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 HCC 201 neither supersedes nor is superseded by any other category, so it always counts alongside unrelated HCCs.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 (living at home, age 65 or over, not also enrolled in Medicaid). 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.