F32.1
BillableMajor depressive disorder, single episode, moderate
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is F32.1 an HCC code?
Yes. F32.1 maps to Major Depressive, Bipolar, and Paranoid 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 F32.1
For F32.1 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 F32.1 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
F32.1 is the ICD-10-CM diagnosis code for major depressive disorder, single episode, moderate. A first-time episode of major depression with moderate symptoms that cause noticeable difficulty with work, school, or daily activities. F32.1 sits in the ICD-10-CM chapter for mental, behavioral and neurodevelopmental disorders (f01-f99), within the section covering mood [affective] disorders (f30-f39).
Under the CMS-HCC V28 risk adjustment model, F32.1 maps to Major Depressive, Bipolar, and Paranoid Disorders (HCC 155) with a community, non-dual, aged base RAF weight of 0.425. Under the older V24 model, F32.1 mapped to the same category but with a base RAF weight of 0.309 — 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.
Moderate severity indicates more significant functional impairment than mild but less than severe. Because F32.1 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 F32.1 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Moderate severity indicates more significant functional impairment than mild but less than severe
- •Document specific depressive symptoms (sleep changes, appetite changes, concentration problems, etc.) to support severity level
Clinical Significance
Major depressive disorder, single episode, moderate represents a first-time major depressive episode with meaningful functional impairment in work, social, and personal domains. Moderate severity indicates the patient is struggling significantly but can still perform some daily functions. This severity level typically drives active treatment with antidepressants and/or psychotherapy.
Documentation Requirements
- ✓Provider documentation of major depressive disorder meeting diagnostic criteria
- ✓Single (first) episode confirmed through history review
- ✓Moderate severity explicitly documented with functional impairment described
- ✓Core depressive symptoms documented with at least 5 of 9 criteria met
- ✓Duration of at least 2 weeks
- ✓Treatment plan appropriate for moderate depression