Program Codes
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Program Codes

Revised January 14, 2008

Purpose:

Cash Assistance

Food Assistance

Medical Assistance

 

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
P Pregnant F01 TANF Medicaid
F Regular - Mixed Fed & SFA F01 TANF Medicaid
AF (TANF)

(No longer valid)

 G Pregnancy - Mixed Fed & SFA F01 TANF Medicaid
AF (TANF) 6 Regular - SFA Only F01 TANF Medicaid
7 Pregnancy - SFA Only F01 TANF Medicaid
9  State Funded F01 Child Relinquished for Adoption
DA (Diversion Cash Assistance) R Regular ----- ----------
P Pregnancy ----- ----------
EA (CEAP) R Regular ----- ----------
GA (General Assistance) 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
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) (Invalid effective 5/1/99) P Pregnant P01 Categorically Needy PW Medical
GW (ADATSA) W Treatment W01 ADATSA Medical
Y Inpatient W01 ADATSA Medical
Z Shelter W01 ADATSA Medical
RF (Refugee) R Regular R01 Refugee Medical
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 - 09/30/02)

 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
General Assistance 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 Services 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 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
Long Term Care SSI Related MA A, B, D Aged, Blind, Disabled L02 Categorically Needy  Long Term Care
L04 Undocumented Alien Long Term Care
L95 Long Term Care  Zero Spenddown
L99 Long Term Care with Spenddown

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Modification Date: January 14, 2008
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