CMS-HCC Risk Adjustment · V28 Model · Payment Year 2026 64 Codes

HCC 201: Seizure Disorders and Convulsions ICD-10-CM

CMS-HCC Category 201 (Seizure Disorders and Convulsions) is a payment HCC in the V28 Medicare Advantage risk adjustment model. For payment year 2026 it adds a risk adjustment factor between 0.131 and 0.245 to a beneficiary's RAF score depending on the payment segment (0.245 for a community, non-dual, aged enrollee). 64 ICD-10-CM diagnosis codes map to HCC 201. It sits at the top of its hierarchy: no other condition category supersedes it.

✓ Built from the official CMS PY 2026 risk adjustment filesV28 pays 100% of MA risk scores from PY 2026
+0.245
RAF, Community Non-Dual Aged
64
ICD-10-CM Codes
Top
Of Its Hierarchy
PY 2026
Dataset
CMS-HCC V28

RAF Weight by Payment Segment 7 segments

Payment SegmentRelative Factor
Community, non-dual, aged0.245
Community, partial-benefit dual, aged0.245
Community, full-benefit dual, aged0.233
Community, non-dual, disabled0.196
Community, partial-benefit dual, disabled0.202
Community, full-benefit dual, disabled0.170
Institutional0.131

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 HCC 201 neither supersedes nor is superseded by any other category, so it always counts alongside unrelated HCCs.

ICD-10-CM

ICD-10-CM Codes That Map to HCC 201 64 codes

64 of 64 shown
  • G40.001 Localization-related (focal) (partial) idiopathic epilepsy and epileptic syndromes with seizures of localized onset, not intractable, with status epilepticus from V24 HCC 79
  • G40.009 Localization-related (focal) (partial) idiopathic epilepsy and epileptic syndromes with seizures of localized onset, not intractable, without status epilepticus from V24 HCC 79
  • G40.011 Localization-related (focal) (partial) idiopathic epilepsy and epileptic syndromes with seizures of localized onset, intractable, with status epilepticus from V24 HCC 79
  • G40.019 Localization-related (focal) (partial) idiopathic epilepsy and epileptic syndromes with seizures of localized onset, intractable, without status epilepticus from V24 HCC 79
  • G40.101 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, not intractable, with status epilepticus from V24 HCC 79
  • G40.109 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, not intractable, without status epilepticus from V24 HCC 79
  • G40.111 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, intractable, with status epilepticus from V24 HCC 79
  • G40.119 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, intractable, without status epilepticus from V24 HCC 79
  • G40.201 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, not intractable, with status epilepticus from V24 HCC 79
  • G40.209 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, not intractable, without status epilepticus from V24 HCC 79
  • G40.211 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, intractable, with status epilepticus from V24 HCC 79
  • G40.219 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, intractable, without status epilepticus from V24 HCC 79
  • G40.301 Generalized idiopathic epilepsy and epileptic syndromes, not intractable, with status epilepticus from V24 HCC 79
  • G40.309 Generalized idiopathic epilepsy and epileptic syndromes, not intractable, without status epilepticus from V24 HCC 79
  • G40.311 Generalized idiopathic epilepsy and epileptic syndromes, intractable, with status epilepticus from V24 HCC 79
  • G40.319 Generalized idiopathic epilepsy and epileptic syndromes, intractable, without status epilepticus from V24 HCC 79
  • G40.401 Other generalized epilepsy and epileptic syndromes, not intractable, with status epilepticus from V24 HCC 79
  • G40.409 Other generalized epilepsy and epileptic syndromes, not intractable, without status epilepticus from V24 HCC 79
  • G40.411 Other generalized epilepsy and epileptic syndromes, intractable, with status epilepticus from V24 HCC 79
  • G40.419 Other generalized epilepsy and epileptic syndromes, intractable, without status epilepticus from V24 HCC 79
  • G40.42 Cyclin-Dependent Kinase-Like 5 Deficiency Disorder from V24 HCC 79
  • G40.501 Epileptic seizures related to external causes, not intractable, with status epilepticus from V24 HCC 79
  • G40.509 Epileptic seizures related to external causes, not intractable, without status epilepticus from V24 HCC 79
  • G40.801 Other epilepsy, not intractable, with status epilepticus from V24 HCC 79
  • G40.802 Other epilepsy, not intractable, without status epilepticus from V24 HCC 79
  • G40.803 Other epilepsy, intractable, with status epilepticus from V24 HCC 79
  • G40.804 Other epilepsy, intractable, without status epilepticus from V24 HCC 79
  • G40.811 Lennox-Gastaut syndrome, not intractable, with status epilepticus from V24 HCC 79
  • G40.812 Lennox-Gastaut syndrome, not intractable, without status epilepticus from V24 HCC 79
  • G40.813 Lennox-Gastaut syndrome, intractable, with status epilepticus from V24 HCC 79
  • G40.814 Lennox-Gastaut syndrome, intractable, without status epilepticus from V24 HCC 79
  • G40.821 Epileptic spasms, not intractable, with status epilepticus from V24 HCC 79
  • G40.822 Epileptic spasms, not intractable, without status epilepticus from V24 HCC 79
  • G40.823 Epileptic spasms, intractable, with status epilepticus from V24 HCC 79
  • G40.824 Epileptic spasms, intractable, without status epilepticus from V24 HCC 79
  • G40.833 Dravet syndrome, intractable, with status epilepticus from V24 HCC 79
  • G40.834 Dravet syndrome, intractable, without status epilepticus from V24 HCC 79
  • G40.841 KCNQ2-related epilepsy, not intractable, with status epilepticus from V24 HCC 79
  • G40.842 KCNQ2-related epilepsy, not intractable, without status epilepticus from V24 HCC 79
  • G40.843 KCNQ2-related epilepsy, intractable, with status epilepticus from V24 HCC 79
  • G40.844 KCNQ2-related epilepsy, intractable, without status epilepticus from V24 HCC 79
  • G40.89 Other seizures from V24 HCC 79
  • G40.901 Epilepsy, unspecified, not intractable, with status epilepticus from V24 HCC 79
  • G40.909 Epilepsy, unspecified, not intractable, without status epilepticus from V24 HCC 79
  • G40.911 Epilepsy, unspecified, intractable, with status epilepticus from V24 HCC 79
  • G40.919 Epilepsy, unspecified, intractable, without status epilepticus from V24 HCC 79
  • G40.A01 Absence epileptic syndrome, not intractable, with status epilepticus from V24 HCC 79
  • G40.A09 Absence epileptic syndrome, not intractable, without status epilepticus from V24 HCC 79
  • G40.A11 Absence epileptic syndrome, intractable, with status epilepticus from V24 HCC 79
  • G40.A19 Absence epileptic syndrome, intractable, without status epilepticus from V24 HCC 79
  • G40.B01 Juvenile myoclonic epilepsy, not intractable, with status epilepticus from V24 HCC 79
  • G40.B09 Juvenile myoclonic epilepsy, not intractable, without status epilepticus from V24 HCC 79
  • G40.B11 Juvenile myoclonic epilepsy, intractable, with status epilepticus from V24 HCC 79
  • G40.B19 Juvenile myoclonic epilepsy, intractable, without status epilepticus from V24 HCC 79
  • G40.C01 Lafora progressive myoclonus epilepsy, not intractable, with status epilepticus from V24 HCC 79
  • G40.C09 Lafora progressive myoclonus epilepsy, not intractable, without status epilepticus from V24 HCC 79
  • G40.C11 Lafora progressive myoclonus epilepsy, intractable, with status epilepticus from V24 HCC 79
  • G40.C19 Lafora progressive myoclonus epilepsy, intractable, without status epilepticus from V24 HCC 79
  • G93.45 Developmental and epileptic encephalopathy from V24 HCC 79
  • P90 Convulsions of newborn new to V28
  • R56.00 Simple febrile convulsions from V24 HCC 79
  • R56.01 Complex febrile convulsions from V24 HCC 79
  • R56.1 Post traumatic seizures from V24 HCC 79
  • R56.9 Unspecified convulsions from V24 HCC 79

Every code above carries the full HCC 201 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 201

What is HCC 201 in the CMS-HCC model?

HCC 201 is CMS-HCC Category 201 (Seizure Disorders and Convulsions) in the V28 risk adjustment model. It covers 64 ICD-10-CM diagnosis codes that raise a Medicare Advantage beneficiary's risk score when documented.

What is the RAF weight for HCC 201?

For payment year 2026, HCC 201 adds 0.245 to the RAF score of a community, non-dual, aged beneficiary. The published weights range from 0.131 to 0.245 across the seven payment segments shown above.

Related References

All HCC CategoriesV24 to V28: What ChangedICD-10-CM Code Lookup

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.