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HCC (Hierarchical Condition Category) Coding for Medical Practitioners: A Six Part Video Series

Joint Sponsorship

Premiere Date: Tuesday, February 16, 2016

This activity offers CE credit for:

  1. Physicians (CME)
  2. Other

All other clinicians will receive a Certificate of Attendance stating this activity was certified for AMA PRA Category 1 Creditâ„¢

Credit Expiration Date:
Thursday, February 16, 2017
Note: Credit Is No Longer Available


Sam Breeding, MDSam Breeding, MD 
Chief Medical Officer
Holston Medical Group, PC

Statement of Need

In 2004 Medicare implemented an HCC (Hierarchical Condition Categories) model to adjust capitation payments to Medicare Advantage plans for the health expenditure risk of their enrollees. The Centers for Medicare and Medicaid (CMS) Risk Adjustment Model measures the disease burden that includes 79 HCC categories (2014 model), which are correlated to diagnosis codes and funds the plan based on the projected needs of the patient.

Provider understanding of the HCC model is important for the financial viability of the Medicare Advantage Plan.

Learning Objectives

At the end of this CE activity, participants should be able to:

  • Describe the impact that diagnosis coding has on risk adjustment models
  • Discuss the elements of the medical record used for diagnosis selection
  • Apply the HCC risk adjustment model to your medical practice

Target Audience

Primary Care Providers and Specialist Physicians who participate in Medicare Advantage Plans and other reimbursement programs that utilize HCC Coding.

Credit Information

CME Credit (Physicians):
CME Outfitters, LLC designates this live activity for a maximum of 5.5 AMA PRA Category 1 CreditsTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of CME Outfitters, LLC and Holston Medical Group. CME Outfitters, LLC is accredited by the ACCME to provide continuing medical education for physicians.

Disclosure Declaration

All faculty participating in CME Outfitters continuing education activities are required to disclose any conflict(s) of interest related to the content of their presentation(s) as defined by the ACCME's Standards for Commercial Support, and other accrediting and regulatory bodies. Full disclosure of faculty relationships will be made on this website and within the activity course materials prior to the premiere date of this activity.

Questions about this activity? Call us at 877.CME.PROS (877.263.7767).


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