Alcohol Use with Psychotic Complications
Under the CMS-HCC V28 risk adjustment model (PY2026 Medicare Advantage), HCC 136 carries a community non-dual aged RAF of 0.424, and 19 payable ICD-10-CM diagnosis codes map to it. In the V28 hierarchy it is superseded by HCC 135 when a more severe category in the same disease group is also present.
RAF factors
The community factor varies by Medicaid and originally-disabled status; the institutional factor applies to long-term-institutional members. These are the CMS-HCC V28 PY2026 relative factors.
V28 hierarchy
Trumped by: HCC 135 (a more severe category in the same disease group supersedes this one).
Supersedes: HCC 137, HCC 138, HCC 139 (this category is counted instead of these when they co-occur).
ICD-10-CM codes that map to HCC 136 (19)
Payable diagnosis codes that map to this category under CMS-HCC V28 PY2026. Open any code for its full description, HCC mapping, and coding guidance.
- F10.131Alcohol abuse with withdrawal delirium
- F10.132Alcohol abuse with withdrawal with perceptual disturbance
- F10.150Alcohol abuse with alcohol-induced psychotic disorder with delusions
- F10.151Alcohol abuse with alcohol-induced psychotic disorder with hallucinations
- F10.159Alcohol abuse with alcohol-induced psychotic disorder, unspecified
- F10.231Alcohol dependence with withdrawal delirium
- F10.232Alcohol dependence with withdrawal with perceptual disturbance
- F10.250Alcohol dependence with alcohol-induced psychotic disorder with delusions
- F10.251Alcohol dependence with alcohol-induced psychotic disorder with hallucinations
- F10.259Alcohol dependence with alcohol-induced psychotic disorder, unspecified
- F10.26Alcohol dependence with alcohol-induced persisting amnestic disorder
- F10.27Alcohol dependence with alcohol-induced persisting dementia
- F10.931Alcohol use, unspecified with withdrawal delirium
- F10.932Alcohol use, unspecified with withdrawal with perceptual disturbance
- F10.950Alcohol use, unspecified with alcohol-induced psychotic disorder with delusions
- F10.951Alcohol use, unspecified with alcohol-induced psychotic disorder with hallucinations
- F10.959Alcohol use, unspecified with alcohol-induced psychotic disorder, unspecified
- F10.96Alcohol use, unspecified with alcohol-induced persisting amnestic disorder
- F10.97Alcohol use, unspecified with alcohol-induced persisting dementia
Frequently asked questions
What is CMS-HCC V28 category 136?
HCC 136 is "Alcohol Use with Psychotic Complications", a payment Hierarchical Condition Category in the CMS-HCC V28 risk adjustment model (100% phase-in for payment year 2026). 19 payable ICD-10-CM codes map to it.
What is the RAF weight for HCC 136?
The community non-dual aged relative factor for CMS-HCC V28 category 136 is 0.424. The exact factor varies by enrollment segment (community Medicaid and originally-disabled status, and institutional); the full segment table is published in the CMS V28 Rate Announcement.
How many ICD-10-CM codes map to HCC 136?
19 payable ICD-10-CM diagnosis codes map to CMS-HCC V28 category 136 (Alcohol Use with Psychotic Complications) for payment year 2026.
Which categories trump HCC 136 in the V28 hierarchy?
HCC 136 is superseded by HCC 135 (Drug Use with Psychotic Complications). When a more severe category in the same disease group is documented, it is counted instead of HCC 136.
Source: CMS published ICD-10-CM mapping file plus CMS-HCC v28 PY2026 model software.