01 = Comprehensive Managed Care Organization (MCO)
02 = Traditional Primary Care Case Management (PCCM) Provider arrangement
03 = Enhanced PCCM Provider arrangement
04 = Health Insuring Organization (HIO)
05 = Medical-only Prepaid Inpatient Health Plan (PIHP) (risk or non-risk/non-comprehensive/with
inpatient hospital or institutional services)
06 = Medical-only Prepaid Ambulatory Health Plan (PAHP) (risk or non-risk/non-comprehensive/no
inpatient hospital or institutional services)
07 = Long-Term Care (LTC) PIHP
08 = Mental health (MH) PIHP
09 = Mental health (MH) PAHP
10 = Substance use disorders (SUD) PIHP
11 = Substance use disorders (SUD) PAHP
12 = Mental health (MH) and substance use disorders (SUD) PIHP
13 = Mental health (MH) and substance use disorders (SUD) PAHP
14 = Dental PAHP
15 = Transportation PAHP
16 = Disease Management PAHP
17 = Program of All-Inclusive Care for the Elderly (PACE)
18 = Pharmacy PAHP
19 = Individual is enrolled in Long-Term Services and Supports (LTSS) and mental health (MH) PIHP
20 = Other
60 = Accountable care organization (ACO)
70 = Health/Medical Home
80 = Integrated care for dual eligibles
Null/missing = source value is missing or unknown

Only one managed care plan type is selected each month from up to 16 monthly managed care plan
type codes (note that this managed care plan type code detail is contained in the DE ― Managed Care
Supplemental File). A priority list, derived for the DE base file is used. The values for the monthly
managed care plan type codes are set according to the hierarchy below:
1) Comprehensive Managed Care Organization (MCO)
2) Health Insuring Organization (HIO)
3) Medical-only Prepaid Inpatient Health Plan (PIHP)
4) Medical-only Prepaid Ambulatory Health Plan (PAHP)
5) Transportation PAHP
6) Long-Term Care (LTC) PIHP
7) Dental PAHP
8) Program of All-Inclusive Care for the Elderly (PACE)
9) Mental health (MH) PIHP
10) MH PAHP
11) Substance use disorders (SUD) PIHP
12) SUD PAHP
13) MH and SUD PIHP
14) MH and SUD PAHP
15) Individual is enrolled in long-term services and supports (LTSS) and mental health (MH) PIHP
16) Pharmacy PAHP
17) Disease Management PAHP
18) Traditional Primary Care Case Management (PCCM) Provider
19) Enhanced PCCM provider
20) Accountable care organization (ACO)
21) Health/Medical home (HH)
22) Integrated care for dual eligibles
23) Other
24) Null values