HCC 190: Amyotrophic Lateral Sclerosis and Other Motor Neuron Disease, Spinal Muscular Atrophy ICD-10-CM
CMS-HCC Category 190 (Amyotrophic Lateral Sclerosis and Other Motor Neuron Disease, Spinal Muscular Atrophy) is a payment HCC in the V28 Medicare Advantage risk adjustment model. For payment year 2026 it adds a risk adjustment factor between 0.628 and 3.642 to a beneficiary's RAF score depending on the payment segment (1.175 for a community, non-dual, aged enrollee). 11 ICD-10-CM diagnosis codes map to HCC 190. It sits at the top of its hierarchy: no other condition category supersedes it.
RAF Weight by Payment Segment 7 segments
| Payment Segment | Relative Factor |
|---|---|
| Community, non-dual, aged | 1.175 |
| Community, partial-benefit dual, aged | 0.640 |
| Community, full-benefit dual, aged | 1.427 |
| Community, non-dual, disabled | 1.792 |
| Community, partial-benefit dual, disabled | 1.243 |
| Community, full-benefit dual, disabled | 3.642 |
| Institutional | 0.628 |
A beneficiary is scored in exactly one segment, set by Medicaid (dual) status, aged or disabled entitlement, and residence. Factors are relative weights, not dollar amounts; new-enrollee segments score on demographics only. HCC 190 neither supersedes nor is superseded by any other category, so it always counts alongside unrelated HCCs.
ICD-10-CM Codes That Map to HCC 190 11 codes
- G12.0 Infantile spinal muscular atrophy, type I [Werdnig-Hoffman] from V24 HCC 72
- G12.1 Other inherited spinal muscular atrophy from V24 HCC 72
- G12.20 Motor neuron disease, unspecified from V24 HCC 73
- G12.21 Amyotrophic lateral sclerosis from V24 HCC 73
- G12.22 Progressive bulbar palsy from V24 HCC 73
- G12.23 Primary lateral sclerosis from V24 HCC 73
- G12.24 Familial motor neuron disease from V24 HCC 73
- G12.25 Progressive spinal muscle atrophy from V24 HCC 73
- G12.29 Other motor neuron disease from V24 HCC 73
- G12.8 Other spinal muscular atrophies and related syndromes from V24 HCC 72
- G12.9 Spinal muscular atrophy, unspecified from V24 HCC 72
Every code above carries the full HCC 190 weight when documented and reported on a Medicare Advantage encounter. The code link opens its full page with the complete risk adjustment card.
Questions About HCC 190
What is HCC 190 in the CMS-HCC model?
HCC 190 is CMS-HCC Category 190 (Amyotrophic Lateral Sclerosis and Other Motor Neuron Disease, Spinal Muscular Atrophy) in the V28 risk adjustment model. It covers 11 ICD-10-CM diagnosis codes that raise a Medicare Advantage beneficiary's risk score when documented.
What is the RAF weight for HCC 190?
For payment year 2026, HCC 190 adds 1.175 to the RAF score of a community, non-dual, aged beneficiary. The published weights range from 0.628 to 3.642 across the seven payment segments shown above.
Related References
Source: Centers for Medicare & Medicaid Services, Payment Year 2026 risk adjustment mapping and model software releases (CMS-HCC V28), applied to the FY 2026 ICD-10-CM code set. ICD List is not affiliated with CMS.
