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 (2020-2026)

Plan (Population)PY 2020PY 2021PY 2022PY 2023 PY 2024 PY 2025 PY 2026
Medicare Part C
(non-PACE, non-ESRD)		 50% CMS v22
50% CMS v24		 25% CMS v22
75% CMS v24		 100% CMS v24 100% CMS v2467% CMS v24
33% CMS v28		 33% CMS v24
67% CMS v28		 100% CMS v28
Medicare Part C (ESRD) ESRD v21 ESRD v21 ESRD v21ESRD v24 ESRD v24
Medicare Part C (PACE) CMS v22 CMS v22 CMS v22 CMS v22CMS v22
Medicare Part C (ESRD + PACE) ESRD v21ESRD v21 ESRD v21ESRD v21ESRD v21
Medicare Part D RxHCC v05 RxHCC v05 RxHCC v05 RxHCC v08 RxHCC v08
Affordable Care Act HHS v05 HHS v05 HHS v07 HHS v07HHS v07
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