F25.8
BillableOther schizoaffective disorders
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is F25.8 an HCC code?
Yes. F25.8 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 F25.8
For F25.8 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 F25.8 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
F25.8 is the ICD-10-CM diagnosis code for other schizoaffective disorders. A mental health condition combining psychotic symptoms with mood disturbances that don't fit neatly into the bipolar or depressive schizoaffective categories. F25.8 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, F25.8 maps to Schizophrenia (HCC 151) with a community, non-dual, aged base RAF weight of 0.244. Under the older V24 model, F25.8 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.
Use this code only when the presentation doesn't clearly fit F25.0 or F25.1. Because F25.8 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 F25.8 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
Clinical Significance
Other schizoaffective disorders captures presentations that combine psychotic and mood features but do not clearly fit the bipolar or depressive schizoaffective subtypes. This may include presentations with mixed mood episodes (simultaneous manic and depressive features with psychosis) or atypical mood patterns. The diagnosis carries the same clinical weight as specified schizoaffective types and requires equally intensive psychiatric treatment.
Documentation Requirements
- ✓Diagnosis by a qualified psychiatrist
- ✓Documentation explaining why the presentation does not fit F25.0 (bipolar type) or F25.1 (depressive type)
- ✓Description of both psychotic and mood symptoms
- ✓Evidence that psychotic symptoms occur outside of mood episodes
- ✓Current treatment plan and medication regimen
- ✓Functional assessment and treatment response documentation
Commonly Confused Codes
- •F25.0 — Schizoaffective disorder, bipolar type if manic episodes predominate
- •F25.1 — Schizoaffective disorder, depressive type if depressive episodes predominate
- •F25.9 — Schizoaffective disorder, unspecified is for when the type cannot be determined
- •F20.3 — Undifferentiated schizophrenia should be used when mood episodes are not prominent
- •F31.9 — Bipolar disorder, unspecified should be used when psychosis occurs only during mood episodes