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V28 HCC 155

Major Depression, Moderate or Severe, without Psychosis

Under the CMS-HCC V28 risk adjustment model (PY2026 Medicare Advantage), HCC 155 has a source-labeled community non-dual aged reference coefficient of 0.299, and 371 ICD-10-CM diagnosis codes appear in its official mapping. In the V28 hierarchy it is superseded by HCC 151, HCC 152, HCC 153, HCC 154 when a more severe category in the same disease group is also present.

By the HCC Buddy Coding Team · Reviewed: May 30, 2026
V28 HCC 155Community non-dual aged reference coefficient 0.299

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.

Community NA: 0.299Community PBA: 0.269Community FBA: 0.316Community ND: 0.166Community PBD: 0.108Community FBD: 0.126Institutional: 0.199

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, HCC 154 (a more severe category in the same disease group supersedes this one).

ICD-10-CM codes that map to HCC 155 (371)

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.

Coder workflow notes

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Frequently asked questions

What is CMS-HCC V28 category 155?

HCC 155 is "Major Depression, Moderate or Severe, without Psychosis", a Hierarchical Condition Category in the CMS-HCC V28 risk adjustment model (100% phase-in for payment year 2026). 371 ICD-10-CM codes appear in its official mapping.

What reference coefficient is published for HCC 155?

The source-labeled community non-dual aged reference coefficient for CMS-HCC V28 category 155 is 0.299. 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 155?

371 ICD-10-CM diagnosis codes appear in the official mapping for CMS-HCC V28 category 155 (Major Depression, Moderate or Severe, without Psychosis) for payment year 2026.

Which categories trump HCC 155 in the V28 hierarchy?

HCC 155 is superseded by HCC 151 (Schizophrenia), HCC 152 (Psychosis, Except Schizophrenia), HCC 153 (Personality Disorders; Anorexia/Bulimia Nervosa), HCC 154 (Bipolar Disorders without Psychosis). When a more severe category in the same disease group is documented, it is counted instead of HCC 155.

Related condition guides

In-depth HCC coding guides for conditions that map to category 155, 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.