F20 ICD-10-CM Code: Schizophrenia
F20 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC coding software
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FY 2026 Apr update / Mental, Behavioral and Neurodevelopmental disorders (F01-F99) / Schizophrenia, schizotypal, delusional, and other non-mood psychotic disorders (F20-F29)
F20
Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidanceSchizophrenia
Schizophrenia
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
N/A—
Not mapped
ACA/HHS
N/A—
Not mapped
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for F20 in this effective period.
Excludes 2
Official- schizophrenic reaction in:
- alcoholism (F10.15-, F10.25-, F10.95-)
- brain disease (F06.2)
- epilepsy (F06.2)
- psychoactive drug use (F11-F19 with .15. .25, .95)
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for F20 in this effective period.
Excludes 1
Official- brief psychotic disorder (F23)
- cyclic schizophrenia (F25.0)
- mood [affective] disorders with psychotic symptoms (F30.2, F31.2, F31.5, F31.64, F32.3, F33.3)
- schizoaffective disorder (F25.-)
- schizophrenic reaction NOS (F23)
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for F20 in this effective period.
Use Additional
Official- code, if applicable, to identify:
- other specified cognitive deficit (R41.84-)
Code Also
OfficialICD-10-CM does not list Code Also instructions for F20 in this effective period.
Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →
- Code
- F20
- Description
- Schizophrenia
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF reference coefficient
- —
- Billable
- No
- Payment year
- 2026
Coder workflow notes
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What This Code Means
F20 is the ICD-10-CM diagnosis code for schizophrenia. F20 sits in the ICD-10-CM chapter for mental, behavioral and neurodevelopmental disorders (f01-f99), within the section covering schizophrenia, schizotypal, delusional, and other non-mood psychotic disorders (f20-f29).
Header codes like F20 cannot be reported on claims directly; they organize child codes that share clinical context. Coders should select the billable child code that matches the documented presentation and then verify its current source-backed HCC mapping. Do not infer a child code or risk adjustment value from the header alone.
HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for F20 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Excludes 1, Do NOT code together
Excludes 2, Not included here, may code separately
Use Additional Code
- code, if applicable, to identify:
- other specified cognitive deficit (R41.84-)