Bipolar Disorders without Psychosis
Under the CMS-HCC V28 risk adjustment model (PY2026 Medicare Advantage), HCC 154 carries a community non-dual aged RAF of 0.351, and 27 payable ICD-10-CM diagnosis codes map to it. In the V28 hierarchy it is superseded by HCC 151, HCC 152, HCC 153 when a more severe category in the same disease group is also present.
Medically reviewed by Jess P., CPC · Reviewed: May 30, 2026
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.
Combine this factor with demographics and other HCCs in the RAF score calculator to model the full CMS-HCC V28 RAF for a member.
V28 hierarchy
Trumped by: HCC 151, HCC 152, HCC 153 (a more severe category in the same disease group supersedes this one).
Supersedes: HCC 155 (this category is counted instead of these when they co-occur).
ICD-10-CM codes that map to HCC 154 (27)
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.
- F30.10Manic episode without psychotic symptoms, unspecified
- F30.11Manic episode without psychotic symptoms, mild
- F30.12Manic episode without psychotic symptoms, moderate
- F30.13Manic episode, severe, without psychotic symptoms
- F30.3Manic episode in partial remission
- F30.8Other manic episodes
- F30.9Manic episode, unspecified
- F31.0Bipolar disorder, current episode hypomanic
- F31.10Bipolar disorder, current episode manic without psychotic features, unspecified
- F31.11Bipolar disorder, current episode manic without psychotic features, mild
- F31.12Bipolar disorder, current episode manic without psychotic features, moderate
- F31.13Bipolar disorder, current episode manic without psychotic features, severe
- F31.30Bipolar disorder, current episode depressed, mild or moderate severity, unspecified
- F31.31Bipolar disorder, current episode depressed, mild
- F31.32Bipolar disorder, current episode depressed, moderate
- F31.4Bipolar disorder, current episode depressed, severe, without psychotic features
- F31.60Bipolar disorder, current episode mixed, unspecified
- F31.61Bipolar disorder, current episode mixed, mild
- F31.62Bipolar disorder, current episode mixed, moderate
- F31.63Bipolar disorder, current episode mixed, severe, without psychotic features
- F31.71Bipolar disorder, in partial remission, most recent episode hypomanic
- F31.73Bipolar disorder, in partial remission, most recent episode manic
- F31.75Bipolar disorder, in partial remission, most recent episode depressed
- F31.77Bipolar disorder, in partial remission, most recent episode mixed
- F31.81Bipolar II disorder
- F31.89Other bipolar disorder
- F31.9Bipolar disorder, unspecified
Coder workflow notes
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Frequently asked questions
What is CMS-HCC V28 category 154?
HCC 154 is "Bipolar Disorders without Psychosis", a payment Hierarchical Condition Category in the CMS-HCC V28 risk adjustment model (100% phase-in for payment year 2026). 27 payable ICD-10-CM codes map to it.
What is the RAF weight for HCC 154?
The community non-dual aged relative factor for CMS-HCC V28 category 154 is 0.351. 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 154?
27 payable ICD-10-CM diagnosis codes map to CMS-HCC V28 category 154 (Bipolar Disorders without Psychosis) for payment year 2026.
Which categories trump HCC 154 in the V28 hierarchy?
HCC 154 is superseded by HCC 151 (Schizophrenia), HCC 152 (Psychosis, Except Schizophrenia), HCC 153 (Personality Disorders; Anorexia/Bulimia Nervosa). When a more severe category in the same disease group is documented, it is counted instead of HCC 154.
Related references
Sources
CMS published ICD-10-CM mapping file plus 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.