Benefit Plan Codes
The Benefit Plan Codes are organized in numerical order by Code number.
| Code | Benefit Plan Name | Short Name |
| 01-01-0100 | AIDS Waiver | AIDS Waiver |
| 01-01-0100 | CDPASS Waiver | CDPAS Waiver |
| 01-01-0100 | Elderly and Disabled Waiver | Aged Waiver |
| 01-01-0100 | IFDSS Waiver | IFDDS Waiver |
| 01-01-0100 | Intensive Assisted Living | Intensive AL |
| 01-01-0100 | Medicaid - CMM Pharmacy | XIX CMM Rx |
| 01-01-0100 | Medicaid - CMM Physician | XIX CMM Phys |
| 01-01-0100 | Medicaid - CMM Transportation | XIX CMM tran |
| 01-01-0100 | Medicaid - ICF | XIX ICF |
| 01-01-0100 | Medicaid - Out of State Provider | XIX OS Prov |
| 01-01-0100 | Medicaid - SNF | XIX SNF |
| 01-01-0100 | Medicaid Fee for Service | Medicaid FFs |
| 01-01-0100 | Medicaid Long Stay Hospital | XIX LS Hosp |
| 01-01-0100 | MR Waiver | MR Waiver |
| 01-01-0100 | Regular Assisted Living | Regular AL |
| 01-01-0100 | Technology Assisted Waiver | Vent Waiver |
| 01-01-0200 | Partial Medicare Premium | Prt Med Prem |
| 01-01-0300 | Medicare Premium | Med Premium |
| 01-01-0400 | Medicare Coinsurance & Deductibles | Med Co & Ded |
| 01-01-0500 | HIPP Premium Payments | HIPP Premium |
| 01-01-3000 | Medicaid FFS Emergency Services Only | XIX FFS Emer |
| 01-01-3001 | Medicaid FFS Dialysis Services Only | XIX FFS Dial |
| 01-01-3002 | Family Planning Waiver | Fmly Pln Wvr |
| 01-02-0600 | Medicaid - Medallion PCP | XIX PCP |
| 01-03-0801 | Medicaid - Medallion II Tidewater | XIX Tidewtr |
| 01-03-0803 | Medicaid - Medallion II Central | XIX Central |
| 01-03-0805 | Medicaid - Medallion II USWVA | XIX USWVA |
| 01-03-0807 | Medicaid - Medallion II Halifax | XIX Halifax |
| 01-04-0702 | Medicaid - Medallion III MCO Northern Virginia | XIX M-3 NOVA |
| 01-04-0704 | Medicaid - Medallion III MCO CDPR | XIX M-3 CDPR |
| 01-04-0706 | Medicaid - Medallion III MCO LSWVA | XIX M-3 LSWV |
| 01-04-0799 | Medicaid - Default Mandatory Medallion III MCO | XIX M-3 MCO |
| 01-05-2000 | Pre-PACE | Pre-PACE |
| 01-05-2001 | PACE | PACE |
| 01-07-0600 | Medicaid - Medallion III PCP | XIX M-3 PCP |
| 02-00-0000 | Temporary Detention Order | TDO |
| 03-00-0000 | State and Local Hospital | SLH |
| 04-00-0000 | HIV Premium | HIV Premium |
| 05-06-0000 | Regular Assisted Living | Reg Assist L |
| 06-00-0000 | Health Insurance Demonstration Program | HIDP |
| 07-01-0100 | FAMIIS - Out of State Provider | FAMIS OS Prv |
| 07-01-0100 | FAMIS - CMM Pharmacy | FAMIS CMM Rx |
| 07-01-0100 | FAMIS - CMM Physician | FAMIS CMM Py |
| 07-01-0100 | FAMIS - CMM Transportation | FAMIS CMM Tr |
| 07-01-0100 | FAMIS - Fee for Service | FAMIS FFS |
| 07-01-0100 | FAMIS - ICF | FAMIS ICF |
| 07-01-0100 | FAMIS - Long Stay Hospital | FAMIS LS Hos |
| 07-01-0100 | FAMIS - Regular Assisted Living | FAMIS Reg AL |
| 07-01-0100 | FAMIS - SNF | FAMIS SNF |
| 07-01-0500 | FAMIS HIPP Premium Payments | FAMIS HIPP P |
| 07-02-0600 | FAMIS - Medallion PCP | FAMIS PCP |
| 07-03-0801 | FAMIS - Medallion II Tidewater | FAMIS Tidewr |
| 07-03-0802 | FAMIS - Medallion II Northern Virginia | FAMIS NorVa |
| 07-03-0803 | FAMIS - Medallion II Central | FAMIS Centra |
| 07-03-0804 | FAMIS - Medallion II CDPR | FAMIS - CDPR |
| 07-03-0805 | FAMIS - Medallion II USWVA | FAMIS - USWV |
| 07-03-0806 | FAMIS - Medallion II LSWVA | FAMIS - LSWV |
| 07-03-0807 | FAMIS - Medallion II Halifax | FAMIS - Hair |
| 07-03-0899 | FAMIS - Default Mandatory MCO | FAMIS - MCO |
| 07-03-0899 | Medicaid - Default Mandatory MCO | XIX Def MCO |
| 07-04-0799 | FAMIS - Default Medallion III MCO | FAMIS M3 MCO |
| 08-00-1001 | Assessments Nursing Home Level 1 | ASM NH LVL 1 |
| 08-00-1002 | Assessments Nursing Home Level 2 | FAMIS Reg AL |
| 08-00-1003 | ACR Assessments | ASM ACR ASSM |
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VCU-VISSTA. All rights reserved. Last Modified: June 3, 2003 Send comments to VISSTA Media Lab |
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