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. 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.
