HCC / Risk Adjustment • Engine V28

The chronic conditions your engine should flag before the reset closes

Every documented chronic HCC drops off at midnight on December 31. If it is not re-documented and re-coded during the calendar year, its risk weight resets to zero and the revenue walks out the door with it.

The short answer: recapture is not a coding cleanup you do in Q1. It is a documentation deadline. Under CMS-HCC V28, a condition counts only if a face-to-face encounter this calendar year carries a specific, ICD-10-CM FY2026 code with monitor / evaluate / assess / treat support. The calculator below shows what an unrecaptured panel is worth, and exactly what each gap needs to close.

V28
CMS-HCC model, fully phased in for payment year 2026
Jan 1
Annual reset. Prior-year diagnoses do not carry forward
FY2026
ICD-10-CM specificity effective for dates of service from Oct 1, 2025
M.E.A.T.
Every recaptured HCC needs it in the note, not just on the claim
Why the window is real

The reset is a hard date, not a rolling average

CMS-HCC risk scores are rebuilt from a single collection year of diagnoses. A patient coded with a chronic condition last year starts this year at zero for that condition. The engine's whole job is to surface which conditions have not yet been re-documented while there is still a visit left to do it in.

JAN 1
Reset
Every chronic HCC returns to zero weight for the new collection year.
JAN–SEP
Recapture window
Each qualifying encounter re-establishes a condition with a dated, coded, supported note.
OCT–DEC
Closing fast
The gaps still open now are the ones that need a scheduled visit, not a query.
DEC 31
Window shut
Anything unrecaptured is gone for the year. No retroactive fix short of a compliant encounter.
Interactive • unrecaptured HCC value

Toggle the open gaps. Watch the panel value move.

Select the chronic conditions documented in a prior year but not yet recaptured this year. The panel sums the incremental risk and estimates the revenue at stake. Weights shown are illustrative of the V28 structure for a community, non-dual member and are not a payment quote.

Unrecaptured chronic HCCs

Tap a condition to mark its gap as still open. HCC categories reflect CMS-HCC V28.
Incremental risk score
0.000
Sum of open-gap condition weights for one member
Est. annual revenue at risk
$0
Risk score × benchmark. Illustrative only.

Illustrative model. Actual dollars depend on your county rate book, the member's full risk profile, coding intensity adjustment, and the V28 normalization factor in the CY2026 Rate Announcement. Use it to prioritize, not to bill.

What each gap actually needs

A flag is only useful if it names the documentation

Recapture fails at the note, not the model. A code without support does not survive a RADV review. These are the four things every recaptured HCC needs in the encounter, plus the specificity traps that quietly drop a condition out of a payable category under V28.

M

Monitor

Signs, symptoms, disease progression or regression noted at this visit.

  • Diabetes: current glucose control, A1c trend
  • CHF: weight, edema, functional class
E

Evaluate

Test results, response to treatment, exam findings tied to the condition.

  • CKD: eGFR reviewed and staged
  • COPD: spirometry or O2 status referenced
A

Assess

The condition addressed in the assessment, not carried silently in history.

  • Stated in the A/P, not just the problem list
  • Status clarified: stable, worsening, controlled
T

Treat

Medication, referral, order or plan that ties the diagnosis to the visit.

  • Rx continued or adjusted with reason
  • Specialist referral or care plan update
TRAP
Unspecified codes that lost their HCC
V28 removed or reclassified many low-specificity categories. An unspecified diabetes or vascular code may map to nothing. FY2026 ICD-10-CM specificity is what keeps the condition in a payable HCC.
TRAP
Laterality and stage that must be stated
CKD stage, diabetic complication linkage, and body-site specificity are not optional. "N1" style shortcuts do not mean drop laterality. Code to the full detail the FY2026 tabular requires.
TRAP
Status conditions coded once, then forgotten
Amputation status, ostomy, transplant status and dialysis dependence are chronic HCCs that reset annually the same way. The engine should flag them even when no acute visit is scheduled.
Engine logic

How V28 (our HCC engine) decides what to surface

Recapture is a five-step comparison the engine runs every time it sees a panel. The output is not a score. It is a worklist: which member, which condition, which visit, and what the note is missing.

1

Read prior year

Pull every chronic HCC captured in the last collection year.

2

Check this year

Has a qualifying encounter re-documented it since Jan 1?

3
Test the note

Does the encounter carry M.E.A.T. and an FY2026-specific code?

4
Score the gap

Weight the open condition and rank by revenue and closeability.

5
Route it

Send to the visit, the coder, or the provider query before Dec 31.

Grounded in the real rules

The 2026 guidance this page is built on

No invented benchmarks. Every claim above traces to a named, current source. Verify against the primary documents before you operationalize anything.

2026
CMS-HCC Model V28
The 2024 CMS-HCC risk adjustment model, phased in over three years and fully weighted for payment year 2026. Restructured HCC categories and revised coefficients versus V24.
CY26
CY2026 Medicare Advantage & Part D Rate Announcement
Sets the risk-score normalization factor, coding pattern adjustment, and effective V28 blend for the payment year.
FY26
ICD-10-CM Official Guidelines for Coding and Reporting, FY2026
Effective for discharges and dates of service on or after October 1, 2025. Governs the specificity, laterality, and linkage that keep a diagnosis inside a payable HCC.
2026
ICD-10-CM FY2026 code set (CMS / CDC NCHS)
The annual code additions, deletions, and revisions. New and deleted codes shift how chronic conditions map under V28.
RADV
CMS Risk Adjustment Data Validation program
The audit that recovers payment for diagnoses not supported by the medical record. Why a flagged gap must be closed with documentation, not a code alone.
POL
Medicare Managed Care Manual, Ch. 7 (risk adjustment)
The face-to-face encounter and acceptable-provider-type rules that define what counts as a qualifying recapture visit.

Turn the reset deadline into a ranked worklist, not a year-end scramble

ASP-RCM Solutions runs risk-adjustment gap closure inside your workflow: a V28-aware engine that surfaces unrecaptured chronic HCCs, names the documentation each one needs, and routes the highest-value, most-closeable gaps to the right visit while the window is still open. Grounded in the FY2026 code set, tuned for RADV defensibility, and built to hand your coders a list instead of a mystery.

Book a recapture readiness review
See where your panel stands before December 31 • ASP-RCM Solutions • Frisco, TX