PROFESSIONAL PART B B CROSSOVER OUTPATIENT PART B C CROSSOVER UB-04 D DENTAL HOME HEALTH AND COMMUNITY H HEALTH I HOSPITAL INPATIENT L LONG TERM CARE M PHYSICIAN O HOSPITAL OUTPATIENT P PHARMACY Q COMPOUND DRUG CLAIMS Required when submitter is MassHealth Rate Report the value that defines the MC Rate 10/30/14 Rate Text varchar[3] and 100% A2 Code Indicator element. Code code = 002 and MC246 = I or A Report MC here. This validates the Record type of file and the data contained MC 6/24/10 Text ID File char[2] File Type Identifier All 100% A0 Type within the file. This must match HD004. Record Trailer Record Report here. Indicates the end of TR 1 6/24/10 Text ID Record char[2] Mandatory 100% TM Type Identifier the data file.
B PROFESSIONAL PART B CROSSOVER C OUTPATIENT PART B CROSSOVER UB-04 D DENTAL H HOME HEALTH AND COMMUNITY HEALTH I HOSPITAL INPATIENT L LONG TERM CARE M PHYSICIAN O HOSPITAL OUTPATIENT P PHARMACY Q COMPOUND DRUG CLAIMS MC Rate Code 10/30/14 Rate code Text varchar[3] MassHealth Rate Code Indicator Report the value that defines the element. Required when submitter is and = 002 and MC246 = I or A 100% A2 MC Record Type 6/24/10 Text ID File char[2] File Type Identifier Report MC here. This validates the type of file and the data contained within the file. This must match HD004. All 100% A0 1 Record Type 6/24/10 Text ID Record char[2] Trailer Record Identifier Report TR here. Indicates the end of the data file. Mandatory 100% TM
v6-apcd-medical-claim-file-submission-guide-FINAL.docx