F24
BillableShared psychotic disorder
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is F24 an HCC code?
Yes. F24 maps to Delusional and Other Specified Psychotic Disorders under the CMS-HCC V28 risk adjustment model (and Major Depressive, Bipolar, and Paranoid Disorders 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 F24
For F24 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 F24 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
F24 is the ICD-10-CM diagnosis code for shared psychotic disorder. A rare condition where delusional beliefs are transmitted from one individual to another, typically occurring in people who are closely related or live together. F24 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, F24 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, F24 maps to Major Depressive, Bipolar, and Paranoid Disorders (HCC 59) with a community, non-dual, aged base RAF weight of 0.309. 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.
Both the primary and secondary cases should be coded; document the relationship between affected individuals. Because F24 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 F24 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Both the primary and secondary cases should be coded; document the relationship between affected individuals
- •Ensure documentation clearly identifies which person has the primary psychotic disorder
Clinical Significance
Shared psychotic disorder (folie a deux) is a rare condition where delusional beliefs are transmitted from a person with a primary psychotic disorder to a closely associated individual. The secondary case typically would not have developed psychosis independently. This condition requires identification and treatment of both the primary and secondary cases. Accurate coding captures the psychiatric complexity and ensures appropriate risk adjustment for both patients involved.
Documentation Requirements
- ✓Documented identification of both the primary case (person with original psychotic disorder) and the secondary case
- ✓Description of the shared delusional content
- ✓Documentation of the close relationship between the affected individuals (family members, cohabitants)
- ✓Assessment confirming the secondary case would not have developed the delusion independently
- ✓Treatment plan including separation from the primary case and individual psychiatric treatment
- ✓Assessment of whether the shared delusions persist after separation