FAA6.K Code Listings : 09 PMMIS Eligibility Codes : A PMMIS Eligibility Key Codes
A PMMIS Eligibility Key Codes
PMMIS Eligibility Key Codes are as follows:
 
Code
Description
040
LTC SSI Aged
050
LTC SSI Blind
060
LTC SSI Disabled
080
LTC CA
085
LTC 1931
090
LTC SSI Aged
100
LTC Child
110
LTC Deprived
120
LTC Pregnant
130
LTC SSI Blind
140
LTC SSI Disabled
200
Acute SSI Aged
210
Acute SSI Blind
220
Acute SSI Disabled
231
Acute 1931
232
Acute 1931E
260
Acute Adoption Subsidy
265
Acute State Adoption Subsidy
270
Acute Foster
275
Acute YATI
305
Acute C.O.B.R.A. Foster
320
Acute Four Month Continuation Support
325
Acute S.O.B.R.A. HIFA Parent
327
Acute KidsCare HIFA Parent
332
Acute Six Month Continuation (1st Extension)
334
Acute Six Month Continuation (2nd Extension)
350
Acute S.O.B.R.A. Children
351
Acute SC Expanded
355
Acute DES S.O.B.R.A. Newborn
357
Acute DES Newborn
360
Acute S.O.B.R.A. Pregnancy
361
Acute S.O.B.R.A. Pregnancy Expanded
368
Acute KidsCare
370
Acute SSI Aged
371
Acute SSI MAO (AHCCCS Care SA, Medically Indigent)
372
Acute SSI MAO Expanded (AHCCCS Care SM)
375
Acute SSI MAO Aged Expanded
380
Acute SSI Aged Pickle
382
Acute SSI Aged Exparte
390
Acute SSI Blind
392
Acute SSI Blind Exparte
393
Acute SSI Blind Freedom To Work
394
Acute SSI Blind Appeal
395
Acute S.O.B.R.A. Expanded
400
Acute SSI Blind Pickle
403
Acute SSI Disabled Freedom To Work
410
Acute SSI Disabled
415
Acute SSI Disabled Expanded
420
Acute SSI Disabled Pickle
422
Acute SSI Disabled Exparte
424
Acute SSI Disabled Appeal
426
Acute SSI Disabled Adult Child
428
Acute SSI Disabled Child
430
Acute SSI Disabled Widow(er)
431
Acute SSI Disabled Aged Widow(er)
432
Acute SSI Blind Widow(er)
440
Acute Newborn
445
Acute S.O.B.R.A. Newborn
447
S.O.B.R.A. HIFA Newborn
450
Acute SSI Newborn
455
Acute KidsCare Newborn
460
Acute Six Month Guarantee
461
Acute Expanded Six Month Guarantee
462
Acute S.O.B.R.A. Child Six Month Guarantee
463
Acute AHCCCS Care Six Month Guarantee
464
Acute S.O.B.R.A. Pregnant Six Month Guarantee
467
Acute AHCCCS Care Medically Indigent Six Month Guarantee
468
Acute KidsCare 12 Month Guarantee
470
Acute SSI Aged Six Month Guarantee
471
Acute SSI Aged Expanded Six Month Guarantee
472
Acute MED Six Month Guarantee
480
Acute SSI Blind Six Month Guarantee
481
Acute SSI Blind Expanded Six Month Guarantee
482
Acute SSI Blind Freedom To Work Six Month Guarantee
485
Acute SSI Newborn Six Month Guarantee
490
Acute SSI Disabled Six Month Guarantee
491
Acute SSI Disabled Expanded Six Month Guarantee
492
Acute SSI Disabled Freedom To Work Six Month Guarantee
560
Acute BC Patient
565
Acute CC Patient
570
Acute CL Patient
575
Acute SSDI TMC
581
Transplant Option 1
582
Transplant Option 2
585
Acute AHCCCS Care (AC)
587
Acute AHCCCS Care Medically Indigent (AM)
595
Acute MED
725
LTC SSI Blind Freedom To Work
735
LTC SSI Disabled Freedom To Work
740
LTC Cash
800
QMB Only
810
QMB Only - Aged
820
QMB Only - Blind
830
QMB Only - Disabled
840
SLMB
850
Ql1
900
Acute Emergency Services Undocumented
905
Acute Emergency Services Pregnancy Undocumented
908
Acute Emergency Services Non-pregnancy
910
Acute SSI Aged Emergency Services Undocumented
911
Acute SSI Aged Emergency Services Expanded
915
Acute SSI Blind Emergency Services Expanded
916
Acute SSI Blind Emergency Services Expanded
920
Acute SSI Disabled Emergency Services Undocumented
921
Acute SSI Disabled Emergency Services Expanded