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Table VIII-9. 2026 RxHCC Model with Disease Hierarchies (previously published in the 2023 Rate Announcement40) RxHCC If the Disease Group is listed in this column… …Then drop the RxHCC(s) listed in this column

RxHCC Model Hierarchical Condition Category Label

15 Chronic Myeloid Leukemia 17, 18, 19, 20, 21, 22 16 Multiple Myeloma and Other Hematologic Cancers 17, 18, 19, 20, 21, 22 17 Secondary Cancer of Bone and Kidney 18, 19, 20, 21, 22 18 Secondary Cancer of Lung, Liver, Brain, and Other Sites 19, 20, 21, 22 19 Leukemias and Other Hematologic Cancers 20, 21, 22 20 Lung, Kidney, and Other Cancers; Secondary Cancer of Lymph Nodes and Other Sites 21, 22 21 Lymphomas and Other Hematologic Cancers 22 30 Diabetes with Complications 31 40 Alpha-1-Antitrypsin Deficiency 43 41 Lysosomal Storage Disorders 43 42 Acromegaly and Other Endocrine and Metabolic Disorders 43 54 Chronic Viral Hepatitis C 55 65 Chronic Pancreatitis 66 81 Psoriatic Arthropathy 83, 84, 316 82 Systemic Sclerosis 83, 84 83 Rheumatoid Arthritis and Other Inflammatory Polyarthropathy 84 84 Systemic Lupus Erythematosus and Other Systemic Connective Tissue Disorders 317 111 Alzheimer's Disease 112 130 Schizophrenia and Other Psychosis 131, 132, 133 131 Bipolar Disorders 132, 133 132 Depression 133 146 Profound or Severe Intellectual Disability/Developmental Disorder 147, 148 147 Moderate Intellectual Disability/Developmental Disorder 148

40 Refer to CMS’ CY 2023 Rate Announcement.