US · guidance
CMS Pub. 100-24, ch. 3, § 3.5.8
Personal Characteristics Change Record (RIC-E)
This reply record is designed to demonstrate that the information provided by the state
differs in some fashion to the information stored on the EDB. Thus, state record
information is displayed as provided in the first set of field values, and CMS EDB
information is displayed in the second set of field values.
Item Field Size Position Format Description
1 Medicare Number
from State Record
12 1-12 Alpha-numeric
The Medicare number
will consist of a nine-position numeric value
followed by an alpha-numeric BIC. Positions
11 and 12 may be blank.
If the beneficiary is
entitled under a RRB
claim number, this field
may consist of an 11-position alpha-numeric
pseudo HICN. The value
in this field will be the
value submitted by the
state on the incoming
transaction.
2 Surname from
State Record
24 13-36 Alpha-numeric
A maximum of 24 alpha-numeric characters. The
value in this field will be
the value submitted by
the state on the incoming
transaction.
Item Field Size Position Format Description
3 Given Name from
State Record
15 37-51 Alphabetic A maximum of 15
alphabetic characters.
The value in this field
will be the value
submitted by the state on
the incoming transaction.
4 Middle Initial
from State Record
1 52 Alphabetic An alphabetic character.
The value in this field
will be the value
submitted by the state on
the incoming transaction.
5 Sex Code from
State Record
1 53 Alphabetic A one-position
alphabetic code (male =
“M,” female = “F”).
The value in this field
will be the value
submitted by the state on
the incoming transaction.
6 Date of Birth from
State Record
8 54-61 Numeric An eight-position
numeric field,
CCYYMMDD (e.g.,
November 1, 2019 will be
displayed as 20191101).
The value in this field
will be the value
submitted by the state on
the incoming transaction.
7 Beneficiary’s
Social Security
Number from State
Record
9 62-70 Numeric A nine-position numeric
field. The value in this
field will be the value
submitted by the state on
the incoming transaction.
8 Filler 2 71-72 Positions reserved for
future use.
Item Field Size Position Format Description
9 Agency Code 3 73-75 Alpha-numeric or
Numeric
A three-position alpha-numeric or numeric code
assigned to the state
which has jurisdiction
over the account.
10 Record
Identification
Code “E”
1 76 Alphabetic “E” constant. The “E”
identifies this record as a
personal characteristics
change record.
11 Filler 5 77-81 Numeric Positions reserved for
future use.
12 Surname from
CMS Records
24 82-105 Alpha-Numeric
A twenty-four-position
alpha-numeric field that
will convey the
beneficiary's surname
exactly as it is appears
on the EDB. Any unused
positions will be blank.
13 Given Name from
CMS Records
15 106-120 Alphabetic A fifteen-position
alphabetic field that will
convey the beneficiary’s
given name exactly as it
appears on the EDB.
Any unused positions will
be blank.
14 Middle Initial
from CMS
Records
1 121 Alphabetic A one-position
alphabetic field that will
convey the beneficiary's
middle initial exactly as
it appears on the EDB.
15 Sex Code from
CMS Records
1 122 Alphabetic A one-position
alphabetic code (male =
“M,” female = “F”)
which will convey the
beneficiary’s sex code as
it appears on the EDB.
Item Field Size Position Format Description
16 Date of Birth from
CMS Records
(CCYYMMDD)
8 123-130 Numeric An eight-position
numeric field that will
convey the beneficiary’s
date of birth exactly as it
appears on the EDB.
17 Beneficiary’s
Social Security
Number from CMS
Records
9 131-139 Numeric A nine-position numeric
field that will convey the
beneficiary's own SSN
exactly as it appears on
the EDB. This field may
be blank if the EDB does
not currently have the
beneficiary’s SSN.
18 Filler 1 140 Position reserved for
future use.
19 Agency Client
Identification
Number from State
Record
20 141-160 Alpha-numeric
The beneficiary’s client
(or Medicaid)
identification number or
any other identifier of the
state’s choice. The value
in this field will be the
value submitted by the
state on the incoming
transaction.
History
(Rev. 4, Issued: 08-21-20, Effective: 09-08-20, Implementation: 09-08-20)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
c697b222562d5f8fc28a7b1e50e4c91e48b60a474db212f79846dda16e531568
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