F15.951
BillableOther stimulant use, unspecified with stimulant-induced psychotic disorder with hallucinations
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is F15.951 an HCC code?
Yes. F15.951 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 F15.951
For F15.951to 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 F15.951 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
F15.951 is the ICD-10-CM diagnosis code for other stimulant use, unspecified with stimulant-induced psychotic disorder with hallucinations. A person is using stimulant drugs (such as cocaine, amphetamines, or similar substances) and is experiencing psychotic symptoms, specifically hallucinations (seeing or hearing things that aren't real) as a direct result of the drug use. This code is used when the specific type of stimulant is not identified. F15.951 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, F15.951 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, F15.951 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.
Verify documentation clearly links the hallucinations to stimulant use rather than an independent psychotic disorder; the psychosis must be substance-induced. Because F15.951 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 F15.951 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Verify documentation clearly links the hallucinations to stimulant use rather than an independent psychotic disorder; the psychosis must be substance-induced
- •If the specific stimulant is identified (cocaine, amphetamine, other specified stimulant), use the more specific F15.1xx or F15.2xx codes instead of the 'unspecified' code
Clinical Significance
Stimulant use, unspecified with stimulant-induced psychotic disorder with hallucinations captures severe psychotic symptoms in the context of stimulant use when the use pattern is not characterized. Hallucinations from stimulants are often vivid and can be visual, auditory, or tactile (formication). This is a high-severity presentation that typically requires emergency psychiatric intervention and maps to the top-tier substance use HCC.
Documentation Requirements
- ✓Documentation of stimulant use
- ✓Hallucinations described with type (auditory, visual, tactile)
- ✓Temporal link between stimulant use and hallucinatory symptoms
- ✓Documentation distinguishing substance-induced hallucinations from primary psychotic disorder
- ✓Psychiatric assessment and treatment plan
- ✓Query to provider regarding abuse vs. dependence
Commonly Confused Codes
- •F15.151 — Stimulant abuse with psychotic disorder with hallucinations; use when abuse is documented
- •F15.251 — Stimulant dependence with psychotic disorder with hallucinations; use when dependence is documented
- •F15.950 — Stimulant use, unspecified with psychotic disorder with delusions; delusions vs. hallucinations
- •F15.922 — Stimulant use, unspecified with intoxication with perceptual disturbance; transient vs. persistent