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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 In the V28 hierarchy it is superseded by HCC 248 when a more severe category in the same disease group is also present.

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

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.

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HCC 249 is superseded by HCC 248 (Intracranial Hemorrhage).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.

Source: CMS published ICD-10-CM mapping file plus CMS-HCC v28 PY2026 model software.