F23
BillableBrief psychotic disorder
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is F23 an HCC code?
Yes. F23 maps to Delusional and Other Specified Psychotic Disorders under the CMS-HCC V28 risk adjustment model (and Reactive and Unspecified Psychosis 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 F23
For F23to 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 F23 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
F23 is the ICD-10-CM diagnosis code for brief psychotic disorder. A temporary mental health condition where a person experiences psychotic symptoms like hallucinations or delusions that last for a short period, typically triggered by extreme stress. F23 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, F23 maps to Delusional and Other Specified Psychotic Disorders (HCC 152) with a community, non-dual, aged base RAF weight of 0.546. Under the older CMS-HCC V24 model, F23 maps to Reactive and Unspecified Psychosis (HCC 58) with a community, non-dual, aged base RAF weight of 0.508. 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.
Specify the duration and whether psychotic symptoms are present or in remission. Because F23 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 F23 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Specify the duration and whether psychotic symptoms are present or in remission
- •Document the precipitating stressor when available to support medical necessity
Clinical Significance
Brief psychotic disorder is a temporary psychotic state lasting from one day to less than one month, often triggered by severe psychological stress. Patients experience a sudden onset of at least one psychotic symptom (delusions, hallucinations, disorganized speech, or grossly disorganized behavior) and typically return to full premorbid functioning. While time-limited, the acute presentation can be severe and requires urgent psychiatric intervention and safety monitoring.
Documentation Requirements
- ✓Documentation of psychotic symptoms (delusions, hallucinations, disorganized speech/behavior)
- ✓Duration specified as less than one month with full return to premorbid functioning
- ✓Identification of any precipitating stressor when present
- ✓Assessment by a qualified mental health professional ruling out other psychotic disorders
- ✓Safety assessment including risk of harm to self or others
- ✓Follow-up plan to ensure symptoms have fully resolved and to monitor for recurrence
Excludes 2 — Not included here, may code separately
Commonly Confused Codes
- •F20.81 — Schizophreniform disorder lasts one to six months; brief psychotic disorder is under one month
- •F20.9 — Schizophrenia requires at least six months of symptoms
- •F22 — Delusional disorder requires at least one month of delusions
- •F19.950/F19.951 — Substance-induced psychotic disorder should be used when psychosis is caused by substance use
- •F06.0/F06.2 — Psychotic disorder due to medical condition should be ruled out