F20.2
BillableCatatonic schizophrenia
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is F20.2 an HCC code?
Yes. F20.2 maps to Schizophrenia under the CMS-HCC V28 risk adjustment model (and Schizophrenia 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 F20.2
For F20.2 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 F20.2 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
F20.2 is the ICD-10-CM diagnosis code for catatonic schizophrenia. A type of schizophrenia where a person exhibits unusual motor behaviors, such as remaining motionless for extended periods, excessive purposeless movement, or mimicking others' movements. F20.2 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).
Under the CMS-HCC V28 risk adjustment model, F20.2 maps to Schizophrenia (HCC 151) with a community, non-dual, aged base RAF weight of 0.244. Under the older V24 model, F20.2 mapped to the same category but with a base RAF weight of 0.508 — 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 specific catatonic features such as waxy flexibility, mutism, or posturing. Because F20.2 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 F20.2 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Document specific catatonic features such as waxy flexibility, mutism, or posturing
- •Ensure catatonic symptoms are present and are not attributed to another medical condition or substance use
Clinical Significance
Catatonic schizophrenia is characterized by prominent psychomotor disturbances including stupor, rigidity, waxy flexibility, negativism, mutism, or excessive purposeless motor activity. This is a potentially life-threatening presentation requiring urgent medical attention, as patients may become unable to eat, drink, or care for themselves. The severe nature of catatonic episodes, which may require benzodiazepines or electroconvulsive therapy, justifies the high HCC weight.
Documentation Requirements
- ✓Diagnosis of schizophrenia with catatonic features by a qualified mental health professional
- ✓Documentation of specific catatonic symptoms (stupor, catalepsy, waxy flexibility, mutism, negativism, posturing, mannerisms, stereotypy, agitation, grimacing, echolalia, echopraxia)
- ✓At least three catatonic features should be documented per diagnostic criteria
- ✓Assessment of nutritional status and ability to maintain hydration during catatonic episodes
- ✓Current treatment approach (benzodiazepines, electroconvulsive therapy, antipsychotics)
- ✓Monitoring plan for medical complications (dehydration, deep vein thrombosis, aspiration)
Excludes 1 — Do NOT code together
- catatonic stupor (R40.1)
Commonly Confused Codes
- •F06.1 — Catatonic disorder due to known physiological condition; use when catatonia has a medical cause (e.g., autoimmune encephalitis)
- •F20.0 — Paranoid schizophrenia lacks the motor features characteristic of catatonic schizophrenia
- •F20.1 — Disorganized schizophrenia has behavioral disorganization but not the specific motor features of catatonia
- •R40.1 — Stupor as a symptom code should not be used when catatonic schizophrenia is diagnosed
- •F31.2 — Bipolar disorder with catatonic features may present similarly but involves mood episodes