Getting started:

To get the most of this guide, we recommend downloading our synthesized Person and Diagnosis data so you can get started right away with testing out the application.

To get started, visit our customer Portal and create an account. On the Menu panel select MSCORE™ and download the version of the application best suited for your Operating System (OS). Your license key, required to activate the application, is also provided on this page. An email will also be sent to the registered address with your license key.


Note

With a paid plan, you can utilize the license key across multiple machines within the same plan. Nonetheless, be mindful that any score runs conducted using this key will incur charges. To activate a new machine, simply include the relevant argument along with your license key.





Quick Start:

Once the application is downloaded, you can access it by navigating to its location using your preferred terminal and specifying the necessary arguments to run your first score!


Diagnosis File


Upload file by providing the full file path name. A Diagnosis file is required for Model execution. Accepted input format is CSV. This field can be entered manually; however, we recommend using the browser button for streamlined navigation and to eliminate user input errors.


Required Diagnosis input file format:

Field Name Description Values Format
MBI Person identification variable Unique to each individual Character/Numeric
DIAG Diagnosis ICD-10 codes of up to 7 characters with no periods. Note: By default, the model performs the Medicare Code Editor edits on the submitted diagnosis codes. Character

Person File


Upload file by providing the full file path name. A Person file is required for Model execution. Accepted input format is CSV. This field can be entered manually; however, we recommend using the browser button for streamlined navigation and to eliminate user input errors.


Required Person input file format:

Field Name Description Values Format
MBI Person identification variable Unique to each individual Character/Numeric
SEX Beneficiary Sex 1= Male
2= Female
Character
DOB Beneficiary Date of Birth Requires year/month/day format. Date
LTIMCAID Medicare Beneficiary Has Medicaid 1= Number of Medicaid months in payment year > 0
0=Number of Medicaid months in payment year =0
Numeric
NEMCAID New Medicare Beneficiary with Medicaid 1= New Medicare enrollee with number of months in Medicaid in payment year >0
2= Otherwise
Numeric
OREC Original Reason for Entitlement 0= Old Age(OASI)
1= Disability (DIB)
2= ESRD
3= Both DIB and ESRD
Charcter

Output Directory

Enter the location where you want scored results saved. This field can be entered manually; however, we recommend using the browser button for streamlined navigation and to eliminate user input errors.


Output File Name

Name your score file in the Output File Name field. Do not add the file extension.


Output File Type

Currently only the CSV format is available.


Model Type

Select a Model Type from the dropdown. Currently only the CMS-HCC Model is supported in the application.


Model Version

Select a Model Version (V22, V24, or V28) from the dropdown.


Model Year

Select a Model Year (2021, 2022, 2023, 2024, 2025) from the dropdown.


Select Columns to Include in Output

Select columns (Scores Only, Scores & Demography, Scores, Demography & HCC, Scores, Demography, HCC & CC, Scores, HCC & Interactions, or All Fields) to include on your output scored file.

Once all selections are made, click on Run Scores, and navigate to your designated Output Directory to view results. A window will open notifying you that the scoring is complete and includes the file name and location. Output data will be provided in one of the following formats depending on the selected Model Version listed at the end of this document.


Generate Score Relative Factors Output

MSCORE™ Version: 23.02.01 and up supports the option to report all Relative Factors which make up an individual person's raw risk score.

Check the box to have a separate Relative Factor report generated to your designated Output Directory.




Python Package Index (PyPI) Tutorial:

MSCORE™ is a python package designed to streamline the CMS-HCC model risk score calculation process for health plans and providers participating in Medicare Advantage and value-based care. It provides a SAS®-free alternative to produce HCCs and risk scores. It streamlines your data processing for enhanced accessibility and allows you to keep your data secure in-house, so you can focus on execution of your risk adjustment strategy.

Features

  • Implement Anywhere: MSCORE™ unlocks multiple integration opportunities including real-time scoring, embedding in EHR or enterprise data warehouse, incorporating into cloud applications, and traditional batch scoring.

  • SAS®-Free: Create HCC and risk scores without SAS® software. Reduce software license costs and avoid the headache of re-coding and maintaining software in another programming language.

  • Enhanced Output: MSCORE™ provides the numeric relative factor value for each HCC assigned to a person allowing for a deeper understanding of how each factor contributes to an individual's overall risk score.

  • Reliable: Validated on over 1 million plus enrollees. MSCORE™ is rigorously tested and updated with each HCC model release.

  • CMS-HCC Model Support: Supports HCC models V22, V24, and V28, covering payment years 2021-2025 with upgrades for each release from CMS (Initial, Mid-Year, Final).

  • Easy to Set Up & Maintain: Easily installed and upgraded using pip, Python's standard package manager.

  • Platform Compatibility: Compatible with Mac, Windows and Linux operating systems.

  • Optimized Performance: Efficient processing with fast runtimes, ensuring quick and accurate risk score calculations.

  • Improved Data Security: Securely process personal health information within your organization's IT infrastructure.

Installation

                pip install mscore
            

Registration

Registration is required to use the mscore package. Please log in or register on this site to create a user account and receive a license key.

Trial License

After you've installed mscore, run the following command to activate your free 90-day trial. An internet connection is required to activate & run the package.

                mscore -a <license key>
            

Subscribe

To use MSCORE™ for internal business operations beyond the 90-day trial period, a pay-as-you-go subscription and payment method is needed. Please set up your payment method in our customer portal on the billing tab. To license MSCORE™ for commercial purposes other than internal business operations, please contact us directly for alternative licensing.

For more information on pricing, please see our product page. If you do not see a price you like, then please email us so we can discuss your requirements.

Academic users are eligible for a free license of our software. Please contact us to obtain your complimentary academic license.

Basic Use

Before you can run your scores, you will need to generate an authorization token object.

                
import sourcedefender #This package is required at the top
from mscore import AuthorizeLicense, MScore,
auth = AuthorizeLicense(license_key).validate()

Note:

You must import sourcedefender at the top of every package that imports MScore.


Required

  • authorizer - The authorization token obtained when AuthroizeLicense is ran
  • year
  • version
  • model
  • person_data (Pandas DataFrame, csv, or parquet file)
  • diag_data (Pandas DataFrame, csv, or parquet file)
  • columns

Optional

  • rf-output (boolean) - Generates a file of your scores Relative Factors
  • dev (boolean) - Runs the application in 'Development' mode

Note:

The example below assumes you already have a Pandas DataFrame generated for your person and diagnosis datasets. If you don't have this data yet and want to test mscore, download our synthetic data files here:

                    
import sourcedefender
import pandas as pd
from mscore import AuthorizeLicense, MScore,
# Generate DataFrames if using our test files
person_df = pd.read_csv('person.csv')
diag_df = pd.read_csv('diag.csv')
auth = AuthorizeLicense(license_key).validate()
model = MScore( authorizer = auth, year = '2024', version = 'V24', model = 'CMS-HCC', person_data = person_df, diag_data = diag_df, columns = 'all-fields', rf_output = True, )
v24_2024_scores = model.score_mscore()
print(v24_2024_scores.risk_scores)
print(v24_2024_scores.relative_factors)

The resulting 'v24_2024_scores' output is a data model object of pandas.DataFrames. You can access your risk scores or relative factors data sets by calling the respective model name from the grouped data model.

  • v24_2024_scores.risk_scores
  • v24_2024_scores.relative_factors

From here you can proceed to use the risk score or relative factor DataFrames for further downstream processing or utilize the Pandas built-in methods to save to a file type of your choosing.


Supported Data

The mscore class attributes, person_data and diag_data, will accept a Pandas.DataFrame object, CSV or Parquet filepath directly without the need to load your input data to DataFrame first. The resulting outputs will be a Pandas DataFrame object.

Supported Environments

MSCORE™ is designed to be universally compatible, ensuring seamless integration across various platforms.

  • Operating Systems: Mac, Windows and Linux • Python Versions: 3.10 or greater (both 32-bit and 64-bit architectures)

If your required environment is not listed, please contact us as support@riskadjustmentmodel.com for an alternate solution.




Command Line Interface Tutorial:

The Command Line Interface (CLI) Application is recognized for its robustness, offering the ability to effortlessly load directly into your data warehouse and seamlessly integrate across various systems.

Open linux terminal and navigate to the location of the application. To skip this step, provide the full file path location when you input arguments.

A list of accepted input arguments are available using --help command.

  • Linux: ./Mscore --help

The below input arguments are required to run the application:

  • --person_data
  • --diag_data
  • --year
  • --version
  • --model
  • --columns
  • --output_dir
  • --file_name
  • --relative_factors
  • --file_ext

Linux:




Output File Format:

The table below maps all of the potential columns available in the output file. Depending on your model version and column output selection, the amount and order of the columns may vary. You can find which columns to expect, for each model version selected, on the Model column in the table below.

For example, running the V24 model will produce a column named "D" on the output file. The V22 model does not use this column so it will not be present on the output file if selected.


Note

Field names are sorted alphabetically.


Field Name Description Values Format Output Model
AGE_RANGES Beneficiary Age Category 0_34= 0 to 34 Years Old
35_44= 35 to 44 Years Old
45_54= 45 to 54 Years Old
55_59= 55 to 59 Years Old
60_64= 60 to 64 Years Old
65_69= 65 to 69 Years Old
70_74= 70 to 74 Years Old
75_79= 75 to 79 Years Old
80_84= 80 to 84 Years Old
85_89= 85 to 89 Years Old
90_94= 90 to 94 Years Old
95 to GT= 95 Years Old and Up
Character Demographic V22, V24, V28
AGE_SEX Beneficiary Sex and Age Range M|F0_34 Years Old
M|F35_44 Years Old
M|F45_54 Years Old
M|F55_59 Years Old
M|F60_64 Years Old
M|F65_69 Years Old
M|F70_74 Years Old
M|F75_79 Years Old
M|F80_84 Years Old
M|F85_89 Years Old
M|F90_94 Years Old
M|F95_GT(95+) Years Old
Character Demographic V22, V24, V28
ART_OPENINGS_PRES_ULC Beneficiary has the Artificial Openings HCC [188] and at least one Pressure Ulcer HCC [V22=157/158, V24=157/158/159] 0=No
1=Yes
Numeric Interaction V22, V24
ASP_SPEC_BACT_PNEUM_PRES_ULC Beneficiary has the Aspiration and Specified Bacterial Pneumonias HCC [114] and at least one Pressure Ulcers HCC [V22=157/158, V24=157/158/159] 0=No
1=Yes
Numeric Interaction V22, V24
CANCER Beneficiary has at least one Cancer HCC V22/V24=[8/9/10/11/12], V28=[17, 18, 19, 20, 21, 22, 23] 0=No
1=Yes
Numeric Interaction V22, V24, V28
CARD_RESP_FAIL Beneficiary has at least one of Cardiorespiratory Failure HCC(s) V22/V24=[82/83/84], V28=[211, 212, 213] 0=No
1=Yes
Numeric Interaction V22, V24, V28
CC List of Beneficiary's Condition Category (CC) codes, separated by "," and enclosed with "[]" Varies
Character CC V22, V24, V28
CFA_SCORE Community Full Benefit Dual Aged Risk Score Risk adjustment factor with up to 3 decimals
Numeric Score V22, V24, V28
CFD_SCORE Community Full Benefit Dual Disabled Risk Score Risk adjustment factor with up to 3 decimals
Numeric Score V22, V24, V28
CHF Beneficiary has the Congestive Heart Failure (CHF) HCC [85] 0=No
1=Yes
Numeric Interaction V22, V24
CHF_GCOPDCF Beneficiary has both the CHF HCC [85] and at least one of the COPD/CF HCCs [110/111/112] 0=No
1=Yes
Numeric Interaction V22, V24
CHR_LUNG Beneficiary has at least one Chronic Lung Disorder HCC V28=[276-280] 0=No
1=Yes
Numeric Interaction V28
CHR_LUNG_CARD_RESP_FAIL_V28 Beneficiary has at least one Chronic Lung Disorder HCC V28=[276-280] and Cardiorespiratory Failure HCC V28=[211-213] 0=No
1=Yes
Numeric Interaction V28
CNA_SCORE Community Non-Dual Aged Risk Score Risk adjustment factor with up to 3 decimals
Numeric Score V22, V24, V28
CND_SCORE Community Non-Dual Disabled Risk Score Risk adjustment factor with up to 3 decimals
Numeric Score V22, V24, V28
CPA_SCORE Community Partial Benefit Dual Aged Risk Score Risk adjustment factor with up to 3 decimals
Numeric Score V22, V24, V28
CPD_SCORE Community Partial Benefit Dual Disabled Risk Score Risk adjustment factor with up to 3 decimals
Numeric Score V22, V24, V28
D Number of HCCs Assigned to Beneficiary D1= 1 HCC
D2= 2 HCCs
D3= 3 HCCs
D4= 4 HCCs
D5= 5 HCCs
D6= 6 HCCs
D7= 7 HCCs
D8= 8 HCCs
D9= 9 HCCS
D10P= 10+ HCCs
Character HCC V24, V28
DIABETES Beneficiary has at least one Diabetes HCC V22/V24=[17/18/19], V28=[35, 36, 37, 38] 0=No
1=Yes
Numeric Interaction V22, V24, V28
DIABETES_CHF Beneficiary has at least one Diabetes HCC [17/18/19] and the CHF HCC [85] 0=No
1=Yes
Numeric Interaction V22, V24
DIABETES_HF_V28 Beneficiary has at least one Diabetes HCC V28=[35-38] and Heart Failure HCC V28=[221-226] 0=No
1=Yes
Numeric Interaction V28
DISABL Disability Indicator: Beneficiary is Less Than 65 Years Old and Original Entitlement Not Due to Old Age 0=No
1=Yes
Numeric Demographic V22, V24, V28
DISABLED_CANCER_V28 Beneficiary Disabled and has at least one Cancer HCC V28=[17-23] 0=No
1=Yes
Numeric Interaction V28
DISABLED_CHR_LUNG_V28 Beneficiary Disabled and has at least one Chronic Lung Disorder HCC V28=[276-280] 0=No
1=Yes
Numeric Interaction V28
DISABLED_HCC161 Beneficiary is Disabled and has the Chronic Ulcer of Skin, Except Pressure HCC [161] 0=No
1=Yes
Numeric Interaction V22, V24
DISABLED_HCC39 Beneficiary is Disabled and has the Bone/Joint/Muscle Infections/Necrosis HCC [39] 0=No
1=Yes
Numeric Interaction V22, V24
DISABLED_HCC6 Beneficiary is Disabled and has the Opportunistic Infections HCC [6] 0=No
1=Yes
Numeric Interaction V22, V24
DISABLED_HCC77 Beneficiary is Disabled and has the Multiple Sclerosis HCC [77] 0=No
1=Yes
Numeric Interaction V22, V24
DISABLED_HCC85 Beneficiary is Disabled and has the CHF HCC [85] 0=No
1=Yes
Numeric Interaction V22, V24
DISABLED_HF_V28 Beneficiary Disabled and has at least one Heart Failure HCC V28=[221-226] 0=No
1=Yes
Numeric Interaction V28
DISABLED_NEURO_V28 Beneficiary Disabled and has at least one Neurological HCC V28=[180-182, 190-192, 195, 196, 198, 199] 0=No
1=Yes
Numeric Interaction V28
DISABLED_PRESSURE_ULCER Beneficiary is Disabled and has at least one Pressure Ulcer HCC [v22=157/158, v24=157/158/159] 0=No
1=Yes
Numeric Interaction V22, V24
DISABLED_ULCER_V28 Beneficiary Disabled and has at least one Skin Ulcer HCC V28=[379-382] 0=No
1=Yes
Numeric Interaction V28
DOB Beneficiary Date of Birth All date formats except numeric dates in year/month/day format.
Date (year/month/day) Demographic V22, V24, V28
GCOPDCF Beneficiary has at least one of Chronic Obstructive Pulmonary Disease (COPD) HCCs and/or the Cystic Fibrosis (CF) HCC [110/111/112] 0=No
1=Yes
Numeric Interaction V22, V24
GCOPDCF_ASP_SPEC_BACT_PNEUM Beneficiary has at least one of the COPD/CF HCCs [110/111/112] and the Aspiration and Specified Bacterial Pneumonias HCC [114] 0=No
1=Yes
Numeric Interaction V22, V24
GCOPDCF_CARD_RESP_FAIL Beneficiary has at least one of the COPD/CF HCCs [110/111/112] and at least one Cardiorespiratory Failure HCC(s) [82/83/84] 0=No
1=Yes
Numeric Interaction V22, V24
GPSYCH Beneficiary has at least one Psychiatric HCC [v22=57/58, v24=57/58/59/60], V28=[151, 152, 153, 154, 155] 0=No
1=Yes
Numeric Interaction V22, V24, V28
GRESPDEPANDARRE_GCOPDCF Beneficiary has at least one Cardiorespiratory Failure HCC(s) = [82/83/84] and at least one of COPD/CF HCC(s) [110/111/112] 0=No
1=Yes
Numeric Interaction V22
GSUBSTANCEUSEDISORDER Beneficiary has at least one Substance Use Disorder HCC [v22=54/55, v24=54/55/56] 0=No
1=Yes
Numeric Interaction V22, V24
GSUBSTANCEUSEDISORDER_GPSYCH Beneficiary has both a Substance Use Disorder HCC [v22=54/55, v24=54/55/56] and at least one Psychiatric HCC [v22=57/58, v24=57/58/59/60] 0=No
1=Yes
Numeric Interaction V22, V24
GSUBUSEDISORDER Beneficiary has at least one Substance Use Disorder HCC V28=[135-139] 0=No
1=Yes
Numeric Interaction V28
GSUBUSEDISORDER_GPSYCH_V28 Beneficiary has at least one Substance Use Disorder HCC V28=[135-139] and at least one Psychiatric HCC V28=[151-155] 0=No
1=Yes
Numeric Interaction V28
HCC List of Beneficiary's Hierarchical Condition Category (HCC) codes, separated by "," and enclosed with "[]" Varies
Character HCC V22, V24, V28
HCC47_GCANCER Beneficiary has both the Immune Disorders HCC [47] and at least one Cancer HCC [8/9/10/11/12] 0=No
1=Yes
Numeric Interaction V22, V24
HCC85_GCOPDCF Beneficiary has both the Congestive Heart Failure HCC [85] and has at least one of COPD and/or CF HCC(s) [110/111/112] 0=No
1=Yes
Numeric Interaction V22
HCC85_GDIABETESMELLIT Beneficiary has both the Congestive Heart Failure HCC [85] and has at least one Diabetes HCC [17/18/19] 0=No
1=Yes
Numeric Interaction V22
HCC85_HCC96 Beneficiary has both the CHF HCC [85] and the Specified Heart Arrhythmias HCC [96] 0=No
1=Yes
Numeric Interaction V22, V24
HCC85_RENAL Beneficiary has both the CHF HCC [85] and at least one Renal HCC [v22=134/135/136/137, v24=134/135/136/137/138] 0=No
1=Yes
Numeric Interaction V22, V24
HCC_COUNT Number of HCCs Assigned to Beneficiary Varies
Numeric HCC V22, V24, V28
HF Beneficiary has at least one Heart Failure HCC V28=[221-226] 0=No
1=Yes
Numeric Interaction V28
HF_CHR_LUNG_V28 Beneficiary has at least one Heart Failure HCC V28=[221-226] and at least one Chronic Lung Disorder HCC V28=[276-280] 0=No
1=Yes
Numeric Interaction V28
HF_HCC238_V28 Beneficiary has at least one Heart Failure HCC V28=[221-226] and Specified Heart Arrhythmias HCC V28=[238] 0=No
1=Yes
Numeric Interaction V28
HF_KIDNEY_V28 Beneficiary has at least one Heart Failure HCC V28=[221-226] and Chronic Kidney Disease HCC V28=[326-329] 0=No
1=Yes
Numeric Interaction V28
INS_SCORE Institutional Risk Score Risk adjustment factor with up to 3 decimals
Numeric Score V22, V24, V28
KIDNEY Beneficiary has at least one Chronic Kidney Disease HCC V28=[326-329] 0=No
1=Yes
Numeric Interaction V28
LTIMCAID Medicare Beneficiary Has Medicaid 1= Number of Medicaid months in payment year > 0
0=Number of Medicaid months in payment year =0
Numeric Demographic V22, V24, V28
MBI Person identification variable Unique to each individual
Character/Numeric Demographic V22, V24, V28
NEMCAID New Medicare Beneficiary with Medicaid 1= New Medicare enrollee with number of months in Medicaid in payment year >0
2= Otherwise
Numeric Demographic V22, V24, V28
NEURO Beneficiary has at least one Neurological HCC V28=[180-182, 190-192, 195, 196, 198, 199] 0=No
1=Yes
Numeric Interaction V28
NE_AGE_RANGES Beneficiary Age Category - Breakout of 65-69 years Olds for New Enrollees 0_34= 0 to 34 Years Old
35_44= 35 to 44 Years Old
45_54= 45 to 54 Years Old
55_59= 55 to 59 Years Old
60_64= 60 to 64 Years Old
65= 65 Years Old
66= 66 Years Old
67= 67 Years Old
68= 68 Years Old
69= 69 Years Old
70_74= 70 to 74 Years Old
75_79= 75 to 79 Years Old
80_84= 80 to 84 Years Old
85_89= 85 to 89 Years Old
90_94= 90 to 94 Years Old
95 to GT= 95 Years Old and Up
Character Demographic V22, V24, V28
NE_ORIGDS New Enrollee- Originally Disabled 0= Less Than 65 Years Old or Not Originally Disabled
1= At Least 65 Years Old and Originally Disabled
Numeric Demographic V22, V24, V28
NE_SCORE New Enrollee Risk Score Risk adjustment factor with up to 3 decimals
Numeric Score V22, V24, V28
N_MCAID_N_ORIGDS Combined Indicator of Medicaid and Originally Disabled MCAID_NORIGDIS= Medicaid
Not Originally Disabled
MCAID_ORIGDIS= Medicaid
Originally Disabled
NMCAID_NORIGDIS= No Medicaid
Not Originally Disabled
NMCAID_ORIGDIS= No Medicaid
Originally Disabled
Character Demographic V22, V24, V28
OREC Original Reason for Entitlement 0= Old Age(OASI)
1= Disability (DIB)
2= ESRD
3= Both DIB and ESRD
Character Demographic V22, V24, V28
ORIGDS Original Reason for Beneficiary's Medicare Entitlement is Due to Disability 0=No
1=Yes
Character Demographic V22, V24, V28
ORIG_DS_M_F Combined Indicator of Originally Disabled and Beneficiary Sex OriginallyDisabled_Female = Originally Disabled and Female
OriginallyDisabled_Male= Originally Disabled and Male
NULL= Not Originally Disabled
Character Demographic V22, V24, V28
PRESSURE_ULCER Beneficiary has at least one Pressure Ulcer HCC [v22=157/158, v24=157/158/159] 0=No
1=Yes
Numeric Interaction V22, V24
RENAL Beneficiary has at least one Renal HCC [v22=134/135/136/137, v24=134/135/136/137/138] 0=No
1=Yes
Numeric Interaction V22, V24
SCHIZOPHRENIA_CHF Beneficiary has both the Schizophrenia HCC [57] and the CHF HCC [85] 0=No
1=Yes
Numeric Interaction V22, V24
SCHIZOPHRENIA_GCOPDCF Beneficiary has both the Schizophrenia HCC [57] and at least one of the COPD/CF HCCs [110/111/112] 0=No
1=Yes
Numeric Interaction V22, V24
SCHIZOPHRENIA_SEIZURES Beneficiary has both the Schizophrenia HCC [57] and the Seizure Disorders and Convulsions HCC [79] 0=No
1=Yes
Numeric Interaction V22, V24
SEPSIS Beneficiary has the Sepsis HCC [2] 0=No
1=Yes
Numeric Interaction V22, V24
SEPSIS_ARTIF_OPENINGS Beneficiary has both the Sepsis HCC [2] and the Artificial Openings HCC [188] 0=No
1=Yes
Numeric Interaction V22, V24
SEPSIS_ASP_SPEC_BACT_PNEUM Beneficiary has both the Sepsis HCC [2] and the Aspiration and Specified Bacterial Pneumonias HCC [114] 0=No
1=Yes
Numeric Interaction V22, V24
SEPSIS_PRESSURE_ULCER Beneficiary has both the Sepsis HCC [2] and at least one Pressure Ulcer HCC [v22=157/158, v24=157/158/159] 0=No
1=Yes
Numeric Interaction V22, V24
SEX Beneficiary Sex 1= Male
2= Female
Character Demographic V22, V24, V28
SNPNE_SCORE New Enrollee SNP Risk Score Risk adjustment factor with up to 3 decimals
Numeric Score V22, V24, V28
ULCER Beneficiary has at least one Skin Ulcer HCC V28=[379-382] 0=No
1=Yes
Numeric Interaction V28



Model HCCs:

Select a model version to display the HCCs or download a copy for your records.

CMS-HCC Version 22 (V22)

HCC Description
HCC1 HIV/AIDS
HCC2 Septicemia, Sepsis, Systemic Inflammatory Response Syndrome/Shock
HCC6 Opportunistic Infections
HCC8 Metastatic Cancer and Acute Leukemia
HCC9 Lung and Other Severe Cancers
HCC10 Lymphoma and Other Cancers
HCC11 Colorectal, Bladder, and Other Cancers
HCC12 Breast, Prostate, and Other Cancers and Tumors
HCC17 Diabetes with Acute Complications
HCC18 Diabetes with Chronic Complications
HCC19 Diabetes without Complication
HCC21 Protein-Calorie Malnutrition
HCC22 Morbid Obesity
HCC23 Other Significant Endocrine and Metabolic Disorders
HCC27 End-Stage Liver Disease
HCC28 Cirrhosis of Liver
HCC29 Chronic Hepatitis
HCC33 Intestinal Obstruction/Perforation
HCC34 Chronic Pancreatitis
HCC35 Inflammatory Bowel Disease
HCC39 Bone/Joint/Muscle Infections/Necrosis
HCC40 Rheumatoid Arthritis and Inflammatory Connective Tissue Disease
HCC46 Severe Hematological Disorders
HCC47 Disorders of Immunity
HCC48 Coagulation Defects and Other Specified Hematological Disorders
HCC54 Drug/Alcohol Psychosis
HCC55 Drug/Alcohol Dependence
HCC57 Schizophrenia
HCC58 Major Depressive, Bipolar, and Paranoid Disorders
HCC70 Quadriplegia
HCC71 Paraplegia
HCC72 Spinal Cord Disorders/Injuries
HCC73 Amyotrophic Lateral Sclerosis and Other Motor Neuron Disease
HCC74 Cerebral Palsy
HCC75 Myasthenia Gravis/Myoneural Disorders, Inflammatory and Toxic Neuropathy
HCC76 Muscular Dystrophy
HCC77 Multiple Sclerosis
HCC78 Parkinson's and Huntington's Diseases
HCC79 Seizure Disorders and Convulsions
HCC80 Coma, Brain Compression/Anoxic Damage
HCC82 Respirator Dependence/Tracheostomy Status
HCC83 Respiratory Arrest
HCC84 Cardio-Respiratory Failure and Shock
HCC85 Congestive Heart Failure
HCC86 Acute Myocardial Infarction
HCC87 Unstable Angina and Other Acute Ischemic Heart Disease
HCC88 Angina Pectoris
HCC96 Specified Heart Arrhythmias
HCC99 Cerebral Hemorrhage
HCC100 Ischemic or Unspecified Stroke
HCC103 Hemiplegia/Hemiparesis
HCC104 Monoplegia, Other Paralytic Syndromes
HCC106 Atherosclerosis of the Extremities with Ulceration or Gangrene
HCC107 Vascular Disease with Complications
HCC108 Vascular Disease
HCC110 Cystic Fibrosis
HCC111 Chronic Obstructive Pulmonary Disease
HCC112 Fibrosis of Lung and Other Chronic Lung Disorders
HCC114 Aspiration and Specified Bacterial Pneumonias
HCC115 Pneumococcal Pneumonia, Empyema, Lung Abscess
HCC122 Proliferative Diabetic Retinopathy and Vitreous Hemorrhage
HCC124 Exudative Macular Degeneration
HCC134 Dialysis Status
HCC135 Acute Renal Failure
HCC136 Chronic Kidney Disease, Stage 5
HCC137 Chronic Kidney Disease, Severe (Stage 4)
HCC157 Pressure Ulcer of Skin with Necrosis Through to Muscle, Tendon, or Bone
HCC158 Pressure Ulcer of Skin with Full Thickness Skin Loss
HCC161 Chronic Ulcer of Skin, Except Pressure
HCC162 Severe Skin Burn or Condition
HCC166 Severe Head Injury
HCC167 Major Head Injury
HCC169 Vertebral Fractures without Spinal Cord Injury
HCC170 Hip Fracture/Dislocation
HCC173 Traumatic Amputations and Complications
HCC176 Complications of Specified Implanted Device or Graft
HCC186 Major Organ Transplant or Replacement Status
HCC188 Artificial Openings for Feeding or Elimination
HCC189 Amputation Status, Lower Limb/Amputation Complications

CMS-HCC Version 24 (V24)

HCC Description
HCC1 HIV/AIDS
HCC2 Septicemia, Sepsis, Systemic Inflammatory Response Syndrome/Shock
HCC6 Opportunistic Infections
HCC8 Metastatic Cancer and Acute Leukemia
HCC9 Lung and Other Severe Cancers
HCC10 Lymphoma and Other Cancers
HCC11 Colorectal, Bladder, and Other Cancers
HCC12 Breast, Prostate, and Other Cancers and Tumors
HCC17 Diabetes with Acute Complications
HCC18 Diabetes with Chronic Complications
HCC19 Diabetes without Complication
HCC21 Protein-Calorie Malnutrition
HCC22 Morbid Obesity
HCC23 Other Significant Endocrine and Metabolic i,orders
HCC27 End-Stage Liver Disease
HCC28 Cirrhosis of Liver
HCC29 Chronic Hepatitis
HCC33 Intestinal Obstruction/Perforation
HCC34 Chronic Pancreatitis
HCC35 Inflammatory Bowel Disease
HCC39 Bone/Joint/Muscle Infections/Necrosis
HCC40 Rheumatoid Arthritis and Inflammatory Connc,ive Tissue Disease
HCC46 Severe Hematological Disorders
HCC47 Disorders of Immunity
HCC48 Coagulation Defects and Other Specified Hea,ological Disorders
HCC51 Dementia With Complications
HCC52 Dementia Without Complication
HCC54 Substance Use with Psychotic Complications
HCC55 Substance Use Disorder, Moderate/Severe, or Substance Use with Complications
HCC56 Substance Use Disorder, Mild, Except Alcohol and Cannabis
HCC57 Schizophrenia
HCC58 Reactive and Unspecified Psychosis
HCC59 Major Depressive, Bipolar, and Paranoid Disorders
HCC60 Personality Disorders
HCC70 Quadriplegia
HCC71 Paraplegia
HCC72 Spinal Cord Disorders/Injuries
HCC73 Amyotrophic Lateral Sclerosis and Other Motor Neuron Disease
HCC74 Cerebral Palsy
HCC75 Myasthenia Gravis/Myoneural Disorders and Guillain-Barre Syndrome/Inflammatory and Toxic Neuropathy
HCC76 Muscular Dystrophy
HCC77 Multiple Sclerosis
HCC78 Parkinson's and Huntington's Diseases
HCC79 Seizure Disorders and Convulsions
HCC80 Coma, Brain Compression/Anoxic Damage
HCC82 Respirator Dependence/Tracheostomy Status
HCC83 Respiratory Arrest
HCC84 Cardio-Respiratory Failure and Shock
HCC85 Congestive Heart Failure
HCC86 Acute Myocardial Infarction
HCC87 Unstable Angina and Other Acute Ischemic Heart Disease
HCC88 Angina Pectoris
HCC96 Specified Heart Arrhythmias
HCC99 Intracranial Hemorrhage
HCC100 Ischemic or Unspecified Stroke
HCC103 Hemiplegia/Hemiparesis
HCC104 Monoplegia, Other Paralytic Syndromes
HCC106 Atherosclerosis of the Extremities with Ulceration or Gangrene
HCC107 Vascular Disease with Complications
HCC108 Vascular Disease
HCC110 Cystic Fibrosis
HCC111 Chronic Obstructive Pulmonary Disease
HCC112 Fibrosis of Lung and Other Chronic Lung Disorders
HCC114 Aspiration and Specified Bacterial Pneumonias
HCC115 Pneumococcal Pneumonia, Empyema, Lung Abscess
HCC122 Proliferative Diabetic Retinopathy and Vitreous Hemorrhage
HCC124 Exudative Macular Degeneration
HCC134 Dialysis Status
HCC135 Acute Renal Failure
HCC136 Chronic Kidney Disease, Stage 5
HCC137 Chronic Kidney Disease, Severe (Stage 4)
HCC138 Chronic Kidney Disease, Moderate (Stage 3)
HCC157 Pressure Ulcer of Skin with Necrosis Through to Muscle, Tendon, or Bone
HCC158 Pressure Ulcer of Skin with Full Thickness Skin Loss
HCC159 Pressure Ulcer of Skin with Partial Thickness Skin Loss
HCC161 Chronic Ulcer of Skin, Except Pressure
HCC162 Severe Skin Burn or Condition
HCC166 Severe Head Injury
HCC167 Major Head Injury
HCC169 Vertebral Fractures without Spinal Cord Injury
HCC170 Hip Fracture/Dislocation
HCC173 Traumatic Amputations and Complications
HCC176 Complications of Specified Implanted Device or Graft
HCC186 Major Organ Transplant or Replacement Status
HCC188 Artificial Openings for Feeding or Elimination
HCC189 Amputation Status, Lower Limb/Amputation Complication

CMS-HCC Version 28 (V28)

HCC Description
HCC1 HIV/AIDS
HCC2 Septicemia, Sepsis, Systemic Inflammatory Response Syndrome/Shock
HCC6 Opportunistic Infections
HCC17 Cancer Metastatic to Lung, Liver, Brain, and Other Organs; Acute Myeloid Leukemia Except Promyelocytic
HCC18 Cancer Metastatic to Bone, Other and Unspecified Metastatic Cancer; Acute Leukemia Except Myeloid
HCC19 Myelodysplastic Syndromes, Multiple Myeloma, and Other Cancers
HCC20 Lung and Other Severe Cancers
HCC21 Lymphoma and Other Cancers
HCC22 Bladder, Colorectal, and Other Cancers
HCC23 Prostate, Breast, and Other Cancers and Tumors
HCC35 Pancreas Transplant Status
HCC36 Diabetes with Severe Acute Complications
HCC37 Diabetes with Chronic Complications
HCC38 Diabetes with Glycemic, Unspecified, or No Complications
HCC48 Morbid Obesity
HCC49 Specified Lysosomal Storage Disorders
HCC50 Amyloidosis, Porphyria, and Other Specified Metabolic Disorders
HCC51 Addison's and Cushing's Diseases, Acromegaly, and Other Specified Endocrine Disorders
HCC62 Liver Transplant Status/Complications
HCC63 Chronic Liver Failure/End-Stage Liver Disorders
HCC64 Cirrhosis of Liver
HCC65 Chronic Hepatitis
HCC68 Cholangitis and Obstruction of Bile Duct Without Gallstones
HCC77 Intestine Transplant Status/Complications
HCC78 Intestinal Obstruction/Perforation
HCC79 Chronic Pancreatitis
HCC80 Crohn's Disease (Regional Enteritis)
HCC81 Ulcerative Colitis
HCC92 Bone/Joint/Muscle/Severe Soft Tissue Infections/Necrosis
HCC93 Rheumatoid Arthritis and Other Specified Inflammatory Rheumatic Disorders
HCC94 Systemic Lupus Erythematosus and Other Specified Systemic Connective Tissue Disorders
HCC107 Sickle Cell Anemia (Hb-SS) and Thalassemia Beta Zero
HCC108 Sickle Cell Disorders, Except Sickle Cell Anemia (Hb-SS) and Thalassemia Beta Zero; Beta Thalassemia Major
HCC109 Acquired Hemolytic, Aplastic, and Sideroblastic Anemias
HCC111 Hemophilia, Male
HCC112 Immune Thrombocytopenia and Specified Coagulation Defects and Hemorrhagic Conditions
HCC114 Common Variable and Combined Immunodeficiencies
HCC115 Specified Immunodeficiencies and White Blood Cell Disorders
HCC125 Dementia, Severe
HCC126 Dementia, Moderate
HCC127 Dementia, Mild or Unspecified
HCC135 Drug Use with Psychotic Complications
HCC136 Alcohol Use with Psychotic Complications
HCC137 Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications
HCC138 Drug Use Disorder, Mild, Uncomplicated, Except Cannabis
HCC139 Alcohol Use Disorder, Moderate/Severe, or Alcohol Use with Specified Non-Psychotic Complications
HCC151 Schizophrenia
HCC152 Psychosis, Except Schizophrenia
HCC153 Personality Disorders; Anorexia/Bulimia Nervosa
HCC154 Bipolar Disorders without Psychosis
HCC155 Major Depression, Moderate or Severe, without Psychosis
HCC180 Quadriplegia
HCC181 Paraplegia
HCC182 Spinal Cord Disorders/Injuries
HCC190 Amyotrophic Lateral Sclerosis and Other Motor Neuron Disease, Spinal Muscular Atrophy
HCC191 Quadriplegic Cerebral Palsy
HCC192 Cerebral Palsy, Except Quadriplegic
HCC193 Chronic Inflammatory Demyelinating Polyneuritis and Multifocal Motor Neuropathy
HCC195 Myasthenia Gravis with (Acute) Exacerbation
HCC196 Myasthenia Gravis without (Acute) Exacerbation and Other Myoneural Disorders
HCC197 Muscular Dystrophy
HCC198 Multiple Sclerosis
HCC199 Parkinson and Other Degenerative Disease of Basal Ganglia
HCC200 Friedreich and Other Hereditary Ataxias; Huntington Disease
HCC201 Seizure Disorders and Convulsions
HCC202 Coma, Brain Compression/Anoxic Damage
HCC211 Respirator Dependence/Tracheostomy Status/Complications
HCC212 Respiratory Arrest
HCC213 Cardio-Respiratory Failure and Shock
HCC221 Heart Transplant Status/Complications
HCC222 End-Stage Heart Failure
HCC223 Heart Failure with Heart Assist Device/Artificial Heart
HCC224 Acute on Chronic Heart Failure
HCC225 Acute Heart Failure (Excludes Acute on Chronic)
HCC226 Heart Failure, Except End-Stage and Acute
HCC227 Cardiomyopathy/Myocarditis
HCC228 Acute Myocardial Infarction
HCC229 Unstable Angina and Other Acute Ischemic Heart Disease
HCC238 Specified Heart Arrhythmias
HCC248 Intracranial Hemorrhage
HCC249 Ischemic or Unspecified Stroke
HCC253 Hemiplegia/Hemiparesis
HCC254 Monoplegia, Other Paralytic Syndromes
HCC263 Atherosclerosis of Arteries of the Extremities with Ulceration or Gangrene
HCC264 Vascular Disease with Complications
HCC267 Deep Vein Thrombosis and Pulmonary Embolism
HCC276 Lung Transplant Status/Complications
HCC277 Cystic Fibrosis
HCC278 Idiopathic Pulmonary Fibrosis and Lung Involvement in Systemic Sclerosis
HCC279 Severe Persistent Asthma
HCC280 Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders
HCC282 Aspiration and Specified Bacterial Pneumonias
HCC283 Empyema, Lung Abscess
HCC298 Severe Diabetic Eye Disease, Retinal Vein Occlusion, and Vitreous Hemorrhage
HCC300 Exudative Macular Degeneration
HCC326 Chronic Kidney Disease, Stage 5
HCC327 Chronic Kidney Disease, Severe (Stage 4)
HCC328 Chronic Kidney Disease, Moderate (Stage 3B)
HCC329 Chronic Kidney Disease, Moderate (Stage 3, Except 3B)
HCC379 Pressure Ulcer of Skin with Necrosis Through to Muscle, Tendon, or Bone
HCC380 Chronic Ulcer of Skin, Except Pressure, Through to Bone or Muscle
HCC381 Pressure Ulcer of Skin with Full Thickness Skin Loss
HCC382 Pressure Ulcer of Skin with Partial Thickness Skin Loss
HCC383 Chronic Ulcer of Skin, Except Pressure, Not Specified as Through to Bone or Muscle
HCC385 Severe Skin Burn
HCC387 Pemphigus, Pemphigoid, and Other Specified Autoimmune Skin Disorders
HCC397 Major Head Injury with Loss of Consciousness > 1 Hour
HCC398 Major Head Injury with Loss of Consciousness < 1 Hour or Unspecified
HCC399 Major Head Injury without Loss of Consciousness
HCC401 Vertebral Fractures without Spinal Cord Injury
HCC402 Hip Fracture/Dislocation
HCC405 Traumatic Amputations and Complications
HCC409 Amputation Status, Lower Limb/Amputation Complications
HCC454 Stem Cell, Including Bone Marrow, Transplant Status/Complications
HCC463 Artificial Openings for Feeding or Elimination



Performance Notice & Requirements:

As with any data-processing-intensive application, larger input datasets require higher system resources, particularly in terms of RAM/memory.

Minimum System Requirements for PyPI:

MacOS | Windows | Linux
Operating system MacOS 10 + | Windows 10 + | Linux Ubuntu 20.04 +
Memory 8 GB RAM*

Minimum System Requirements for CLI:

Linux
Operating system Linux Ubuntu 20.04 +
Memory 8 GB RAM*

Note

Our stress tests of running 500,000 people through the application have shown to use up to 4 GB of RAM (just under 1 GB per 100K people). This will vary based on the number of diagnoses per person. Consider breaking down large data runs into smaller chunks.




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