F15.950
BillableOther stimulant use, unspecified 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 F15.950 an HCC code?
Yes. F15.950 maps to Drug Use with Psychotic Complications under the CMS-HCC V28 risk adjustment model (and Substance Use with Psychotic Complications 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 F15.950
For F15.950to 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 F15.950 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
F15.950 is the ICD-10-CM diagnosis code for other stimulant use, unspecified with stimulant-induced psychotic disorder with delusions. A serious mental condition where stimulant drug use causes psychotic symptoms including false beliefs (delusions) in someone with unspecified use pattern. F15.950 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, F15.950 maps to Drug Use with Psychotic Complications (HCC 135) with a community, non-dual, aged base RAF weight of 0.424. Under the older CMS-HCC V24 model, F15.950 maps to Substance Use with Psychotic Complications (HCC 54) with a community, non-dual, aged base RAF weight of 0.329. 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 the specific type of delusions (paranoid, grandiose, etc.) if available for clinical clarity. Because F15.950 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 F15.950 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Document the specific type of delusions (paranoid, grandiose, etc.) if available for clinical clarity
- •This is a more severe presentation requiring psychiatric evaluation and possible hospitalization
Clinical Significance
Stimulant use, unspecified with stimulant-induced psychotic disorder with delusions represents a severe psychiatric presentation where psychosis with delusions develops in the context of stimulant use. Despite the unspecified use pattern, the psychotic features elevate this to the highest substance use HCC category. This code is commonly used when acute psychosis is the presenting complaint and full substance use history is not yet available.
Documentation Requirements
- ✓Documentation of stimulant use (specific substance when possible)
- ✓Psychotic symptoms specifically characterized as delusions
- ✓Temporal relationship between stimulant use and onset of delusions
- ✓Documentation ruling out primary psychotic disorder
- ✓Psychiatric evaluation and treatment plan
- ✓Query to provider regarding abuse vs. dependence status
Commonly Confused Codes
- •F15.150 — Stimulant abuse with psychotic disorder with delusions; use when abuse is documented
- •F15.250 — Stimulant dependence with psychotic disorder with delusions; use when dependence is documented
- •F15.951 — Stimulant use, unspecified with psychotic disorder with hallucinations; hallucinations vs. delusions
- •F22 — Delusional disorder; primary delusional disorder, not substance-induced