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F95.1 ICD-10-CM Code: Chronic motor or vocal tic disorder

F95.1 is not a CMS-HCC payment code. MEAT criteria · RAF calculator · free HCC coding tools

ICD-10-CM Code View

HCC Buddy Code Card

Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.

FY 2026 Apr update / Mental, Behavioral and Neurodevelopmental disorders (F01-F99) / Behavioral and emotional disorders with onset usually occurring in childhood and adolescence (F90-F98)

F95.1

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

Chronic motor or vocal tic disorder

Persistent involuntary, repetitive movements or sounds (tics) that continue for more than one year, significantly impacting the child's daily functioning or social interactions.

Buddy the Bee presenting code insight

Buddy Insight

Chronic motor or vocal tic disorder involves single or multiple motor tics OR vocal tics (but not both motor and vocal) that have persisted for more than one year since first onset.

CMS-HCC V28

N/A

—

Not mapped

CMS-HCC V24

N/A

—

Not mapped

ACA/HHS

N/A

—

Not mapped

ESRD/PACE

N/A

—

Not mapped

RXHCC

HCC 133

RAF 0.035

Code Book Path

Official
F95Tic disorder
F95.1Chronic motor or vocal tic disorder

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for F95.1 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for F95.1 in this effective period.

Related Child Codes

Official
F95.0Transient tic disorder
F95.2Tourette's disorder
F95.8Other tic disorders
F95.9Tic disorder, unspecified

Includes

Official

ICD-10-CM does not list Includes notes for F95.1 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for F95.1 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for F95.1 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for F95.1 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for F95.1 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance
Provider documentation of chronic tic disorder specifying motor OR vocal tics (not both)
Documentation that tics have been present for more than 12 consecutive months since first onset
Description of specific tic types and their impact on functioning
Documentation that both motor AND vocal tics have NOT been present simultaneously (which would be Tourette's)

MEAT Support

HCC Buddy guidance
Provider documentation of chronic tic disorder specifying motor OR vocal tics (not both)
Documentation that tics have been present for more than 12 consecutive months since first onset
Description of specific tic types and their impact on functioning
Documentation that both motor AND vocal tics have NOT been present simultaneously (which would be Tourette's)

Audit Caution

HCC Buddy guidance
Coding F95.1 when the patient has both motor AND vocal tics — this should be F95.2 (Tourette's)
Not updating from F95.0 (transient) to F95.1 (chronic) when tics persist beyond one year
Failing to document whether tics are motor, vocal, or both — this distinction determines the correct code
Using F95.9 (unspecified) when the chronic nature and tic type are clearly documented

Common Mistakes

HCC Buddy guidance
F95.2 — Tourette's disorder; Tourette's requires both multiple motor AND at least one vocal tic for more than one year
F95.0 — Transient tic disorder; transient tics last less than one year
F95.8 — Other tic disorders; for atypical presentations not fitting standard categories
F42.x — OCD; tics and OCD frequently co-occur but are separate diagnoses

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 F95.1 an HCC code?

F95.1 is not in the CMS-HCC V28 or V24 community payment model, but it does map to Personality Disorders, Anxiety, and Other Specified Mental Disorders under the Part D RxHCC model.

Code
F95.1
Description
Chronic motor or vocal tic disorder
HCC (V28)
No CMS-HCC V28 mapping
RAF
—
Billable
Yes
Payment year
2026

HCC Category Mapping

RxHCCHCC 133, Personality Disorders, Anxiety, and Other Specified Mental Disorders
0.035

Each model's RAF is its CMS base weight for that model's standard population, so 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 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.

Work F95.1 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for F95.1

For F95.1 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 F95.1 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

F95.1 is the ICD-10-CM diagnosis code for chronic motor or vocal tic disorder. Persistent involuntary, repetitive movements or sounds (tics) that continue for more than one year, significantly impacting the child's daily functioning or social interactions. F95.1 sits in the ICD-10-CM chapter for mental, behavioral and neurodevelopmental disorders (f01-f99), within the section covering behavioral and emotional disorders with onset usually occurring in childhood and adolescence (f90-f98).

F95.1 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.

This code does not map to a CMS-HCC V28 payment category. Capture depends on documentation that supports the diagnosis; verify the HCC assignment against the current CMS mapping for the applicable payment year. Coders reviewing F95.1 should check whether additional documentation would support a more specific child code in the same hierarchy that does map to a payment HCC, capturing the correct specificity is the highest-impact RAF improvement available within accurate coding.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for F95.1 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • •Specify whether the tics are motor only, vocal only, or both in the clinical documentation
  • •Document the duration of symptoms (must be at least 1 year) and functional impact to support the diagnosis

Clinical Significance

Chronic motor or vocal tic disorder involves single or multiple motor tics OR vocal tics (but not both motor and vocal) that have persisted for more than one year since first onset. This is distinguished from Tourette's disorder, which requires both motor and vocal tics. The condition may wax and wane in severity and can cause social embarrassment and functional impairment. Treatment is indicated when tics cause significant distress or impairment.

Documentation Requirements

  • ✓Provider documentation of chronic tic disorder specifying motor OR vocal tics (not both)
  • ✓Documentation that tics have been present for more than 12 consecutive months since first onset
  • ✓Description of specific tic types and their impact on functioning
  • ✓Documentation that both motor AND vocal tics have NOT been present simultaneously (which would be Tourette's)
  • ✓Assessment for comorbid conditions (ADHD, OCD) and treatment plan

Commonly Confused Codes

  • •F95.2: Tourette's disorder; Tourette's requires both multiple motor AND at least one vocal tic for more than one year
  • •F95.0: Transient tic disorder; transient tics last less than one year
  • •F95.8: Other tic disorders; for atypical presentations not fitting standard categories
  • •F42.x: OCD; tics and OCD frequently co-occur but are separate diagnoses

Child Codes

F95.0Transient tic disorder
F95.1Chronic motor or vocal tic disorder
F95.2Tourette's disorder
F95.8Other tic disorders
F95.9Tic disorder, unspecified

Code Hierarchy

└F95Tic disorder└F95.1Chronic motor or vocal tic disorder
└F95.1Chronic motor or vocal tic disorder

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