Integrate CMS-HCC Risk Adjustment Anywhere

Fast EHR & care management integration

Focus on your app, we maintain the CMS-HCC models

Complete HCC & risk factor profile

Pricing as low as ¢2 per API call


A REST API for the CMS-HCC risk adjustment models. The model is used by the Centers for Medicare and Medicaid Serivces (CMS) to ensure payments to participating Medicare Advantage (MA) health plans reflect the relative health risk of enrollees. This API supports model years 2021-2024 and version models V22, V24 and V28(Proposed) used to make payments to MA and PACE organizations.

Enable your data scientists and developers to integrate HCCs and risk scores into medical record review, EHR, care management, and other analytic processes. Simply submit your demographic and diagnosis data to the API to produce a full risk profile for your enrollee.