Dataset: California Medicaid Eligibility Groups By Medi-Cal Aid Code

About this Dataset

California Medicaid Eligibility Groups By Medi-Cal Aid Code

This dataset identifies California’s eligibility groups by aid code. California uses aid codes to account for eligibility group populations and the eligibility requirements, scope of benefits, services, costs, claims, encounter data, and managed care arrangements related to those populations. Aid codes in this dataset are mapped to the Transformed Medicaid Statistical Information System (T-MSIS) eligibility group descriptions and codes. California uses this mapping to submit claims data, enrollee encounter data, and supporting information to the Centers for Medicare & Medicaid Services (CMS), as required by Section 4735 of the Balanced Budget Act of 1997 and Section 6504 of the Affordable Care Act for the purpose of program integrity, program oversight, and administration. This dataset includes aid codes that do not have Medi-Cal benefits or have benefits and are not federal programs. Some aid codes may appear to be identical but possess distinct benefits or grouping factors. An aid code may appear more than once if multiple populations are represented in one aid code and can be identified and mapped to distinct T-MSIS groups.
Organization: State of California
Last updated: 2024-11-26T22:13:59.354595
Tags: aid-codes, california-department-of-health-care-services, dhcs, eligibility, medi-cal, medicaid, t-msis, transformed-medicaid-statistical-information-system

Tables

California Medicaid Eligibility Groups By Medi-Cal Aid Code

@usgov.ca_gov_california_medicaid_eligibility_groups_by_medi__3b065495.california_medicaid_eligibility_groups_by_medi_cal_aid_code

26.82 KB
387 rows
11 columns


CREATE TABLE california_medicaid_eligibility_groups_by_medi_cal_aid_code (
  "aid_code" VARCHAR,
  "aid_code_name" VARCHAR,
  "benefits" VARCHAR,
  "eligibility_group" VARCHAR,
  "short_description" VARCHAR,
  "group_code" VARCHAR,
  "type" VARCHAR,
  "federal_category" VARCHAR,
  "medicaid_or_chip" VARCHAR,
  "social_security_act_citation" VARCHAR,
  "code_of_federal_regulations_citation" VARCHAR
);

TMSIS Change Log For California Medicaid Eligibility Groups By Medi-Cal Aid Code

@usgov.ca_gov_california_medicaid_eligibility_groups_by_medi__3b065495.tmsis_change_log_for_california_medicaid_eligibility_g_902e214b

5.2 KB
21 rows
2 columns


CREATE TABLE tmsis_change_log_for_california_medicaid_eligibility_g_902e214b (
  "date" TIMESTAMP,
  "tmsis_change_description" VARCHAR
);