HCC Coding

HCC Coding (Hierarchical Condition Category Coding)

HCC Coding is a risk-adjustment model used by Medicare to estimate the future health care costs of patients and ensure fair reimbursement to providers managing complex patient populations.

Through accurate documentation and coding of chronic conditions, HCC Coding plays a critical role in value-based payment models by aligning reimbursement with patient risk and care needs.

The HCC Coding model:

• Captures patient complexity to support accurate risk adjustment.

• Encourages continuous condition documentation and monitoring.

Supports financial sustainability in population-based care models.