Schizophrenia
Under the CMS-HCC V28 risk adjustment model (PY2026 Medicare Advantage), HCC 151 carries a community non-dual aged RAF of 0.511, and 12 payable ICD-10-CM diagnosis codes map to it.
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
Supersedes: HCC 152, HCC 153, HCC 154, HCC 155 (this category is counted instead of these when they co-occur).
ICD-10-CM codes that map to HCC 151 (12)
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.
- F20.0Paranoid schizophrenia
- F20.1Disorganized schizophrenia
- F20.2Catatonic schizophrenia
- F20.3Undifferentiated schizophrenia
- F20.5Residual schizophrenia
- F20.81Schizophreniform disorder
- F20.89Other schizophrenia
- F20.9Schizophrenia, unspecified
- F25.0Schizoaffective disorder, bipolar type
- F25.1Schizoaffective disorder, depressive type
- F25.8Other schizoaffective disorders
- F25.9Schizoaffective disorder, unspecified
Frequently asked questions
What is CMS-HCC V28 category 151?
HCC 151 is "Schizophrenia", a payment Hierarchical Condition Category in the CMS-HCC V28 risk adjustment model (100% phase-in for payment year 2026). 12 payable ICD-10-CM codes map to it.
What is the RAF weight for HCC 151?
The community non-dual aged relative factor for CMS-HCC V28 category 151 is 0.511. 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 151?
12 payable ICD-10-CM diagnosis codes map to CMS-HCC V28 category 151 (Schizophrenia) for payment year 2026.
Source: CMS published ICD-10-CM mapping file plus CMS-HCC v28 PY2026 model software.