V28 HCC 152
Psychosis, Except Schizophrenia
Under the CMS-HCC V28 risk adjustment model (PY2026 Medicare Advantage), HCC 152 has a source-labeled community non-dual aged reference coefficient of 0.484, and 12 ICD-10-CM diagnosis codes appear in its official mapping. In the V28 hierarchy it is superseded by HCC 151 when a more severe category in the same disease group is also present.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.
These are source-labeled code-level HCC coefficient references, not a full member score. Use the RAF Calculator with complete member context for CMS-HCC V28 PY2026. No score is shown unless every required source and calculation check passes.
V28 hierarchy
Trumped by: HCC 151 (a more severe category in the same disease group supersedes this one).
Supersedes: 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 152 (12)
ICD-10-CM codes in the official mapping for this category under CMS-HCC V28 PY2026. Open any code for its full description and coding guidance.
- F22Delusional disorders
- F23Brief psychotic disorder
- F24Shared psychotic disorder
- F28Other psychotic disorder not due to a substance or known physiological condition
- F29Unspecified psychosis not due to a substance or known physiological condition
- F30.2Manic episode, severe with psychotic symptoms
- F31.2Bipolar disorder, current episode manic severe with psychotic features
- F31.5Bipolar disorder, current episode depressed, severe, with psychotic features
- F31.64Bipolar disorder, current episode mixed, severe, with psychotic features
- F32.3Major depressive disorder, single episode, severe with psychotic features
- F33.3Major depressive disorder, recurrent, severe with psychotic symptoms
- F53.1Puerperal psychosis
Coder workflow notes
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Frequently asked questions
What is CMS-HCC V28 category 152?
HCC 152 is "Psychosis, Except Schizophrenia", a Hierarchical Condition Category in the CMS-HCC V28 risk adjustment model (100% phase-in for payment year 2026). 12 ICD-10-CM codes appear in its official mapping.
What reference coefficient is published for HCC 152?
The source-labeled community non-dual aged reference coefficient for CMS-HCC V28 category 152 is 0.484. The exact coefficient varies by enrollment segment (community Medicaid and originally-disabled status, and institutional); the full segment table is published in the CMS V28 model files.
How many ICD-10-CM codes map to HCC 152?
12 ICD-10-CM diagnosis codes appear in the official mapping for CMS-HCC V28 category 152 (Psychosis, Except Schizophrenia) for payment year 2026.
Which categories trump HCC 152 in the V28 hierarchy?
HCC 152 is superseded by HCC 151 (Schizophrenia). When a more severe category in the same disease group is documented, it is counted instead of HCC 152.
Related condition guides
In-depth HCC coding guides for conditions that map to category 152, with documentation tips, common mistakes, and the V24-to-V28 changes.
Related references
Sources
CMS ICD-10-CM order-file billability plus the published mapping and CMS-HCC V28 PY2026 model software. CMS-HCC V28 model published at CMS.gov Risk Adjustors; ICD-10-CM member codes from the CMS ICD-10-CM code set.
Verified current to CMS-HCC V28, payment year 2026 — last reviewed May 30, 2026.