Risk Adjustment (HCC) & MIPS
The AAPC-style add-ons on our own engine: a CMS-HCC / ESRD-HCC / Rx-HCC risk-score (RAF) calculator, and a MIPS measures lookup by code, keyword, or measure number.
CMS-HCC v28/v22, ESRD-HCC v24 and RxHCC v8 are loaded from the official CMS packages — real
relative factors, hierarchies, interactions and the full ICD-10→HCC crosswalk. v28 adds the restructured
HCCs and the payment-count (D1–D10+) factors; v22 stays available for the legacy blend. ESRD-HCC and
RxHCC use continuing-enrollee segments — pick the segment (dialysis / graft state, or Part D LIS
status) that matches the enrollee. HHS-HCC (marketplace) is still a seed; the "seed model" tag flags it.
Always confirm against the CMS software before payment use. MIPS is a starter measure set — replace with
the full QPP/AAPC list.
HCC Risk Calculator
Risk score
Enter demographics + diagnoses, then Calculate RAF.
MIPS Value Pathway (MVP)
2026 BHW status: MVPs remain reference/future-readiness tools here. BHW is currently opt-in eligible rather than required to report, so the Quality Command Center does not represent M0005 as registered or currently available for submission.
Select a pathway.
MIPS measure lookup
Search Quality / Cost / Improvement Activities / Promoting Interoperability by measure number, keyword, or CPT/HCPCS code.
Type to search the measure set.