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TMSIS Dataguide Medicaid.gov
Version 3.28.0

WAIVER-PARTICIPATION

File Segment

File Segment Number

ELG00012

File Name

ELG - ELIGIBLE

Last updated

No Updates

Data Elements Reference
DE Number System DE Number Data Element Definition Valid Values
ELG168 ELG.012.168 RECORD-ID The Record ID represents the type of segment being reported. The Record ID communicates how the contents of a given row of data should be interpreted depending on which segment type the Record ID represents. Each type of segment collects different data elements so each segment type has a distinct layout. The first 3 characters identify the relevant file (e.g., ELG, PRV, CIP, etc.). The last 5 digits are the segment identifier padded with leading zeros (e.g., 00001, 00002, 00003, etc.). ELG168 Values
ELG169 ELG.012.169 SUBMITTING-STATE A code that uniquely identifies the U.S. State or Territory from which T-MSIS system data resources were received. ELG169 Values
ELG170 ELG.012.170 RECORD-NUMBER

A sequential number assigned by the submitter to identify each record segment row in the submission file. The Record Number, in conjunction with the Record Identifier, uniquely identifies a single record within the submission file.

 N/A
ELG171 ELG.012.171 MSIS-IDENTIFICATION-NUM

A state-assigned unique identification number used to identify a Medicaid/CHIP enrolled individual (except on service tracking payments). Value may be an SSN, temporary SSN or State-assigned eligible individual identifier. MSIS Identification Numbers are a unique "key" value used to maintain referential integrity of data distributed over multiples files, segments and reporting periods. See T-MSIS Guidance Document, "CMS Guidance: Reporting Shared MSIS Identification Numbers" for information on reporting the MSIS Identification Numbers ID for pregnant women, unborn children, mothers, and their deemed newborns younger than 1 year of age who share the same MSIS Identification Number. https://www.medicaid.gov/medicaid/data-and-systems/macbis/tmsis/tmsis-blog/entry/47572

 N/A
ELG172 ELG.012.172 WAIVER-ID

Field specifying the waiver or demonstration which authorized payment for a claim. These IDs must be the approved, full federal waiver ID number assigned during the state submission and CMS approval process. Waiver IDs should actually only be the "core" part of the waiver IDs, without including suffixes for renewals or amendments.

 N/A
ELG173 ELG.012.173 WAIVER-TYPE Code for specifying waiver types under which the eligible individual is covered during the month. ELG173 Values
ELG174 ELG.012.174 WAIVER-ENROLLMENT-EFF-DATE The first calendar day on which all of the other data elements in the same segment were effective. N/A
ELG175 ELG.012.175 WAIVER-ENROLLMENT-END-DATE The last calendar day on which all of the other data elements in the same segment were effective. N/A
ELG176 ELG.012.176 STATE-NOTATION

A free text field for the submitting state to enter whatever information it chooses.

 N/A
Definition
A record to capture the identity of the waivers in which an eligible person is enrolled.

File Segment Length
1000