HCC 195: Myasthenia Gravis with (Acute) Exacerbation ICD-10-CM
CMS-HCC Category 195 (Myasthenia Gravis with (Acute) Exacerbation) is a payment HCC in the V28 Medicare Advantage risk adjustment model. For payment year 2026 it adds a risk adjustment factor between 1.779 and 3.633 to a beneficiary's RAF score depending on the payment segment (2.909 for a community, non-dual, aged enrollee). 1 ICD-10-CM diagnosis codes map to HCC 195. 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 | 2.909 |
| Community, partial-benefit dual, aged | 2.690 |
| Community, full-benefit dual, aged | 2.153 |
| Community, non-dual, disabled | 3.633 |
| Community, partial-benefit dual, disabled | 1.779 |
| Community, full-benefit dual, disabled | 3.323 |
| Institutional | 1.837 |
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 195 in turn supersedes HCC 196 (Myasthenia Gravis without (Acute) Exacerbation and Other Myoneural Disorders).
ICD-10-CM Codes That Map to HCC 195 1 codes
- G70.01 Myasthenia gravis with (acute) exacerbation from V24 HCC 75
Every code above carries the full HCC 195 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 195
What is HCC 195 in the CMS-HCC model?
HCC 195 is CMS-HCC Category 195 (Myasthenia Gravis with (Acute) Exacerbation) 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 195?
For payment year 2026, HCC 195 adds 2.909 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 1.779 to 3.633 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.
