V28 HCC 154
Bipolar Disorders without Psychosis
Under the CMS-HCC V28 risk adjustment model (PY2026 Medicare Advantage), HCC 154 has a source-labeled community non-dual aged reference coefficient of 0.351, and 27 ICD-10-CM diagnosis codes appear in its official mapping. In the V28 hierarchy it is superseded by HCC 151, HCC 152, HCC 153 when a more severe category in the same disease group is also present.
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, 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)
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.
- 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 Hierarchical Condition Category in the CMS-HCC V28 risk adjustment model (100% phase-in for payment year 2026). 27 ICD-10-CM codes appear in its official mapping.
What reference coefficient is published for HCC 154?
The source-labeled community non-dual aged reference coefficient for CMS-HCC V28 category 154 is 0.351. 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 154?
27 ICD-10-CM diagnosis codes appear in the official mapping for 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 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.