HL7 Terminology (THO)
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This page is part of the HL7 Terminology (v5.5.0: Release) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

: CMS Hierarchical Condition Categories - XML Representation

Active as of 2024-01-26

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<CodeSystem xmlns="http://hl7.org/fhir">
  <id value="cmshcc"/>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p>This case-sensitive code system <code>http://terminology.hl7.org/CodeSystem/cmshcc</code> defines codes, but no codes are represented here</p></div>
  </text>
  <url value="http://terminology.hl7.org/CodeSystem/cmshcc"/>
  <identifier>
    <system value="urn:ietf:rfc:3986"/>
    <value value="urn:oid:2.16.840.1.113883.6.349"/>
  </identifier>
  <version value="1.1.0"/>
  <name value="CMSHCC"/>
  <title value="CMS Hierarchical Condition Categories"/>
  <status value="active"/>
  <experimental value="false"/>
  <date value="2024-01-26T00:00:00-00:00"/>
  <publisher value="Centers for Medicare &amp; Medicaid Services"/>
  <contact>
    <name
          value="Centers for Medicare &amp; Medicaid Services; 7500 Security Boulevard, Baltimore, MD 21244"/>
  </contact>
  <description
               value="The CMS-HCC model uses more than 9,000 ICD-10-CM codes, which are mapped to condition categories that predict costs well. The condition categories are based on diagnoses clinically related to one another and with similar predicted cost implications. Hierarchies are imposed on the condition categories to capture the most costly diagnoses. Hierarchy logic is imposed on certain condition categories to account for different hierarchical costs, thus, the term Hierarchical Condition Category, or HCC.

For more information, see https://www.cms.gov/Medicare/Health-Plans/MedicareAdvtgSpecRateStats/Risk-Adjustors.

The CMS HCCs are in the public domain and are free to use without restriction."/>
  <caseSensitive value="true"/>
  <content value="not-present"/>
</CodeSystem>