Program Codes
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Program Codes


Revised December 17, 2013



Cash Assistance

 

Food Assistance

 

Medical Assistance

 

MAGI Medical

 


Cash Assistance Program Codes

Program Codes

Program Types

Program Type Definitions

Med Cvrg Group Code

Medical Coverage Group Definition

AF (TANF - Temporary Assistance for Needy Families)

R

Regular

F01

TANF Medicaid

(Invalid as of 9/30/2013)

P

Pregnant

F01

TANF Medicaid

(Invalid as of 9/30/2013)

F

Regular - Mixed Fed & SFA

F01

TANF Medicaid

(Invalid as of 9/30/2013)

AF (TANF)

(No longer valid)

G

Pregnancy - Mixed Fed & SFA

F01

TANF Medicaid

AF (TANF)

6

Regular - SFA Only

F01

TANF Medicaid

(Invalid as of 9/30/2013)

7

Pregnancy - SFA Only

F01

TANF Medicaid

(Invalid as of 9/30/2013)

9

 State Funded

F01

Child Relinquished for Adoption

(Invalid as of 9/30/2013)

DA (Diversion Cash Assistance)

R

Regular

-----

----------

P

Pregnancy

-----

----------

EA (CEAP)

R

Regular

-----

----------

GA (Disability Lifeline)

(Invalid as of 10/31/2011)

U

Unemployable

G01

Medical Care Services Unemployed (based on living arrangement)

R

Regular

G01

Categorically Needy Medical - Child Under 19

A

Aged

G02

Categorically Needy ABD Medical

B

Blind

G02

Categorically Needy ABD Medical

D

Disabled

G02

Categorically Needy ABD Medical

X

Pending SSI

G02

Categorically Needy ABD Medical

GA (Aged, Blind, Disabled)

A

Aged

G02

Categorically Needy ABD Medical

B

Blind

G02

Categorically Needy ABD Medical

D

Disabled

G02

Categorically Needy ABD Medical

X

Pending SSI

G02

Categorically Needy ABD Medical

GI (Institution for the Mentally Diseased)

A

Aged in an IMD

I01

Aged in an Institution for the Mentally Diseased

K

Kids in an IMD

I01

Kids in an Institution for the Mentally Diseased

GS (Pregnant Women)

P

Pregnancy/Family Planning

-----

----------

GW (ADATSA)

 

 

W

Treatment

W01

ADATSA Medical

Y

Inpatient

W01

ADATSA Medical

Z

Shelter

W01

ADATSA Medical

RF (Refugee)

R

Regular

R01

Refugee Medical

(Invalid as of 9/30/2013)

SSP (SSI State Supplement Payment

 

 

I

Ineligible Spouse

 

 

M

Mandatory Income Level

 

 

A

Aged (65 or Over)

 

 

B

Blind

 

 

 

Basic Food Program Codes

Program Codes

Program Types

Program Type Definitions

 

Med Cvrg Group Code

Medical Coverage Group Definition

FS (Food Assistance)

C

Total PA FS Household

-----

----------

FS (Food Assistance)

S

Non PA FS Household

-----

----------

FS (Food Assistance)

T

SSI / FS

-----

----------

FS (Food Assistance)

F

Total PA Household Mixed FS and FAP

-----

----------

FS (Food Assistance)

G

Non PA Household Mixed FS and FAP

-----

----------

FS (Food Assistance)

J

SSI Household Mixed FS and FAP

-----

----------

FS (Food Assistance)

6

Total PA Household FAP Only

-----

----------

FS (Food Assistance)

7

Non PA Household FAP Only

-----

----------

FS (Food Assistance)

8

SSI Household FAP Only

-----

----------

 

Medical Assistance Program Codes

Program Codes

Program Types

Program Type Definitions

Med Cvrg Group Code

Medical Coverage Group Definition

MA [Foster Care (FC) / Adoption Support (AS) / Juvenile Rehabilitation (JR)]

1

IV-E FC Federal Funded

D01

Title IV-E Foster Care Medical SSI Related CN

D02

Title IV-E Foster Care Medical Non-SSI Related

MA [Foster Care (FC) / Adoption Support (AS) /Juvenile Rehabilitation (JR)]

2

Non IV-E FC State Funded

D01

Non IV-E Foster Care Medical SSI Related CN

D02

Non IV-E Foster Care Medical Non SSI Related

MA [Foster Care (FC) / Adoption Support (AS) / Juvenile Rehabilitation (JR)]

3

IV-E AS Federal Funded

D01

Title IV-E Adoption Support Medical SSI Related CN

D02

Title IV-E Adoption Support Medical Non SSI Related

MA [Foster Care (FC) / Adoption Support (AS) / Juvenile Rehabilitation (JR)]

4

Non IV-E Adoption Support State Funded

D01

Non IV-E State Funded Adoption Support Medical SSI Related CN

D02

Non IV-E State Funded Adoption Support Medical Non SSI Related

MA [Foster Care (FC) / Adoption Support (AS) / Juvenile Rehabilitation (JR)]

5

Juvenile Rehabilitation

D01

SSI Related CN Medical Juvenile Rehabilitation

D02

Non SSI Related Medical Juvenile Rehabilitation

Family Related MA

(E no longer valid)

R, P

Regular, Pregnant

F02

Transitional Medicaid

Family Related MA

F

Regular  Mixed Fed & SFA

F02

TANF Related

Family Related MA

(No longer valid)

G

Pregnancy  Mixed Fed & SFA

F02

TANF Related

J

Employable Mixed Fed & SFA

F02

TANF Related

Family Related MA

6

Regular  SFA Only

F02

TANF Related

7

Pregnancy  SFA Only

F02

TANF Related

Family Related MA

(No longer valid)

8

Employable SFA Only

F02

TANF Related

Family Related MA

(E, employable, no longer valid)

R, P

Regular, Pregnant

F03

Post TANF Child / Spousal Support

Family Related MA

F

Regular  Mixed Fed & SFA

F03

TANF Related

Family Related MA

(No longer valid)

G

Pregnancy Mixed Fed & SFA

F03

TANF Related

J

Employable  Mixed Fed & SFA

F03

TANF Related

Family Related MA

6

Regular SFA Only

F03

TANF Related

7

Pregnancy  SFA Only

F03

TANF Related

Family Related MA

(No longer valid)

8

Employable SFA Only

F03

TANF Related

Family Related MA

(E, employable, no longer valid)

R, P

Regular, Pregnant

F04

TANF Related

Family Related MA

F

Regular Mixed Fed & SFA

F04

TANF Related

Family Related MA

(No longer valid)

G

Pregnancy  Mixed Fed & SFA

F04

TANF Related

J

Employable  Mixed Fed & SFA

F04

TANF Related

Family Related MA

6

Regular SFA Only

F04

TANF Related

7

Pregnancy  SFA Only

F04

TANF Related

Family Related MA

(No longer valid)

8

Employable SFA Only

F04

TANF Related

Family Related MA

R

Regular

F05

Newborns

F06

Categorically Needy (CN) for Children

F07

Children's Health Insurance Program (CHIP)

Family Related MA

(No longer valid – 9/30/02)

R

Regular

F08

Undocumented Alien Children

Family Related MA

R

Regular

F09

Undocumented Alien

Family Related MA

R, P

Regular, 
Pregnancy

F10

TANF Related

F

Regular
Mixed Fed & SFA

F10

TANF Related

6

Regular 
SFA Only

F10

TANF Related

7

Pregnancy 
SFA Only

F10

TANF Related

Family Related MA

(Invalid as of 12/31/00)

R

Regular

F20

Family Medical Project

Family Related MA

R, P, E

Regular, Pregnant, Employable

F95

Medically Needy Zero Spenddown

F99

Medically Needy Spenddown

Medical Care Services MA

U

Unemployable

G01

Medical Care Services Unemployed

R

Regular

G01

Categorically Needy Medical – Child Under 19

SSI Related Non-Institutional Alternate Living Facility MA

 

A, B, D

Aged, Blind, Disabled

G03

Categorically Needy ALF

G95

Medically Needy Zero Spenddown ALF

G99

Medically Needy with Spenddown ALF

Medically Indigent MA

(Invalid as of 07/01/2003)

R

Regular

M99

Medically Indigent

Pregnant MA

 

 

 

 

 

 

 

 

 

 

P

 

 

 

 

 

 

 

 

 

Pregnant

 

 

 

 

 

 

 

 

 

P02

Pregnant 185% + Postpartum Extension

P04

Undocumented Alien Pregnant Woman

P05

Family Planning Extension

P99

Medically Needy Pregnant Woman + Postpartum Extension

Pregnant MA

 

P

Family Planning

P06

Take Charge Family Planning Service Only

Psychiatric Indigent Inpatient MA

R

Regular

M99

Psychiatric Indigent Inpatient

Refugee MA

R

Regular

R02

Transitional 4 Month Extension

R03

Refugee Categorically Needy

SSI Related  MA

A, B, D

Aged, Blind, Disabled

S01

SSI Recipient

M

Aged with  Cash Payment

S01

SSI Recipient

N

Blind with Cash Payment

S01

SSI Recipient

O

Disabled with Cash Payment

S01

SSI Recipient

A, B, D

Aged, Blind, Disabled

S02

ABD Categorically Needy

A, B, D

Aged, Blind, Disabled

S03

Qualified Medicare Beneficiary (QMB) - Medicare Cost Sharing

A, B, D

Aged, Blind, Disabled

S04

Qualified Disabled Working Individual (QDWI) - Medicare Cost Sharing

A, B, D

Aged, Blind, Disabled

S05

Special Medicare Beneficiary (SLMB) - Medicare Cost Sharing

A, B, D

Aged, Blind, Disabled

S06

Expanded Special Medicare Beneficiary (ESLMB) - Medicare Cost Sharing

A, B, D

Aged, Blind, Disabled

S07

Undocumented Alien

HWD 

A, B, D

Aged, Blind, Disabled

S08

CN - Requires Premium Payment by Client

SSI Related  MA 

A, B, D

Aged, Blind, Disabled

S95

Medically Needy - Zero Spenddown

S99

Medically Needy - with Spenddown

ADATSA  (Medical Assistance)

W

Treatment

W02

ADATSA Medical Care

Z

Shelter

W01

ADATSA Medical Care

DETOX

I

DETOX - Hospital Payment Only

W03

DETOX

Home & Community Based Waiver MA

 

(Invalid as of 02/01/2011)

A, B, D

Aged, Blind, Disabled

C01

Categorically Needy Home & Community Based Waiver (COPES, CAP, OBRA, and Hospice)

M

Aged with Cash Payment

C01

Categorically Needy Home & Community Based Waiver (COPES, CAP, OBRA, and Hospice)

N

Blind with Cash Payment

C01

Categorically Needy Home & Community Based Waiver (COPES, CAP, OBRA, and Hospice)

O

Disabled with Cash Payment

C01

Categorically Needy Home & Community Based Waiver (COPES, CAP, OBRA, and Hospice)

A, B, D

Aged, Blind, Disabled

C95

Hospice Services No Spenddown

C99

Hospice Services with Spenddown

Family Long Term Care MA

R, K, P

Regular, Kids, Pregnant

K01

Categorically Needy Family Long Term Care

F, G, 6, 7

See F04 MA Cvrg. Grps. for Prgm. Type Description

K01

Categorically Needy Family Long Term Care

Family Long Term Care MA 

(No longer valid)

J

Kids Mixed Fed & SFA

K01

Categorically Needy Family Long Term Care

8

Kids - SFA Only

K01

Categorically Needy Family Long Term Care

Family Long Term Care MA

R, K, P

Regular, Kids, Pregnant

K03

Undocumented Alien Family Long Term Care

F, G, 6, 7

See F04 MA Cvrg. Grps. for Prgm. Type Description

K03

Undocumented Alien Family Long Term Care

Family Long Term Care MA

J

Kids Mixed Fed & SFA

K03

Undocumented Alien Family Long Term Care

8

Kids - SFA Only

K03

Undocumented Alien Family Long Term Care

Family Long Term Care MA

R, K, P

Regular, Kids, Pregnant

K95

Family Long Term Care Zero Spenddown

F, G, 6, 7

See F04 MA Cvrg. Grps. for Prgm. Type Description

K95

Family Long Term Care Zero Spenddown

Family Long Term Care MA 

(No longer valid)

J

Kids Mixed Fed & SFA

K95

Family Long Term Care Zero Spenddown

8

Kids - SFA Only

K95

Family Long Term Care Zero Spenddown

Family Long Term Care MA

R, K, P

Regular, Kids, Pregnant

K99

Family Long Term Care with Spenddown

F, G, 6, 7

See F04 MA Cvrg. Grps. for Prgm. Type Description

K99

Family Long Term Care with Spenddown

Family Long Term Care MA

(No longer valid)

J

Kids Mixed Fed & SFA

K99

Family Long Term Care with Spenddown

8

Kids - SFA Only

K99

Family Long Term Care with Spenddown

Long Term Care SSI Related MA

A, B, D

Aged, Blind, Disabled

L01

SSI Long Term Care

M

Aged with Cash Payment

L01

SSI Long Term Care

O

Disabled with Cash Payment

L01

SSI Long Term Care

Home & Community Based Waiver MA

A, B, D

M, N, O

 

 

Aged, Blind, Disabled

 

 

L21*

SSI Long Term Care

Categorically Needy Home & Community Based Waiver (COPES, DDD, and Hospice)

Home & Community Based Waiver MA

M, N, O

 

Aged, Blind, Disabled

With Cash Payment

L21*

SSI Long Term Care

Categorically Needy Home & Community Based Waiver (COPES, DDD, and Hospice)

Home & Community Based Waiver MA

A, B, D

Aged, Blind, Disabled

L22*

Categorically Needy Home & Community Based Waiver (COPES, DDD, and Hospice)

State Funded Long Term Care

A, B, D

Aged Blind, Disabled

L24

State Funded Long Term Care at home or Alternate Living Facility

Long Term Care SSI Related MA

A, B, D

Aged, Blind, Disabled

L02

Categorically Needy  Long Term Care

L04

State Funded Long Term Care in facility or hospital

L95

Long Term Care – No  Spenddown

Hospice MN

L99

Long Term Care with Spenddown

Hospice MN

Medically Needy Hospice – Institutional

A, B, D

Aged, Blind, Disabled

L95*

MN Hospice – No Spenddown

L99*

MN Hospice – with Spenddown

Breast and Cervical Cancer Treatment Program (BCCTP)

R

Regular

S30

Categorically Needy 

* When Hospice is the priority program, HOSPICE displays on the STAT and ELIG screen.

 

Modification Date: December 17, 2013