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. 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.
