HCC 192: Cerebral Palsy, Except Quadriplegic ICD-10-CM
CMS-HCC Category 192 (Cerebral Palsy, Except Quadriplegic) 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 0.314 to a beneficiary's RAF score depending on the payment segment (0.314 for a community, non-dual, aged enrollee). 9 ICD-10-CM diagnosis codes map to HCC 192. A more severe related category (HCC 191) supersedes it when both are reported.
RAF Weight by Payment Segment 7 segments
| Payment Segment | Relative Factor |
|---|---|
| Community, non-dual, aged | 0.314 |
| Community, partial-benefit dual, aged | 0.220 |
| Community, full-benefit dual, aged | 0.000 |
| Community, non-dual, disabled | 0.129 |
| Community, partial-benefit dual, disabled | 0.104 |
| Community, full-benefit dual, disabled | 0.067 |
| 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. In the hierarchy, HCC 191 (Quadriplegic Cerebral Palsy) supersedes HCC 192 when reported together. HCC 192 in turn supersedes HCC 180 (Quadriplegia), HCC 181 (Paraplegia), HCC 182 (Spinal Cord Disorders/Injuries), HCC 253 (Hemiplegia/Hemiparesis), and HCC 254 (Monoplegia, Other Paralytic Syndromes).
ICD-10-CM Codes That Map to HCC 192 9 codes
- G80.1 Spastic diplegic cerebral palsy from V24 HCC 74
- G80.2 Spastic hemiplegic cerebral palsy from V24 HCC 74
- G80.3 Athetoid cerebral palsy from V24 HCC 74
- G80.4 Ataxic cerebral palsy from V24 HCC 74
- G80.8 Other cerebral palsy from V24 HCC 74
- G80.9 Cerebral palsy, unspecified from V24 HCC 74
- P57.0 Kernicterus due to isoimmunization new to V28
- P57.8 Other specified kernicterus new to V28
- P57.9 Kernicterus, unspecified new to V28
Every code above carries the full HCC 192 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 192
What is HCC 192 in the CMS-HCC model?
HCC 192 is CMS-HCC Category 192 (Cerebral Palsy, Except Quadriplegic) in the V28 risk adjustment model. It covers 9 ICD-10-CM diagnosis codes that raise a Medicare Advantage beneficiary's risk score when documented.
What is the RAF weight for HCC 192?
For payment year 2026, HCC 192 adds 0.314 to the RAF score of a community, non-dual, aged beneficiary. The published weights range from 0.000 to 0.314 across the seven payment segments shown above.
Which categories supersede HCC 192?
HCC 191 (Quadriplegic Cerebral Palsy) sits above HCC 192 in the hierarchy: when a beneficiary has diagnoses in both, only the more severe category is paid.
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.
