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 HCC 190 neither supersedes nor is superseded by any other category, so it always counts alongside unrelated HCCs.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 (living at home, age 65 or over, not also enrolled in Medicaid). 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.
