claim line from an LT file, then the servicing provider type value reported must be in the list of valid values.
RULE-6347	If a claim line is a non-denied claim line from an LT file, then the servicing provider type value reported must be compatible with specified T-MSIS picture format: X(2).

Measure ID	Measure Name
MIS-5-018-18	% missing: SERVICING-PROV-TYPE (CLT00003)
MIS-24-017-17	% missing: SERVICING-PROV-TYPE (CLT00003)
MIS-82-016-16	% missing: SERVICING-PROV-TYPE (CLT00003)

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
CIP263	CIP.003.263	SERVICING-PROV-TYPE	CIP00003	CLAIM-LINE-RECORD-IP
COT192	COT.003.192	SERVICING-PROV-TYPE	COT00003	CLAIM-LINE-RECORD-OT

Published Date	Data Guide Version	Data Element	Action	Field	Before	After