Medicaid Managed Care Capitated Payment Amount— Other Services

This variable is contained in the following files:

Medicare-Medicaid Linked Enrollee Analytic Data Source 3.0

SAS Name

MDCD_OT_MC_CAPTD_SPEND

This variable is the total Medicaid payment amount from all Other Services (OT) claims for capitated payments for the beneficiary during the year.

Comments

CCW calculates this variable as the sum of all MDCD_PD_AMT from the OT header claims that are for managed care capitated payments. These are header claims where the claim type code (T-MSIS variable called CLM_TYPE_CD) is equal to '2' (Medicaid or expansion claim) 'B' (S-CHIP claim) or 'V' (Other Services claim). MMLEADS may count claims (in the MDCD_OT_MC_CAPTD_USE variable) for which there is no corresponding payment information.

Values: $

Source: T-MSIS Other Services Claims file (derived)