HCC 191: Quadriplegic Cerebral Palsy ICD-10-CM
CMS-HCC Category 191 (Quadriplegic Cerebral Palsy) is a payment HCC in the V28 Medicare Advantage risk adjustment model. For payment year 2026 it adds a risk adjustment factor between 0.000 and 0.855 to a beneficiary's RAF score depending on the payment segment (0.855 for a community, non-dual, aged enrollee). 1 ICD-10-CM diagnosis codes map to HCC 191. 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 | 0.855 |
| Community, partial-benefit dual, aged | 0.840 |
| Community, full-benefit dual, aged | 0.393 |
| Community, non-dual, disabled | 0.743 |
| Community, partial-benefit dual, disabled | 0.104 |
| Community, full-benefit dual, disabled | 0.466 |
| Institutional | 0.000 |
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 191 in turn supersedes HCC 180 (Quadriplegia), HCC 181 (Paraplegia), HCC 182 (Spinal Cord Disorders/Injuries), HCC 192 (Cerebral Palsy, Except Quadriplegic), HCC 253 (Hemiplegia/Hemiparesis), and HCC 254 (Monoplegia, Other Paralytic Syndromes).
ICD-10-CM Codes That Map to HCC 191 1 codes
- G80.0 Spastic quadriplegic cerebral palsy from V24 HCC 74
Every code above carries the full HCC 191 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 191
What is HCC 191 in the CMS-HCC model?
HCC 191 is CMS-HCC Category 191 (Quadriplegic Cerebral Palsy) in the V28 risk adjustment model. It covers 1 ICD-10-CM diagnosis codes that raise a Medicare Advantage beneficiary's risk score when documented.
What is the RAF weight for HCC 191?
For payment year 2026, HCC 191 adds 0.855 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 0.000 to 0.855 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.
