V28 HCC 1
HIV/AIDS
Under the CMS-HCC V28 risk adjustment model (PY2026 Medicare Advantage), HCC 1 has a source-labeled community non-dual aged reference coefficient of 0.301, and 3 ICD-10-CM diagnosis codes appear in its official mapping.
RAF factors
The community factor varies by Medicaid and originally-disabled status; the institutional factor applies to long-term-institutional members. These are the CMS-HCC V28 PY2026 relative factors.
These are source-labeled code-level HCC coefficient references, not a full member score. Use the RAF Calculator with complete member context for CMS-HCC V28 PY2026. No score is shown unless every required source and calculation check passes.
ICD-10-CM codes that map to HCC 1 (3)
ICD-10-CM codes in the official mapping for this category under CMS-HCC V28 PY2026. Open any code for its full description and coding guidance.
Coder workflow notes
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Frequently asked questions
What is CMS-HCC V28 category 1?
HCC 1 is "HIV/AIDS", a Hierarchical Condition Category in the CMS-HCC V28 risk adjustment model (100% phase-in for payment year 2026). 3 ICD-10-CM codes appear in its official mapping.
What reference coefficient is published for HCC 1?
The source-labeled community non-dual aged reference coefficient for CMS-HCC V28 category 1 is 0.301. The exact coefficient varies by enrollment segment (community Medicaid and originally-disabled status, and institutional); the full segment table is published in the CMS V28 model files.
How many ICD-10-CM codes map to HCC 1?
3 ICD-10-CM diagnosis codes appear in the official mapping for CMS-HCC V28 category 1 (HIV/AIDS) for payment year 2026.
Related condition guides
In-depth HCC coding guides for conditions that map to category 1, with documentation tips, common mistakes, and the V24-to-V28 changes.
Related references
Sources
CMS ICD-10-CM order-file billability plus the published mapping and CMS-HCC V28 PY2026 model software. CMS-HCC V28 model published at CMS.gov Risk Adjustors; ICD-10-CM member codes from the CMS ICD-10-CM code set.
Verified current to CMS-HCC V28, payment year 2026 — last reviewed May 30, 2026.