ELG.003.038

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TMSIS Dataguide

Medicaid.gov

Version 3.27.0

INCOME-CODE

Data Element

DE Number

ELG038

System DE Number

ELG.003.038

File Name

File Segment Number

File Segment Name

VARIABLE-DEMOGRAPHICS-ELIGIBILITY

Last updated

Overview Valid Values Related Rules Related DQ Measures Other Instances

Definition	A code indicating the federal poverty level range in which the family income falls. If the beneficiary's income was assessed using multiple methodologies (MAGI and Non-MAGI), report the income that applies to their primary eligibility group. A beneficiary’s income is applicable unless it is not required by the eligibility group for which they were determined eligible. For example, the eligibility groups for children with adoption assistance, foster care, or guardianship care under title IV-E and optional eligibility for individuals needing treatment for breast or cervical cancer do not have a Medicaid income test. Additionally, for individuals receiving SSI, states with section 1634 agreements with the Social Security Administration (SSA) and states that use SSI financial methodologies for Medicaid determinations do not conduct separate Medicaid financial eligibility for this group.
Size	X(2)
FLF Start Position	104
FLF Stop Position	105
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value must be in Income 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-2044	If the income code is populated on a variable demographics eligibility file, then the income code reported must be found in the list of valid values.
RULE-6344	If a segment is a variable demographics eligibility segment from an ELG file, then the income code value reported must be compatible with the specified T-MSIS picture format: X(2).

Measure ID	Measure Name
MIS-1-011-11	% distinct MSIS IDs with only missing values in any active segment: INCOME-CODE (ELG00003)

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
07/14/2023	3.10.0	ELG.003.038	UPDATE	Definition	A code indicating the family income level.	A code indicating the federal poverty level range in which the family income falls.If the beneficiary's income was assessed using multiple methodologies (MAGI and Non-MAGI), report the income that applies to their primary eligibility group.A beneficiary’s income is applicable unless it is not required by the eligibility group for which they were determined eligible. For example, the eligibility groups for children with adoption assistance, foster care, or guardianship care under title IV-E and optional eligibility for individuals needing treatment for breast or cervical cancer do not have a Medicaid income test. Additionally, for individuals receiving SSI, states with section 1634 agreements with the Social Security Administration (SSA) and states that use SSI financial methodologies for Medicaid determinations do not conduct separate Medicaid financial eligibility for this group.
05/10/2023	3.7.0	ELG.003.038	UPDATE	Necessity	Mandatory	Conditional
05/10/2023	3.7.0	ELG.003.038	UPDATE	Coding requirement	1. Value must be in Income Code List (VVL)2. Value must be 2 characters3. Mandatory	1. Value must be in Income Code List (VVL)2. Value must be 2 characters3. Conditional
07/14/2023	3.10.0	ELG038	UPDATE	Data Dictionary	DE No\|DE Name\|Definition\| ELG038\|INCOME-CODE\|A code indicating the family income level.	DE No\|DE Name\|Definition\| ELG038\|INCOME-CODE\|A code indicating the federal poverty level range in which the family income falls. If the beneficiary's income was assessed using multiple methodologies (MAGI and Non-MAGI), report the income that applies to their primary eligibility group. A beneficiary’s income is applicable unless it is not required by the eligibility group for which they were determined eligible. For example, the eligibility groups for children with adoption assistance, foster care, or guardianship care under title IV-E and optional eligibility for individuals needing treatment for breast or cervical cancer do not have a Medicaid income test. Additionally, for individuals receiving SSI, states with section 1634 agreements with the Social Security Administration (SSA) and states that use SSI financial methodologies for Medicaid determinations do not conduct separate Medicaid financial eligibility for this group.