MC064

Data ElementCapitation Amount
Description

Fee for service equivalent that would have been paid by the healthcare claims processor for a specific service, if the service had not been capitated. "Capitated services" means services rendered by a provider through a contract where payments are based upon a fixed dollar amount for each member on a periodic basis. This is a money field containing dollars and cents. Code decimal point. This field may contain a negative value. $0.00 is a valid value. If record does not meet the dependency, do not populate with $0.00. Leave NULL.

If this field is changed in the versioning process and the dollars must be voided or backed out, the value should be represented as a negative.

TypeNumeric
Format±decimal
Length10,2
Threshold100% if MC206 = Y
RequiredRequired
Tip / Notes
Rank083