Primary Care Payment Model – Full Code Set 2025

1. 2025 PCPM Measure Value Set – Advanced Illness and Frailty [PDF]
2. 2025 PCPM Measure Value Set – Blood Pressure Control of Patients with Diabetes [PDF]
3. 2025 PCPM Measure Value Set – Breast Cancer Screening [PDF]
4. 2025 PCPM Measure Value Set – Cervical Cancer Screening [PDF]
5. 2025 PCPM Measure Value Set – Child and Adolescent Well-Care Visits [PDF]
6. 2025 PCPM Measure Value Set – Childhood Immunization Status [PDF]
7. 2025 PCPM Measure Value Set – Colorectal Cancer Screening [PDF]
8. 2025 PCPM Measure Value Set – Controlling Blood Pressure [PDF]
9. 2025 PCPM Measure Value Set – Eye Exam for Patients with Diabetes [PDF]
10. 2025 PCPM Measure Value Set – Glycemic Status Assessment for Patients with Diabetes (8.0) [PDF]
11. 2025 PCPM Measure Value Set – Glycemic Status Assessment for Patients with Diabetes (9.0) [PDF]
12. 2025 PCPM Measure Value Set – Immunizations for Adolescents [PDF]
13. 2025 PCPM Measure Value Set – Kidney Health Evaluation for Patients with Diabetes [PDF]
14. 2025 PCPM Measure Value Set – Medication Adherence for Cholesterol (Statins) [PDF]
15. 2025 PCPM Measure Value Set – Medication Adherence for Diabetes [PDF]
16. 2025 PCPM Measure Value Set – Review of Chronic Conditions [PDF]
17. 2025 PCPM Measure Value Set – Screening for Depression and Follow-Up Plan [PDF]
18. 2025 PCPM Measure Value Set – Statin Therapy for Patients with Cardiovascular Disease - Received Statin Therapy (PCP Performance) [PDF]
19. 2025 PCPM Measure Value Set – Well-Child Visits in the First 30 Months of Life [PDF]

2025 Acceptable Specialty Types for the Review of Chronic Conditions Measure [PDF]

https://www.cms.gov/medicare/payment/medicare-advantage-rates-statistics/risk-adjustment/2025-model-software/icd-10-mappings

Please click on the link to download the full list of Center for Medicare Services (CMS) – Hierarchical Condition Categories (HCC) ICD-10 Codes. After selecting the applicable year, on the next page, click on “(Year selected) Initial ICD-10 Mappings (ZIP)”. Once the file is finished downloading, you will need to open and “unzip” the file to access the excel version of the CMS-HCC ICD-10 Code list. If you experience any issues downloading the file or have any questions regarding the HCC code list, please reach out to PSInquiries@hmsa.com.

2025 PO Performance Measures

2025 PCPM Measure Value Set – Statin Therapy for Patients with Cardiovascular Disease – Received Statin Therapy (PO Performance) [PDF]

2025 PT Performance Measures

2025 Thresholds, Adjustment Factors, and Weights (PCPM Performance Measure) [PDF]

Provider Communications

Curant Health: Medication Adherence Program Overview [PDF]

Revision History