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Announcement of Calendar Year (CY) 2024 Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies

 

CMS-Hierarchical Condition Categories (CMS-HCC) Risk Adjustment Model (Non-PACE)

In the proposed CY 2024 Advance Notice, on page 3, there is a proposed announcement that the risk scores will be calculated as a blend of 67% of the risk scores calculated with the current model (the 2020 model) and 33% of the risk scores calculated with the updated model (the 2024 model).

For CY 2025, they expect risk scores to be calculated as a blend of 33% of the risk scores calculated with the 2020 model and 67% of the risk scores calculated with the 2024 model,

and for CY 2026, they  expect 100% of the risk scores to be calculated with the 2024 model.

Link to the document: Announcement March 31 2023

file:///C:/Users/cjtrujillo/Downloads/2024%20Rate%20Announcement%20033123_FINAL508.pdf



Disclaimer: This guidance is to be used for an easy reference; the ICD-9-CM and ICD-10-CM code books and the Official Guidelines for Coding and Reporting are the authoritative references for accurate and complete coding. This blog may contain references or links to statutes, regulations, or other policy materials. It is not intended to take the place of either the written law or regulations.  The information presented herein is for general informational purposes only and is accurate as of the date of publication.


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