F15.250
BillableOther stimulant dependence with stimulant-induced psychotic disorder with delusions
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is F15.250 an HCC code?
Yes. F15.250 maps to Drug/Alcohol Psychosis under the CMS-HCC V28 risk adjustment model (and Drug/Alcohol Psychosis under V24).
HCC Category Mapping
RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. Actual per-patient RAF contribution depends on member segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.
MEAT Criteria for F15.250
For F15.250 to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically — it has to be re-documented and supported each calendar year.
- MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
- EEvaluate: test results, medication response, or physical findings reviewed by the provider
- AAssess: explicit mention in the assessment or plan with acknowledgment of status
- TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis
Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed F15.250 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
F15.250 is the ICD-10-CM diagnosis code for other stimulant dependence with stimulant-induced psychotic disorder with delusions. A person dependent on stimulants who has developed psychosis (a severe mental condition) with delusions, which are false beliefs caused by the stimulant use. F15.250 sits in the ICD-10-CM chapter for mental, behavioral and neurodevelopmental disorders (f01-f99), within the section covering mental and behavioral disorders due to psychoactive substance use (f10-f19).
Under the CMS-HCC V28 risk adjustment model, F15.250 maps to Drug/Alcohol Psychosis (HCC 135) with a community, non-dual, aged base RAF weight of 0.000. Under the older V24 model, F15.250 mapped to the same category but with a base RAF weight of 0.434 — V28 recalibrated weights across the entire model. V28 is the CMS-HCC risk adjustment model that reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition.
Document psychotic symptoms with specific mention of delusions (false fixed beliefs). Because F15.250 maps to a payment HCC, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's Medicare Advantage risk adjustment score. When documentation is ambiguous, coders should issue a provider query rather than assume the highest-specificity variant.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for F15.250 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Document psychotic symptoms with specific mention of delusions (false fixed beliefs)
- •Distinguish from intoxication-related perceptual disturbances by documenting true psychotic disorder features
Clinical Significance
Stimulant dependence with stimulant-induced psychotic disorder with delusions is a severe psychiatric presentation combining chronic dependence with active psychosis. Stimulant-induced delusions (often paranoid in nature) can persist beyond the period of acute intoxication and may require extended psychiatric treatment. This represents the highest severity level within the stimulant use disorder spectrum for risk adjustment purposes.
Documentation Requirements
- ✓Documented stimulant dependence meeting clinical criteria
- ✓Psychotic symptoms specifically described as delusions (fixed false beliefs, often paranoid)
- ✓Clear temporal and causal relationship between stimulant use and onset of delusions
- ✓Documentation ruling out primary psychotic disorder (schizophrenia, schizoaffective disorder)
- ✓Psychiatric evaluation and treatment plan for both psychosis and dependence
Commonly Confused Codes
- •F15.150 — Stimulant abuse with psychotic disorder with delusions; abuse is less severe than dependence
- •F15.251 — Stimulant dependence with psychotic disorder with hallucinations; hallucinations vs. delusions
- •F15.222 — Stimulant dependence with intoxication with perceptual disturbance; transient intoxication effect, not persistent psychosis
- •F20.0 — Paranoid schizophrenia; primary psychotic disorder, not substance-induced
- •F14.250 — Cocaine dependence with psychotic disorder with delusions; use when cocaine is identified