Major Depressive Disorder HCC Coding Guide
Major Depressive Disorder (e.g. F32.1) maps to HCC 155 (Major Depression, Moderate or Severe, without Psychosis) under the CMS-HCC V28 risk adjustment model, with a community, non-dual, aged RAF weight of 0.299; V28 reached 100% phase-in for payment year 2026. F32.0, major depressive disorder, single episode, mild, is non-HCC under V28. It can also map to HCC 152 (Psychosis, Except Schizophrenia) when the documentation supports those manifestations.
Complete HCC coding guide for Major Depressive Disorder (F32.x, F33.x) including ICD-10 to HCC mapping, V28 RAF weights, and episode documentation.
Medically reviewed by Jess P., CPC · Reviewed: May 9, 2026 · Updated for CMS-HCC V28 and FY2026 ICD-10-CM
Quick Facts
HCC Categories
HCC 152, Psychosis, Except Schizophrenia
HCC 155, Major Depression, Moderate or Severe, without Psychosis
RAF Weight Range
0.299 to 0.484
Community, non-dual, aged (V28)
Model
CMS-HCC V28 (PY2026, 100% phase-in)
6 ICD-10 codes map to payment HCCs
What HCC category does Major Depressive Disorder map to under V28?
Major depressive disorder is one of the most common behavioral health conditions in risk adjustment, with roughly 21 million US adults reporting a major depressive episode in a given year. Under CMS-HCC V28, these codes do not all land in one bucket. Moderate and severe-without-psychosis episodes (F32.1, F32.2, F33.1, F33.2) map to HCC 155, Major Depression, Moderate or Severe, without Psychosis (community non-dual aged RAF 0.299). Episodes with psychotic features (F32.3, F33.3) instead map to HCC 152, Psychosis, Except Schizophrenia (RAF 0.484). Mild episodes, remission codes, and unspecified depression (F32.9, F32.A) carry no V28 payment HCC, so documenting episode type, severity, and any psychotic features is what drives the correct category.
ICD-10 to HCC Mapping
| ICD-10 Code | Description | Billable | HCC Mapping |
|---|---|---|---|
| F32.0 | Major depressive disorder, single episode, mild | Yes | No HCC (not risk-adjusting under V28) |
| F32.1 | Major depressive disorder, single episode, moderate | Yes | HCC 155 |
| F32.2 | Major depressive disorder, single episode, severe without psychotic features | Yes | HCC 155 |
| F32.3 | Major depressive disorder, single episode, severe with psychotic features | Yes | HCC 152 |
| F33.0 | Major depressive disorder, recurrent, mild | Yes | No HCC (not risk-adjusting under V28) |
| F33.1 | Major depressive disorder, recurrent, moderate | Yes | HCC 155 |
| F33.2 | Major depressive disorder, recurrent, severe without psychotic features | Yes | HCC 155 |
| F33.3 | Major depressive disorder, recurrent, severe with psychotic features | Yes | HCC 152 |
| F33.40 | Major depressive disorder, recurrent, in remission, unspecified | Yes | No HCC (not risk-adjusting under V28) |
| F33.41 | Major depressive disorder, recurrent, in partial remission | Yes | No HCC (not risk-adjusting under V28) |
RAF weights are community, non-dual, aged base coefficients from the CMS-HCC V28 model (PY2026). Verify against the latest CMS rate announcement for payment calculations.
HCC Buddy maps Major Depressive Disorder from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Documentation Tips
Clearly document 'major depressive disorder', do not use vague terms like 'depression' or 'depressed mood' which may not support an MDD code.
Specify single episode (F32) vs. recurrent (F33) based on the patient's history of prior depressive episodes.
Document the current severity: mild, moderate, severe, or severe with psychotic features.
Include PHQ-9 score or other validated assessment tool results to support severity documentation.
Record current treatment: medication names, psychotherapy modality, and any treatment changes to satisfy MEAT criteria.
Document whether the patient is in partial or full remission if the acute episode has resolved, remission codes also map to HCC 155.
Note any co-occurring anxiety, substance use, or psychotic features that may affect code selection.
Common Coding Mistakes
Coding F32.A (depression, unspecified) or F32.9 instead of a specific severity code when the provider has documented mild, moderate, or severe depression.
Using 'recurrent' (F33) for a first-time episode, or 'single episode' (F32) for a patient with documented prior episodes.
Failing to capture psychotic features (F32.3 or F33.3) when documented, which reflects higher severity.
Confusing major depressive disorder with persistent depressive disorder (F34.1/dysthymia), which does not map to HCC 155 in V28.
V24 to V28 Changes
In V28, depression is no longer a single broad payment category. CMS split it by severity and psychotic status: moderate and severe-without-psychosis episodes feed HCC 155, Major Depression, Moderate or Severe, without Psychosis (community non-dual aged RAF 0.299), while episodes with psychotic features route to HCC 152, Psychosis, Except Schizophrenia (RAF 0.484). This is a good example of one diagnosis family mapping to more than one HCC, where the documented detail, not the base diagnosis alone, decides the category. V28 also dropped mild, remission, and unspecified depression codes (including F32.9 and F32.A) from payment mapping, so vague or low-severity documentation no longer earns an HCC.
Related Conditions
Related references
Sources
RAF weights are community, non-dual, aged base coefficients from the CMS-HCC V28 model (PY2026). Verify against the latest CMS Rate Announcement for payment.
Verified current to CMS-HCC V28, payment year 2026 — last reviewed May 9, 2026.
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