HL7 Terminology (THO)
5.5.0 - Publication International flag

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. For a full list of available versions, see the Directory of published versions

CodeSystem: Chronic Illness and Disability Payment System (CDPS)

Official URL: http://terminology.hl7.org/CodeSystem/CDPS Version: 1.0.0
Active as of 2023-08-22 Responsible: UC San Diego Computable Name: CDPS

Copyright/Legal: For licensing CDPS including MRX and CDPS+MRx, please contact Subramanian (Subbu) Venkatraman at: suvenkatraman@ucsd.edu

“The Chronic Illness and Disability Payment System (CDPS) is a diagnostic-based risk adjustment model that is widely used to adjust capitated payments for health plans that enroll Medicaid beneficiaries.

CDPS uses International Classification of Disease (ICD) codes to assign CDPS Categories that indicate illness burden related to major body systems (e.g. cardiovascular) or types of chronic disease (e.g. diabetes). Within each major category is a hierarchy reflecting both the clinical severity of the condition and its expected effect on future costs. Each of the hierarchical CDPS Categories is assigned a CDPS weight. CDPS weights are additive across major categories.”

“The CDPS model was developed in 2000 using data from seven Fee-for-Service (FFS) Medicaid programs. The model received major updates in 2009 (using national FFS Medicaid data from 2002-2005) and in 2014 (using additional national FFS Medicaid data from 2011). CDPS has also received regular annual updates to include the most recent ICD and NDC codes.”

For more information, please visit https://hwsph.ucsd.edu/research/programs-groups/cdps.html.

This Code system is referenced in the content logical definition of the following value sets:

  • This CodeSystem is not used here; it may be used elsewhere (e.g. specifications and/or implementations that use this content)

This case-sensitive code system http://terminology.hl7.org/CodeSystem/CDPS defines codes, but no codes are represented here


2023-09-07createJessica BotaTSMGAdd Chronic Illness and Disability Payment System per HTA; up-460