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MC064

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Data ElementCapitation Amount
Description

Fee for service equivalent that would have been paid by the health care claims processor for a specific service if the service had not been capit“ted. "Capitated se”vices" 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
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