Managed Care Plan Type Category Code

SAS Name
MC_PLAN_TYPE_CTGRY_CD

Managed Care Plan Type Category Code — Aggregated categories based on the managed care plan type values (MC_PLAN_TYPE_CD); most recent in the calendar year.

Comments

This field is derived from the MC_PLAN_TYPE_CD using the following logic: 1 if MC_PLAN_TYPE_CD equals 01, 04, 17

2 if MC_PLAN_TYPE_CD equals 02, 03

3 if MC_PLAN_TYPE_CD equals 05, 06

4 if MC_PLAN_TYPE_CD equals 07, 19

5 if MC_PLAN_TYPE_CD equals 08, 09, 10, 11, 12, 13

6 if MC_PLAN_TYPE_CD equals 14

7 if MC_PLAN_TYPE_CD equals 15

8 if MC_PLAN_TYPE_CD equals 16

9 if MC_PLAN_TYPE_CD equals 18

10 if MC_PLAN_TYPE_CD equals 60

11 if MC_PLAN_TYPE_CD equals 70

12 if MC_PLAN_TYPE_CD equals 80

13 if MC_PLAN_TYPE_CD equals 20

Source: T-MSIS Annual Managed Care Plan TAF

Code Code value
1 Comprehensive medical care
2 PCCM
3 Medical only prepaid health plan
4 LTC PIHP
5 Mental health and/or SUD plan
6 Dental PAHP
7 Transportation PAHP
8 Disease management PAHP
9 Pharmacy PAHP
10 Accountable Care Organization
11 Health home or medical home
12 Integrated care for dual eligible
13 Other
Null/missing Unknown/Missing