RAF Score Calculator
Calculate Risk Adjustment Factor scores based on HCC codes
1 Patient Information
2 Select HCC Codes
Select all applicable HCC codes for the patient. Additional codes can be added using the custom input below.
Add Custom HCC Code
RAF Score Results
Base Score
–
HCC Score
–
Total RAF Score
–
Selected HCC Codes:
About RAF Scores
What is a RAF Score?
The Risk Adjustment Factor (RAF) score is used by Medicare Advantage plans to predict healthcare costs for individual patients. Higher RAF scores indicate patients with more complex medical conditions who are expected to require more healthcare resources.
How it’s Calculated
RAF scores are calculated using demographic factors (age, gender) and Hierarchical Condition Category (HCC) codes that represent specific medical conditions and their associated risk weights.
Key Components
- •Demographic factors (age, gender, Medicaid status)
- •HCC codes representing medical conditions
- •Risk weights assigned to each condition
- •Interaction factors between conditions
Note: This calculator provides estimates based on simplified CMS-HCC model factors. Actual RAF scores may vary based on additional factors and current CMS guidelines.