HCC Calculator

1. The CMS-HCC risk adjustment model is used to calculate risk scores to adjust capitated payments made for aged and disabled beneficiaries enrolled in Medicare Advantage (MA) plans and certain demonstrations. Risk Adjustments, in addition, are used to access an illness or severity and comparing classifications of diseases using diagnosis codes. Using the risk adjustment calculator offers support on how to accurately code and report risk and HEDIS. The Risk Calculator offers a tool that gives you the ability to search for risk calculations on an individual.

2. The HCC Calculator is located under the 'Coding Tools' Tab

3. Select your model. Supported Models: CMS-HCC - Used to calculate the risk score for Medicare beneficiaries ESRD- HCC- Used to derive risk assessment on End-stage renal disease Rx-HCC Used for prescription drug hierarchical conditions for risk adjustment programs

4. Select your code set

5. Select your diagnosis codes and patient information      
 

6. Click 'Calculate' to see your results

7. You can Print your results

8. The HCC Calculator is available with the Pro Fee and Complete Coder Annual Subscriptions.