About the HCC Models

CMS
Models used for Medicare Part C (Medicare Advantage).

ESRD
Models used for dialysis, transplant, and functioning graft populations.

RxHCC
Models used for Medicare Part D.

HHS
Models used by plans established by the Affordable Care Act.

Models by Plan and Payment Year (2020-2022)

Plan (Population)PY 2020PY 2021PY 2022
Medicare Part C
(non-PACE, non-ESRD)
50% CMS v22
50% CMS v24
25% CMS v22
75% CMS v24
100% CMS v24
Medicare Part C (ESRD) ESRD v21 ESRD v21 ESRD v21
Medicare Part C (PACE) CMS v22 CMS v22 CMS v22
Medicare Part D RxHCC v05 RxHCC v05 RxHCC v05
Affordable Care Act HHS v05 HHS v05 HHS v07
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