HCC Risk Stratification Calculator
Estimate a patient’s CMS-HCC RAF (Risk Adjustment Factor) score and Medicare Advantage revenue impact based on Hierarchical Condition Categories and patient demographics. Uses approximate V28 model coefficients for educational purposes.
Patient Demographics
Demographic coefficient: 0.527
HCC Categories
RAF Score
Est. MA Revenue Impact
Based on ~$11,000 national MA benchmark. Actual payment varies by county, plan type, and CMS rate book.
Select HCC categories from the list to add conditions to this score.
Demographic baseline only is shown above.
Educational use only. This calculator uses approximate CMS-HCC V28 community coefficients and a national average Medicare Advantage benchmark. Actual risk scores and payments depend on the specific MA plan, county benchmark, plan bid, and CMS reconciliation. HCC coding requires supporting clinical documentation. Do not report diagnoses that are not clinically supported.
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