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Medicare Advantage & Part DSource-backed product

CMS-HCC Risk Adjustment Model

The diagnosis-to-HCC mappings and model coefficients used to translate member conditions into Medicare Advantage risk scores across model years.

What Vlada adds: Preserves the publisher data, normalizes schema eras and identifiers, and connects the product to compatible healthcare entities with measured join coverage.

rows
341.8K
rows
datasets
2
datasets
cadence
annual
cadence
coverage
2026
coverage

Publishers: Centers for Medicare & Medicaid Services

What's inside

ICD-10 to HCC crosswalk
CMS reference crosswalk mapping each ICD-10-CM diagnosis to its Hierarchical Condition Category under a specific risk-model version and payment year.
grain: One row per (icd_code, model_version, rate_year). 171,676 rows.
333.0K rows
HCC risk-model coefficients
CMS risk-adjustment COEFFICIENT tables (Part C HCC + Part D RxHCC).
grain: One row per (rate_year, model_version, variable, segment) = one risk-model coefficient. 8,805 rows.
8.8K rows