Multiple Sclerosis
Under the CMS-HCC V28 risk adjustment model (PY2026 Medicare Advantage), HCC 198 carries a community non-dual aged RAF of 0.647, and 20 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.
Combine this factor with demographics and other HCCs in the RAF score calculator to model the full CMS-HCC V28 RAF for a member.
ICD-10-CM codes that map to HCC 198 (20)
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.
- G35Multiple sclerosis
- G35.ARelapsing-remitting multiple sclerosis
- G35.B0Primary progressive multiple sclerosis, unspecified
- G35.B1Active primary progressive multiple sclerosis
- G35.B2Non-active primary progressive multiple sclerosis
- G35.C0Secondary progressive multiple sclerosis, unspecified
- G35.C1Active secondary progressive multiple sclerosis
- G35.C2Non-active secondary progressive multiple sclerosis
- G35.DMultiple sclerosis, unspecified
- G36.0Neuromyelitis optica [Devic]
- G36.1Acute and subacute hemorrhagic leukoencephalitis [Hurst]
- G36.8Other specified acute disseminated demyelination
- G36.9Acute disseminated demyelination, unspecified
- G37.0Diffuse sclerosis of central nervous system
- G37.1Central demyelination of corpus callosum
- G37.2Central pontine myelinolysis
- G37.5Concentric sclerosis [Balo] of central nervous system
- G37.81Myelin oligodendrocyte glycoprotein antibody disease
- G37.89Other specified demyelinating diseases of central nervous system
- G37.9Demyelinating disease of central nervous system, unspecified
Coder workflow notes
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Frequently asked questions
What is CMS-HCC V28 category 198?
HCC 198 is "Multiple Sclerosis", a payment Hierarchical Condition Category in the CMS-HCC V28 risk adjustment model (100% phase-in for payment year 2026). 20 payable ICD-10-CM codes map to it.
What is the RAF weight for HCC 198?
The community non-dual aged relative factor for CMS-HCC V28 category 198 is 0.647. 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 198?
20 payable ICD-10-CM diagnosis codes map to CMS-HCC V28 category 198 (Multiple Sclerosis) 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.