MCR.004.058

MANAGED-CARE-SERVICE-AREA-NAME

Data Element

DE Number

MCR058

System DE Number

MCR.004.058

File Name

MCR - MANAGED CARE PLAN INFORMATION

File Segment Number

MCR00004

File Segment Name

MANAGED-CARE-SERVICE-AREA

Last updated

Overview Valid Values Related Rules Related DQ Measures Other Instances

Definition	The specific identifiers for the counties, cities, regions, ZIP Codes and/or other geographic areas that the managed care entity serves. Put each zip code, city, county, region, or other area descriptor on a separate record. Use 5 digit zip codes when service area definition is zip code based. Use ANSI codes when service area is defined by counties or cities The value reported in Managed Care Service Area should represent the geographical unit of the values reported in the Managed Care Service Area Name See T-MSIS Guidance Document, "CMS Guidance: Best Practice for Reporting Managed Care Service Area in the Managed Care File". https://www.medicaid.gov/medicaid/data-and-systems/macbis/tmsis/tmsis-blog/entry/47542
Size	X(30)
FLF Start Position	34
FLF Stop Position	63
Segment Key Field Identifier	3
Coding Requirements	1. Value must be in Managed Care Service Area Name List (VVL) 2. If associated Managed Care Service Area (MCR.002.029) is in [2,3,4,5,6], then value is mandatory and must be provided 3. Value must not contain a pipe or asterisk symbol 4. Value must be 30 characters or less 5. Conditional 6. If associated Managed Care Service Area (MCR.002.029) equals "5" (zipcode), then value must be a 5-digit zipcode 7. If associated Managed Care Service Area (MCR.002.029) equals "2" (county code), then value must be a 3-digit number

This data element's valid value code set is maintained by a Code Set Maintenance Organization (CSMO), the official licensing organization for specific valid value code sets. The CSMO is the system of record for those specific valid value code sets. While T-MSIS endeavors to be in-sync with CMSO's updates, minor delays may occur but that shouldn't block T-MSIS data submissions using the CSMO's latest version.

Managed Care Service Area Name List

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

RULE ID	RULE Definition
RULE-2632	If the managed care service area name is populated on the managed care service area file, then the managed care service area name reported must not contain any pipe or asterisk characters.
RULE-6447	If a segment is a managed care service area segment from an MCR file, then the managed care service area name value reported must be compatible with the specified T-MSIS picture format: X(30).
RULE-7168	If managed care service area is for county on a managed care main segment from an MCR file, then the managed care service area name value reported must be in the list of valid values for county.

Measure ID	Measure Name
MIS-10-012-12	% distinct STATE-PLAN-ID-NUMs with only missing values in any active segment: MANAGED-CARE-SERVICE-AREA-NAME (MCR00004)

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

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
09/12/2024	3.29.0	MCR.004.058	UPDATE	Coding requirement	1. Value must be in Managed Care Service Area Name List (VVL)2. If associated Managed Care Service Area (MCR.002.029) is in [ 2, 3, 4, 5, 6 ], then value is mandatory and must be provided3. Value must not contain a pipe or asterisk symbol4. Value must be 30 characters or less5. Conditional6. If associated Managed Care Service Area (MCR.002.029) equals '5' (zipcode), then value must be a 5-digit zipcode7. If associated Managed Care Service Area (MCR.002.029) equals '2' (county code), then value must be a 3-digit number	1. Value must be in Managed Care Service Area Name List (VVL)2. If associated Managed Care Service Area (MCR.002.029) is in [2,3,4,5,6], then value is mandatory and must be provided3. Value must not contain a pipe or asterisk symbol4. Value must be 30 characters or less5. Conditional6. If associated Managed Care Service Area (MCR.002.029) equals "5" (zipcode), then value must be a 5-digit zipcode7. If associated Managed Care Service Area (MCR.002.029) equals "2" (county code), then value must be a 3-digit number
09/21/2023	3.13.0	MCR.004.058	UPDATE	Segment key field identifier	Not Applicable	3