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V28 HCC 249Community non-dual aged RAF 0.239

Ischemic or Unspecified Stroke

Under the CMS-HCC V28 risk adjustment model (PY2026 Medicare Advantage), HCC 249 carries a community non-dual aged RAF of 0.239, and 95 payable ICD-10-CM diagnosis codes map to it. In the V28 hierarchy it is superseded by HCC 248 when a more severe category in the same disease group is also present.

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: 0.239Community PBA: 0.299Community FBA: 0.377Community ND: 0.18Community PBD: 0.172Community FBD: 0.277Institutional: 0.081

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

Trumped by: HCC 248 (a more severe category in the same disease group supersedes this one).

ICD-10-CM codes that map to HCC 249 (95)

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 249: 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 249?

HCC 249 is "Ischemic or Unspecified Stroke", a payment Hierarchical Condition Category in the CMS-HCC V28 risk adjustment model (100% phase-in for payment year 2026). 95 payable ICD-10-CM codes map to it.

What is the RAF weight for HCC 249?

The community non-dual aged relative factor for CMS-HCC V28 category 249 is 0.239. 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 249?

95 payable ICD-10-CM diagnosis codes map to CMS-HCC V28 category 249 (Ischemic or Unspecified Stroke) for payment year 2026.

Which categories trump HCC 249 in the V28 hierarchy?

HCC 249 is superseded by HCC 248 (Intracranial Hemorrhage). When a more severe category in the same disease group is documented, it is counted instead of HCC 249.

Related condition guides

In-depth HCC coding guides for conditions that map to category 249, with documentation tips, common mistakes, and the V24-to-V28 changes.

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.