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Hierarchical Condition Categories

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The challenge: identifying, treating and managing complex health conditions

Healthcare continues to shift toward value-based care strategies, but it isn’t without its challenges – like how to care for those with complex healthcare needs while also decreasing unnecessary spend. To help combat this challenge, in 2003, the Centers for Medicare and Medicaid Services (CMS) introduced Hierarchical Condition Categories (HCCs). HCCs are a set of medical codes that help identify individuals with severe acute illnesses or chronic health conditions, helping providers and payors better understand the conditions of patients and their projected needs

Download the overview: Help improve patient care and receive proper reimbursement with HCCs

The solution: Cerner Hierarchical Condition Categories

Cerner Hierarchical Condition Categories aims to improve patient care while also helping you obtain proper reimbursements for the severe or chronically ill populations you serve. Using data-backed intelligence, Cerner HCC coding flags previously documented HCCs that need to be readdressed and identifies suspected conditions based on lab results, vital signs, medications and treatments, aiming to help you uncover gaps in documentation and care to better optimize risk adjustment scores and determine baseline costs so you can receive accurate payments and reimbursements.


Identify previously documented diagnoses


Discover suspected conditions


Schedule appointments


Properly document suspected HCCs


Validate and substantiate claim payments

The Cerner difference

Cerner Hierarchical Condition Categories is just one way we are helping health happen. With nearly a decade of experience in the HCC space and the capability to tap into more than 70 HCCs that correlate to international classification of diseases (ICD-10) diagnoses codes, we have the foundational knowledge to help you close the door on disjointed care and increase reimbursement.


"The HCC advisor is invaluable; having the problem list flag the HCC codes in a visual way was beneficial for our team. We would update problem lists, and then the system would flag HCCs needing coded. That’s worked well especially for diabetes."

Steven Aguilar | Medical Director for Primary Care, Genesis ACO | MD

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Learn how Cerner aims to improve patient care while also helping you obtain proper reimbursements for the severe or chronically ill populations you serve.
Talk with an expert