1.079
2024 CMS-HCC model
- Normalization factor, CY 2027 [2]
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CMS-HCC 2027 model recalibration: what moved, and what CMS shelved
Short answer: the CY 2027 Rate Announcement kept the 2024 CMS-HCC model and declined to finalize the recalibration on 2023 diagnoses and 2024 expenditures [2]. Coefficients coders work to are unchanged. The normalization factor (1.079), the diagnosis sources and the PACE blend are not.
Advance Notice · Jan 26, 2026Rate Announcement · Apr 6, 20262024 CMS-HCC continues · 115 HCCs1.079 · down from 1.083 proposed
Focus
Recalibration
Framework
2024 CMS-HCC
Metric
1.079
Effective date
CY 2027
Horizon
Jan 26 to Apr 6, 2026
Length
6 min
2024CMS-HCC
Model CMS will continue to use for non-PACE risk scores in CY 2027 [2]
1.079
Final normalization factor for that model, down from 1.083 proposed [2]
-1.12%
Payment effect of model revision and normalization, all from the normalization update [1]
+2.48%
Overall expected change in MA payment for CY 2027, versus +0.09% proposed [1]
What CMS proposed, and what it kept
CMS will "continue to calculate Part C non-ESRD risk scores using the 2024 CMS-HCC model while we evaluate risk adjustment model refinements for the future" [2]. Categories, hierarchies and coefficients do not move; everything around them did [1].
| Element | Advance Notice (January 26, 2026) | Rate Announcement (April 6, 2026) |
|---|---|---|
| Part C model, non-PACE | Recalibrated 2027 CMS-HCC model, 2023 diagnoses and 2024 expenditures | 2024 CMS-HCC model continues |
| Model revision and normalization | -3.32 percent | -1.12 percent, all from normalization |
| Normalization factor, 2024 CMS-HCC model | 1.083 proposed (five-year multiple regression) | 1.079 final (four-year simple regression, 2022 to 2025) |
| Sources of diagnoses | -1.53 percent | -1.53 percent; unlinked CRRs excluded with a switcher exception; audio-only excluded |
| MA coding pattern adjustment | 5.90 percent | 5.90 percent |
| Overall expected change | +0.09 percent | +2.48 percent |
Proposed impact by condition group, not adopted
Commenters feared multi-chronic beneficiaries would carry lower weights; CMS answered that coefficients fall and rise in every recalibration [2].
Proposed 2027 model impact on MA risk scores by condition group, after the skin substitute adjustment [2]
Attachment III Section I, response to comments. None of it applies in 2027; it is the best public evidence of where a future recalibration would press. CMS said payment accuracy declines as a model ages.
Metabolic
-6.8%
Kidney
-6.3%
Substance use
-6.1%
Lung
-6.0%
Heart disease
-5.6%
Musculoskeletal
-5.3%
Psychiatric
-5.0%
Diabetes
-4.9%
Transplant
+9.5%the one group that rose
02.557.510%
Lower relative weightHigher relative weight
The normalization factor, and its inputs
Average FFS risk scores under the 2024 CMS-HCC model, the inputs to the 2027 factor [2]
CMS proposed 1.083 on five years with a COVID flag; commenters argued 2021 overstated the trend, and CMS moved to a simple regression on 2022 to 2025 for 1.079, implying about 1.6 percent growth a year. Five years return for CY 2028.
0.968
excluded
2021
0.992
+2.5%
2022
1.009
+1.7%
2023
1.025
+1.6%
2024
1.045
+2.0%
2025
Excluded from the final regressionIn the regressionLatest year
How the 2027 score was set
- 1Advance NoticeJan 26, 2026Recalibrated model proposed; 1.083
- 2Rate AnnouncementApr 6, 20262024 CMS-HCC kept; 1.079 final
- 3Data year closesDec 31, 2026Last 2026 date of service that feeds the 2027 score
- 4Payment year 2027Jan 1, 2027Unlinked CRRs and audio-only diagnoses out of the score
- 5CY 2028 Advance Noticeearly 2027Watch for a second attempt at recalibration on newer data
Keep, change, watch
Keep
- The V28 crosswalk, hierarchies and specificity prompts you run today: same 115 categories, same stage, type and severity language
- Our V28 coding reference stays current for 2027
Change
- Any workflow whose output is a standalone chart review submission; link it to an encounter or make it a pre-visit prompt
- Audio-only encounters are filtered out [1]; see our 2027 playbook
Watch
- The CY 2028 Advance Notice, due in early 2027, for a second recalibration attempt
- For finance: 1.079 and 5.90 percent are the two numbers to update; the RAF score explainer works an example and the RAF calculator runs a panel
Takeaway
The model coders worked to in 2026 is the model that pays in 2027. The divisor moved, and the two policies that changed both reward conditions documented at a face-to-face 2026 visit and nothing else.
Three updates before December 31
Update the finance modelNormalization 1.079 and coding adjustment 5.90 percent in every RAF projection.
Re-point retrospective outputEvery chart review finding links to a 2026 encounter or becomes a prompt for a visit still on the calendar.
Keep the coder sign-offOur risk adjustment coding services code to the 2024 CMS-HCC model with a certified coder owning every code; the HCC risk adjustment AI behind it holds a 7,903-code V28 crosswalk to 115 payment HCCs, audited at 1,500 of 1,500 codes. When CMS recalibrates, the crosswalk changes; the sign-off does not.
Frequently asked questions
Is V28 still the payment model in 2027?
Yes. The 2024 CMS-HCC model, commonly called V28, reached 100 percent of the risk score in 2026 and continues unchanged for CY 2027 for non-PACE organizations. CMS did not finalize the proposed 2027 recalibration.
Why did the model impact fall from -3.32 to -1.12 percent?
The Advance Notice figure combined the proposed recalibration with normalization. Because the recalibration was not adopted, the final -1.12 percent reflects only the updated normalization factor, which also fell from a proposed 1.083 to 1.079.
What data would a future recalibration use?
The proposal used 2023 diagnoses and 2024 expenditures from Original Medicare, the most recent available. CMS said it will consider updates for future years and that payment accuracy declines the longer a model ages.
Does the PACE model change in 2027?
PACE risk scores are a 50/50 blend of the 2024 and 2017 CMS-HCC models for CY 2027, with normalization factors of 1.079 and 1.202 respectively. The unlinked chart review exclusion does not apply to PACE in 2027.
- CMS fact sheet: 2027 Medicare Advantage and Part D Rate Announcement (April 6, 2026)
- CMS: Announcement of CY 2027 Medicare Advantage Capitation Rates and Part C and Part D Payment Policies (April 6, 2026), Attachment III Sections I, L, M and N
Checked October 25, 2026. Rules change; confirm against the source before relying on them. CMS has said the RADV audit schedule is subject to change.
Want your RAF model updated for the 2027 factors?
We re-run your panel on the 2024 CMS-HCC model with the 1.079 normalization factor and 5.90 percent coding adjustment, and show which conditions depended on unlinked chart reviews.