RAF calculator

CMS-HCC risk score, with the working shown. Nothing is stored.

How to use this page

What the published CMS-HCC models do with a set of codes.

Add the codes you want to evaluate, then set the demographic factors the model takes. Dots are optional — a paste straight out of a claims extract works.
The result shows each code that maps to an HCC, the coefficients applied, and the total the published model produces.
Two lists come back separately at the bottom. A code that maps to no HCC is ordinary — most diagnoses do not risk-adjust. A string that is not a code in that year at all is a typo, or a sign the code set year does not match the dates of service.
Use it to check your understanding of a model, or to see why a set of codes scores the way it does.

What this page does not do

This is arithmetic on the published model, nothing more. It is not advice about which codes to report.
A code belongs on a claim when the documentation supports it. That question is answered in the chart, and no calculator can answer it.

Inputs

Scoring a whole roster? Batch scoring runs the same engine across up to 2,000 members and returns a CSV.