F33.2 maps to CMS-HCC V28 155. A source-labeled RAF reference is available. Confirm the documented diagnosis and applicable coding requirements. MEAT criteria · RAF Calculator · HCC coding software

ICD-10-CM Code View

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Code lookupF33.2

Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Mental, Behavioral and Neurodevelopmental disorders (F01-F99) / Mood [affective] disorders (F30-F39)

F33.2

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Major depressive disorder, recurrent severe without psychotic features

Multiple episodes of severe depression throughout a person's life with significant symptoms that greatly impair functioning, but without hallucinations or delusions.

Buddy Insight

Major depressive disorder, recurrent, severe without psychotic features indicates a pattern of repeated major depressive episodes with the current episode causing marked functional impairment.

Overview Risk Models Code Book Documentation Audit Notes Edition comparison

CMS-HCC V28

Mapped

HCC 155

Major Depression, Moderate or...

Coefficient HCC 155: 0.299 (Community Non-Dual Aged (CNA))

CMS-HCC V24

Historical

Not used for standard CY2026 Medicare Advantage payment. Select a historical period to review V24.

Not used for CY2026 payment

ACA/HHS

Context needed

HCC 088

Conditional HHS-HCC mapping: HCC 088 when age >= 2. Select the member context before showing a coefficient reference. Metal level and model segment are required for coefficients; no single RAF is shown.

Coefficient needs member context

ESRD/PACE

Context needed

HCC 59

ESRD candidates: HCC 59 when age >= 2 or age < 2. ESRD mapping is separate from PACE. Dialysis, graft, age, and other member context determine the applicable coefficient.

Coefficient needs member context

RXHCC

Mapped

HCC 132

Depression

Code-level coefficient reference

Code Book Path

Official

F33Major depressive disorder, recurrent F33.2Major depressive disorder, recurrent severe without psychotic features

Inclusion Terms

Official

No inclusion terms are included in this display for F33.2. Check the code and parent instructions in the Code Book.

Excludes 2

Official

symptoms, signs and abnormal clinical laboratory findings, not elsewhere classified (R00-R99)Inherited from F01-F99

Related Codes

Official

F33.0Major depressive disorder, recurrent, mild F33.1Major depressive disorder, recurrent, moderate F33.3Major depressive disorder, recurrent, severe with psychotic symptoms F33.4Major depressive disorder, recurrent, in remission F33.8Other recurrent depressive disorders

Includes

Official

disorders of psychological developmentInherited from F01-F99, F33
recurrent episodes of depressive reactionInherited from F01-F99, F33
recurrent episodes of endogenous depressionInherited from F01-F99, F33
recurrent episodes of major depressionInherited from F01-F99, F33
recurrent episodes of psychogenic depressionInherited from F01-F99, F33
recurrent episodes of reactive depressionInherited from F01-F99, F33
recurrent episodes of seasonal affective disorderInherited from F01-F99, F33
recurrent episodes of seasonal depressive disorderInherited from F01-F99, F33
recurrent episodes of vital depressionInherited from F01-F99, F33

Excludes 1

Official

bipolar disorder (F31.-)Inherited from F33
manic episode (F30.-)Inherited from F33

Code First

Official

No Code First sequencing instructions are included in this display for F33.2. Check the code and parent instructions in the Code Book.

Use Additional

Official

No Use Additional Code instructions are included in this display for F33.2. Check the code and parent instructions in the Code Book.

Code Also

Official

No Code Also instructions are included in this display for F33.2. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance

Provider documentation of major depressive disorder with recurrent episodes

History of at least two separate major depressive episodes

Current episode documented as severe

Explicit absence of psychotic features (no delusions or hallucinations)

MEAT Support

HCC Buddy guidance

Provider documentation of major depressive disorder with recurrent episodes

History of at least two separate major depressive episodes

Current episode documented as severe

Explicit absence of psychotic features (no delusions or hallucinations)

Audit Caution

HCC Buddy guidance

Missing psychotic features that would upgrade to F33.3 — carefully assess for delusions

Coding as single episode when prior episodes are documented

Not documenting suicide risk assessment expected with severe depression

Using moderate when the provider's documentation supports severe

Common Mistakes

HCC Buddy guidance

F33.3 — Major depressive disorder, recurrent, severe with psychotic features: Requires documented psychosis

F33.1 — Major depressive disorder, recurrent, moderate: Less severe impairment

F32.2 — Major depressive disorder, single episode, severe: Only one lifetime episode

F31.4 — Bipolar disorder, depressed, severe: Use when bipolar history is present

Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →

Is F33.2 an HCC code?

Yes. F33.2 (Major depressive disorder, recurrent severe without psychotic features) maps to HCC 155, Major Depression, Moderate or Severe, without Psychosis under the CMS-HCC V28 risk adjustment model, with a source-labeled community non-dual aged reference coefficient of 0.299. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes. It is billable for payment year 2026.

Coder answer: F33.2 is billable and maps to V28 HCC 155, Major Depression, Moderate or Severe, without Psychosis. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.

Code: F33.2
Description: Major depressive disorder, recurrent severe without psychotic features
HCC (V28): HCC 155 — Major Depression, Moderate or Severe, without Psychosis
RAF reference coefficient: 0.299
Billable: Yes
Payment year: 2026

HCC Category Mapping

V28HCC 155, Major Depression, Moderate or Severe, without Psychosis

0.299

RxHCCHCC 132, Depression

Not separately weighted

These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. Weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. Actual per-patient RAF contribution depends on member context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.

Work F33.2 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for F33.2

For F33.2, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule.

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

Coder workflow notes

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What This Code Means

F33.2 is the ICD-10-CM diagnosis code for major depressive disorder, recurrent severe without psychotic features. Multiple episodes of severe depression throughout a person's life with significant symptoms that greatly impair functioning, but without hallucinations or delusions. F33.2 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, F33.2 maps to Major Depression, Moderate or Severe, without Psychosis (HCC 155) with a source-labeled community, non-dual, aged reference coefficient of 0.299. For CY2026 non-PACE Medicare Advantage, CMS uses 100% of the 2024 CMS-HCC model (V28). PACE uses a separate model blend. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes.

MDD, recurrent, severe without psychotic features, recurrent episodes, current severe severity (PHQ-9 15+ or provider narrative), no psychosis documented. For F33.2, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule. 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, source-labeled coefficient references, and MEAT documentation criteria for F33.2 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•MDD, recurrent, severe without psychotic features, recurrent episodes, current severe severity (PHQ-9 15+ or provider narrative), no psychosis documented.
•Do not use F33.2 when psychotic features are present, use F33.3. Severity grading should match documentation, not be reflexively assigned.

Clinical Significance

Major depressive disorder, recurrent, severe without psychotic features indicates a pattern of repeated major depressive episodes with the current episode causing marked functional impairment. Recurrent severe depression is among the most debilitating psychiatric conditions, often requiring multiple medication trials, hospitalization, and extensive psychotherapy. Patients with this pattern are at high risk for suicide and chronic disability.

Documentation Requirements

✓Provider documentation of major depressive disorder with recurrent episodes
✓History of at least two separate major depressive episodes
✓Current episode documented as severe
✓Explicit absence of psychotic features (no delusions or hallucinations)
✓Suicide risk assessment and safety plan
✓Evidence of marked functional impairment
✓Comprehensive treatment plan

Commonly Confused Codes

•F33.3: Major depressive disorder, recurrent, severe with psychotic features: Requires documented psychosis
•F33.1: Major depressive disorder, recurrent, moderate: Less severe impairment
•F32.2: Major depressive disorder, single episode, severe: Only one lifetime episode
•F31.4: Bipolar disorder, depressed, severe: Use when bipolar history is present