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FY2027 ICD-10-CM reference

F19.950: Other psychoactive substance use, unspecified with psychoactive substance-induced psychotic disorder with delusions

By the HCC Buddy Coding Team

The official ICD-10-CM descriptor is Other psychoactive substance use, unspecified with psychoactive substance-induced psychotic disorder with delusions. The FY2027 annual edition starts October 1, 2026. Check the edition that applies to the encounter or inpatient discharge, including any April update.

Billable code. Verified against the official FY2027 order file.

CMS-HCC V28

  • HCC 135: Drug Use with Psychotic Complications · RAF 0.424, Community Non-Dual Aged (CNA)

Payment year 2027, 2026 dates of service. HCC from the CMS 2027 Initial ICD-10-CM Mappings; RAF from the CMS-HCC V28 relative factors. For 2027 dates of service, CMS has not yet published the payment year 2028 mappings.

CMS-HCC V24

Not used for payment year 2027 Medicare Advantage payment

ESRD

  • HCC 54: Substance Use with Psychotic Complications

Coefficient pending: payment year 2027 coefficients for this model are not yet verified, so no RAF is shown. Mapping: PY2026 CMS mapping; CMS 2027 initial file unchanged.

PACE

Source verification pending

RxHCC

No category in the PY2026 CMS mapping; CMS 2027 initial file unchanged

HHS-HCC

  • HCC 81: Drug Use with Psychotic Complications

RAF not applicable: HHS-HCC weights vary by metal level. Mapping: HHS-HCC 2026 benefit year.

FY2027 Tabular instructions

Instructions below include applicable chapter, section and parent-code notes. Each note identifies where it appears in the official source.

Includes

disorders of psychological development

Source: F01-F99 (chapter, inherited).

Excludes2

symptoms, signs and abnormal clinical laboratory findings, not elsewhere classified (R00-R99)

Source: F01-F99 (chapter, inherited).

Includes

polysubstance drug use (indiscriminate drug use)

Source: F19 (category, inherited).

Excludes1

other psychoactive substance abuse (F19.1-)

Source: F19.9 (self, inherited).

Excludes1

other psychoactive substance dependence (F19.2-)

Source: F19.9 (self, inherited).

Source: CMS FY2027 Tabular List and Alphabetic Index.

Open Tabular instructions and code details

Compare the FY2027 additions, removals and billable-status changes

What does F19.950 mean in FY2027?

The official ICD-10-CM descriptor is Other psychoactive substance use, unspecified with psychoactive substance-induced psychotic disorder with delusions. The FY2027 annual edition starts October 1, 2026. Check the edition that applies to the encounter or inpatient discharge, including any April update.

Is F19.950 billable in FY2027?

The FY2027 order file marks F19.950 as billable. Check the complete Tabular instructions and documentation before assigning it.

Does F19.950 map to an HCC?

In the CMS 2027 Initial ICD-10-CM Mappings (payment year 2027, 2026 dates of service), F19.950 maps to CMS-HCC V28 HCC 135 (Drug Use with Psychotic Complications). For 2027 dates of service, CMS has not yet published the payment year 2028 mappings. Under the PY2026 CMS mapping; CMS 2027 initial file unchanged: ESRD HCC 54; no RxHCC category. Coefficients for these models are pending verification for payment year 2027. HHS-HCC: HCC 81 under the HHS-HCC 2026 benefit year mapping (no RAF; HHS-HCC weights vary by metal level). CMS-HCC V24: not used for payment year 2027 Medicare Advantage payment (CMS CY 2027 Rate Announcement). The PACE mapping is still pending verification for FY2027.

Source: CMS FY2027 ICD-10-CM order file. Payment model: CMS CY 2027 Rate Announcement. Read the FY2027 Official Guidelines.

Review the FY2026 April edition