Topic

Risk adjustment

1 published article

From the 2020 CMS-HCC model (V24) to the 2024 CMS-HCC model (V28): 86 to 115 payment HCCs, and from 9,797 to 7,770 ICD-10-CM codes inside the payment model

Risk adjustmentAugust 10, 202613 min read

CMS-HCC V24 vs. V28: what changed and why it matters

The V28 model redefines which diagnoses generate an HCC, reorganizes categories, and changes how clinical risk is represented. We look at the main changes and their impact on Risk Adjustment coding.