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V28 HCC 195Community non-dual aged RAF 2.909

Myasthenia Gravis with (Acute) Exacerbation

Under the CMS-HCC V28 risk adjustment model (PY2026 Medicare Advantage), HCC 195 carries a community non-dual aged RAF of 2.909, and 1 payable ICD-10-CM diagnosis codes map to it.

Medically reviewed by Jess P., CPC · Reviewed: May 30, 2026

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.

Community NA: 2.909Community PBA: 2.69Community FBA: 2.153Community ND: 3.633Community PBD: 1.779Community FBD: 3.323Institutional: 1.837

Combine this factor with demographics and other HCCs in the RAF score calculator to model the full CMS-HCC V28 RAF for a member.

V28 hierarchy

Supersedes: HCC 196 (this category is counted instead of these when they co-occur).

ICD-10-CM codes that map to HCC 195 (1)

Payable diagnosis codes that map to this category under CMS-HCC V28 PY2026. Open any code for its full description, HCC mapping, and coding guidance.

Coder workflow notes

Get the V28 RAF + MEAT cheat sheet

A printable one-pager for HCC 195: which member codes risk-adjust, the RAF weight, and the MEAT your notes need to make it stick. Free, no card.

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Frequently asked questions

What is CMS-HCC V28 category 195?

HCC 195 is "Myasthenia Gravis with (Acute) Exacerbation", a payment Hierarchical Condition Category in the CMS-HCC V28 risk adjustment model (100% phase-in for payment year 2026). 1 payable ICD-10-CM codes map to it.

What is the RAF weight for HCC 195?

The community non-dual aged relative factor for CMS-HCC V28 category 195 is 2.909. The exact factor varies by enrollment segment (community Medicaid and originally-disabled status, and institutional); the full segment table is published in the CMS V28 Rate Announcement.

How many ICD-10-CM codes map to HCC 195?

1 payable ICD-10-CM diagnosis codes map to CMS-HCC V28 category 195 (Myasthenia Gravis with (Acute) Exacerbation) for payment year 2026.

Related references

Sources

CMS published ICD-10-CM mapping file plus 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.