DOLLAR VALUE PLACED ON THE SERVICE BY THE PROVIDER.
(DISPLAY SIGNED NUMERIC) (SAS USERS: ZONED DECIMAL - ZD8)
Comments
USER NOTES: THIS PAYMENT AMOUNT IS > $0 ONLY FOR ENCOUNTER RECORDS. WHILE THIS PAYMENT AMOUNT COULD HAVE VALUE = $0 FOR SOME ENCOUNTER RECORDS, IT WILL ALWAYS HAVE VALUE = $0 FOR OTHER TYPES OF RECORDS. FOR RECORDS IN WHICH 'TYPE OF CLAIM CODE' = 3 (ENCOUNTER), THE MSIS VALUE OF 'AMOUNT-CHARGED' HAS BEEN MOVED TO DATA ELEMENT 'PREPAID PLAN SERVICE VALUE' AND MAX CHARGE AMOUNT HAS BEEN RESET TO VALUE = $0. SEE 'MEDICAID PAYMENT AMOUNT' AND 'CHARGE AMOUNT' FOR ADDITIONAL INFORMATION. AS A RESULT, MAX PREPAID PLAN SERVICE VALUE WILL HAVE VALUE >= $0 FOR ALL RECORDS WITH 'TYPE OF CLAIM CODE' = 3 (ENCOUNTER) AND VALUE = $0 FOR OTHER TYPE OF CLAIM VALUES, INCLUDING VALUE = 1 (FEE-FOR-SERVICE). DEPENDING ON THE PROVIDER AND TYPE OF PREPAID PLAN, THE DOLLAR AMOUNTS IN THIS DATA ELEMENT MAY HAVE DIFFERENT MEANINGS. FOR EXAMPLE, IN AN INDEPENDENT PRACTICE PLAN THE AMOUNT MAY BE A PROVIDER'S CHARGE TO THE PLAN. IN A STAFF MODEL PLAN, THE AMOUNT MAY BE A MEASURE OF RESOURCES USED. FOR THIS REASON, EXTREME CAUTION SHOULD BE EXERCISED WHEN USING THIS DATA ELEMENT.
NOTE: DURING MAX 1999-2011, WHEN THE MEDICAID PAYMENT AMOUNT (NOT THE CHARGE AMOUNT) ON ENCOUNTER RECORDS WAS GREATER THAN ZERO, THE MEDICAID PAYMENT AMOUNT WAS MOVED TO THE PREPAID PLAN SERVICE VALUE AND THE MEDICAID PAYMENT AMOUNT WAS RECODED TO ZERO.
SOURCE: RECODED AS NOTED ABOVE USING MSIS CLAIMS FILE.
USER NOTES: THIS PAYMENT AMOUNT IS > $0 ONLY FOR ENCOUNTER RECORDS. WHILE THIS PAYMENT AMOUNT COULD HAVE VALUE = $0 FOR SOME ENCOUNTER RECORDS, IT WILL ALWAYS HAVE VALUE = $0 FOR OTHER TYPES OF RECORDS. FOR RECORDS IN WHICH 'TYPE OF CLAIM CODE' = 3 (ENCOUNTER), THE MSIS VALUE OF 'AMOUNT-CHARGED' HAS BEEN MOVED TO DATA ELEMENT 'PREPAID PLAN SERVICE VALUE' AND MAX CHARGE AMOUNT HAS BEEN RESET TO VALUE = $0. SEE 'MEDICAID PAYMENT AMOUNT' AND 'CHARGE AMOUNT' FOR ADDITIONAL INFORMATION. AS A RESULT, MAX PREPAID PLAN SERVICE VALUE WILL HAVE VALUE >= $0 FOR ALL RECORDS WITH 'TYPE OF CLAIM CODE' = 3 (ENCOUNTER) AND VALUE = $0 FOR OTHER TYPE OF CLAIM VALUES, INCLUDING VALUE = 1 (FEE-FOR-SERVICE). DEPENDING ON THE PROVIDER AND TYPE OF PREPAID PLAN, THE DOLLAR AMOUNTS IN THIS DATA ELEMENT MAY HAVE DIFFERENT MEANINGS. FOR EXAMPLE, IN AN INDEPENDENT PRACTICE PLAN THE AMOUNT MAY BE A PROVIDER'S CHARGE TO THE PLAN. IN A STAFF MODEL PLAN, THE AMOUNT MAY BE A MEASURE OF RESOURCES USED. FOR THIS REASON, EXTREME CAUTION SHOULD BE EXERCISED WHEN USING THIS DATA ELEMENT.
NOTE: DURING MAX 1999-2011, WHEN THE MEDICAID PAYMENT AMOUNT (NOT THE CHARGE AMOUNT) ON ENCOUNTER RECORDS WAS GREATER THAN ZERO, THE MEDICAID PAYMENT AMOUNT WAS MOVED TO THE PREPAID PLAN SERVICE VALUE AND THE MEDICAID PAYMENT AMOUNT WAS RECODED TO ZERO.
SOURCE: RECODED AS NOTED ABOVE USING MSIS CLAIMS FILE.