Hierarchical Conditional Category (HCC) Practice Test 2026 - Free Practice Questions and Study Guide

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Which agency uses the RAF values for Medicare Advantage payments?

Federal Insurance Commission

National Health Service

Department of Health and Human Services (HHS)

Centers for Medicare & Medicaid Services (CMS)

RAF values are used to adjust Medicare Advantage payments based on enrollees’ health status. The Centers for Medicare & Medicaid Services, a component of the Department of Health and Human Services, runs the Medicare Advantage program and applies these risk-adjusted payments using the RAF scores. This makes CMS the agency that uses RAF values for MA payments. The other options don’t fit because the UK’s National Health Service operates a different system, and while HHS oversees CMS, the specific calculation and application of RAF-based MA payments is handled by CMS.

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