Hierarchical Condition Category (HCC) Coding is the risk adjustment methodology used by the Centers for Medicare and Medicaid Services (CMS) and other programs to determine the annual capitated payments for Medicare Advantage beneficiaries and to determine expected costs in Medicare Shared Savings Programs (ACOs) and newer Alternative Payment Models (APMs). Capturing HCC scores for your patients accurately reflects the severity of care to ensure appropriate funds are available for complex populations and helps your practice be more successful in APM participation or value-based models. This tool was developed to define what conditions carry a risk adjustment weight and provide common example diagnosis codes for home-based primary care. Understanding which conditions risk adjust will help your practice improve their diagnosis coding accuracy and reflect the severity of the complex patient population in which you provide care.

HCCIntelligence™ Premier Tools and Tip Sheets can be purchased individually. We encourage you to take advantage of the discount pricing available through our bundles. If you purchase an individual resource, and then subsequently purchase its associated bundle, please understand HCCI is unable to issue a refund or adjust pricing.