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V28 HCC 155Community non-dual aged RAF 0.299

Major Depression, Moderate or Severe, without Psychosis

Under the CMS-HCC V28 risk adjustment model (PY2026 Medicare Advantage), HCC 155 carries a community non-dual aged RAF of 0.299, and 371 payable ICD-10-CM diagnosis codes map to it. In the V28 hierarchy it is superseded by HCC 151, HCC 152, HCC 153, HCC 154 when a more severe category in the same disease group is also present.

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.

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

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

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

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.

Coder workflow notes

Get the V28 RAF + MEAT cheat sheet

A printable one-pager for HCC 155: which member codes risk-adjust, the RAF weight, and the MEAT your notes need to make it stick. Free, no card.

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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 payment Hierarchical Condition Category in the CMS-HCC V28 risk adjustment model (100% phase-in for payment year 2026). 371 payable ICD-10-CM codes map to it.

What is the RAF weight for HCC 155?

The community non-dual aged relative factor for CMS-HCC V28 category 155 is 0.299. 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 155?

371 payable ICD-10-CM diagnosis codes map to 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HCC 155 is superseded by HCC 151 (Schizophrenia), HCC 152 (Psychosis, Except Schizophrenia), HCC 153 (Personality Disorders; Anorexia/Bulimia Nervosa), HCC 154 (Bipolar Disorders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 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.