Wiki List of HCC with value

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KoBee

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Hello -

Looking to find a list from CMS or another source that has a list of all HCCs with their value raf score. Does anyone know where i can find this or would like to share. To help see which diagnosis has a higher value. as our system doesnt help to show the score for each dx. Maybe I can create a cheat sheet.


Appreciate it so much
 
The attached files contain HCC values from CMS-HCC Version 24 and Version 28. These values are not diagnosis-only based, but instead represent RAF values that vary by beneficiary population type.

Each entry (e.g., CNA_HCC137) reflects a combination of:
  • The diagnosis category (HCC137), and
  • The demographic and enrollment status of the patient (e.g., dual eligibility, disability status, institutional vs. community living).
Below is a breakdown of the population codes used:
  • CNA_HCC137: Community Non-Dual Aged
    • Patient is community-dwelling, aged, and not dually eligible (Medicare only).
  • CFA_HCC137: Community Full Benefit Dual Aged
    • Aged patient in the community with full Medicare and Medicaid coverage.
  • CFD_HCC137: Community Full Benefit Dual Disabled
    • Disabled patient in the community with full dual eligibility.
  • CPA_HCC137: Community Partial Benefit Dual Aged
    • Aged patient in the community with partial Medicaid coverage.
  • CPD_HCC137: Community Partial Benefit Dual Disabled
    • Disabled patient in the community with partial Medicaid coverage.
  • CND_HCC137: Community Non-Dual Disabled
    • Disabled patient in the community with Medicare only (no Medicaid).
  • INS_HCC137: Institutional
    • Beneficiary resides in a long-term care institution.
Always consider both the diagnosis and the demographic/enrollment context when reviewing or interpreting RAF values. The same HCC diagnosis may yield different RAF scores depending on the patient’s population segment. This distinction is critical for accurate risk score forecasting and model integrity.
 
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