HCC coding software
Look up which ICD-10-CM codes risk-adjust under CMS-HCC V28, see what the hierarchy suppresses, and score the whole chart as a RAF. The lookup below is free and needs no account; the RAF calculator is $39 a month or $390 a year, with a 7-day trial that takes no card.
Paste up to 5 diagnosis codes. This is the real tool.
What it does
- CMS-HCC V28 mapping for every ICD-10-CM code, with coefficients
- Hierarchies applied: which captured HCC is suppressed, and by what
- Age and sex edits shown on the mapping
- RAF score for the whole chart: segment, dual status, institutional, new enrollee, interactions, HCC count
- Diagnosis conflict check (Excludes1, laterality, sequencing, 7th characters) on the same codes
- HCC status on every ICD-10-CM code page
- Personal code lists and notes
What it does not
- V24 or older models (for PACE and pre-2026 payment years)
- MEAT documentation review
- Chart retrieval, EHR integration or batch submission to plans
- CPT (not needed for risk adjustment, and not licensed here yet)
What to check before you choose
The model and the year. For 2026 payment that is V28 alone. A tool still blending V24 is scoring last year’s money; a tool with V28 only, like this one, cannot help you audit 2025 or score PACE.
Whether it applies the hierarchy. Most of the “I captured it and the score did not move” questions are a hierarchy: E11.9 and E11.22 together pay only HCC 37. A lookup that lists both as risk-adjusting is wrong about the chart.
The segment. The same HCCs score differently for a full-benefit dual, a partial dual, a long-term institutional resident and a new enrollee. If a calculator only asks for age and sex, its RAF is the non-dual community score, and wrong for everyone else.
What else you code. If risk adjustment is all of your day, a dedicated HCC tool may be the cheaper buy. If you also work claims, inpatient stays or HCPCS, one subscription that does all of it beats two.
What it costs elsewhere
HCC Buddy
$29.99/mo ($19.99 founder rate) · $199.99/yr
V28 plus PY2025 V24 for reference, RAF calculator, MEAT evidence checklist, Chrome extension. Risk adjustment only.
HCC Coder (InnoviHealth)
$515/user/yr Standard · $750 Pro
HCC codes, risk calculators, lay descriptions and batch scoring; its plans also list Coding Clinic, Medicaid CDPS and single sign-on.
This site
$39/mo · $390/yr
V28 lookup and RAF scoring, plus the rest of the job: claim conflict checks, the MS-DRG grouper, ICD-10-PCS, HCPCS, Medicare coverage policy and fees.
From each vendor’s own pricing page, checked October 22, 2026. If risk adjustment is the only thing you do and you want MEAT and V24, HCC Buddy is cheaper and does more of that one job. Our yearly plan saves $78 against paying monthly.
Common questions
- Is there free HCC coding software?
- Yes, the lookup at the top of this page. Paste up to 5 ICD-10-CM codes and it returns each code's CMS-HCC V28 category, the coefficient, the age and sex edits, and which captured HCCs the hierarchy would suppress. No account, no card, no daily cap.
- Which CMS-HCC model does it use?
- V28 (the 2024 CMS-HCC model) for payment year 2026, from CMS's own model software and ICD-10 mappings. V28 is the only model in Medicare Advantage payment for 2026: the three-year phase-in from V24 finished on January 1. PACE organisations are the exception, still paid mostly on the older 2017 model. We carry V28 only, so for PACE or for auditing earlier payment years, use a tool that keeps the older models.
- What does the RAF calculator take into account?
- The patient's age and sex, the segment (community non-dual, partial dual or full dual, aged or disabled; long-term institutional; new enrollee), originally-disabled status, every captured HCC after hierarchies, the disease-interaction terms, and the payment HCC count. A score that ignores dual status is wrong for every dual-eligible patient, so the calculator will not leave it out.
- Does it check documentation (MEAT)?
- No. We map and score the codes you give it; whether the note supports them with monitoring, evaluation, assessment or treatment is your call, and we do not pretend software can make it from a code list. HCC Buddy has a MEAT evidence checklist if that is the piece you want.
- Can I pay monthly?
- Yes. $39 for a month or $390 for a year, one payment each, nothing renews by itself. The trial is 7 days and takes no card.
- Is it for individual coders or teams?
- Built for the individual coder, priced per coder. For a team of three or more, write to us and we set it up on one invoice with a 30-day team trial.
Where the mappings come from, and their release dates: data sources.
Score the whole chart.
The RAF calculator, unlimited lookups and the conflict check on the same codes. 7 days free, no card, nothing to cancel.
$39/mo or $390/yr · 7-day free trial · no card required