2026 ICD-10-CM Diagnosis Code F25.1Schizoaffective disorder, depressive type

ICD-10-CM CodesF01–F99F20-F29F25

ICD-10-CM F25.1
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

F25.1 is a billable ICD-10-CM diagnosis code for schizoaffective disorder, depressive type. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 885. Coders also document this condition as schizoaffective disorder. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Schizophrenia spectrum and other psychotic disorders.

For Medicare Advantage risk adjustment, F25.1 maps to CMS-HCC Category 151 (Schizophrenia) under the V28 model, adding a risk factor of about 0.511 for a community, non-dual, aged beneficiary in payment year 2026.

Code Identity

ICD-10-CM Code
F25.1
Billable Status
Yes — Valid for Submission
Code Describes
Schizoaffective disorder, depressive type
Short Description
Schizoaffective disorder, depressive type
Same as the full description in the CMS dataset.
Parent Code
Schizoaffective disorders

Code Classification

ChapterF01–F99Mental and behavioural disorders
SectionF20-F29Schizophrenia, schizotypal, delusional, and other non-mood psychotic disorders
CategoryF25Schizoaffective disorders
This CodeF25.1Schizoaffective disorder, depressive type

Medicare Risk Adjustment (HCC)Billing

F25.1 maps to a payment category in the CMS-HCC model used to risk-adjust Medicare Advantage payments. Weights are the published community factors for payment year 2026.

CMS-HCC V28 Category (Payment Model)
HCC 151— Schizophrenia
Payment HCC · PY 2026 one of 12 ICD-10-CM codes in this category
Risk Adjustment Factor (RAF) Weight
+0.511
community, non-dual, aged · ranges 0.304–0.591 across segments
Hierarchy
Supersedes HCC 152, HCC 153, HCC 154, and HCC 155
less severe related categories are not paid alongside HCC 151
Prior Model (CMS-HCC V24)
HCC 57
V24 retired V28 pays 100% of MA risk scores since PY 2026
Other CMS Models
PACE (CMS-HCC V22): HCC 57 · ESRD (V21): HCC 57 · ESRD (V24): HCC 57
ESRD V21 weights: 0.142 dialysis, 0.217–0.442 functioning graft · ESRD V24 weights: 0.111 dialysis, 0.230–0.572 functioning graft
Part D (RxHCC)
RxHCC 130 — Schizophrenia and Other Psychosis
also risk-adjusts in the Part D prescription drug model (V08)

Source: CMS Payment Year 2026 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Schizoaffective disorder
  • Schizoaffective disorder, depressive type

Tabular List NotesGuidance

Coding notes and annotation back-references applicable to this code.

Inclusion Terms

  • Schizoaffective psychosis, depressive type

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR MBD001
Schizophrenia spectrum and other psychotic disorders
Default principal diagnosis: inpatient Yes · outpatient Yes

Patient EducationClinical

Depression

Depression is more than a feeling of being sad or irritable for a few days. It's a serious mood disorder. As one of the most common mental disorders in the United States, depression can affect how you think, feel, and your everyday life.

The full article covers:

  • What is depression?
  • What are the different types of depression?
  • What causes depression?
  • Who is at risk of depression?
  • What are the symptoms of depression?
  • How is depression diagnosed?
  • What are the treatments for depression?
  • Can depression be prevented?

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Convert F25.1 to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
295.70 Schizoaffective dis NOS
Approximate The match is approximate rather than exact.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About F25.1Overview

What is the ICD-10 code for schizoaffective disorder, depressive type?

The ICD-10-CM code for schizoaffective disorder, depressive type is F25.1 (sometimes written as F251). It is billable on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

Is F25.1 (Schizoaffective disorders) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report schizoaffective disorder, depressive type on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What MS-DRG does F25.1 group to?

When schizoaffective disorder, depressive type is the principal diagnosis on an inpatient stay, it groups to MS-DRG 885 (psychoses), which carries a relative weight of 1.3968. Higher weights mean higher Medicare reimbursement.

What is the ICD-9 equivalent of F25.1?

Under the General Equivalence Mappings, schizoaffective disorder, depressive type converts to ICD-9-CM 295.70 (schizoaffective dis NOS). The mapping is approximate, so confirm the match fits the documentation.

What HCC is F25.1?

F25.1 (schizoaffective disorder, depressive type) maps to CMS-HCC Category 151 (Schizophrenia), commonly written as HCC 151, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2026. It mapped to HCC 57 under the retired V24 model. It also maps in the PACE (CMS-HCC V22), ESRD (V21), and ESRD (V24) models. In the Part D prescription drug model it maps to RxHCC 130.

Does F25.1 risk-adjust for Medicare Advantage payment?

Yes. When documented and reported on a Medicare Advantage encounter, F25.1 adds a risk adjustment factor of about 0.511 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.304 to 0.591 depending on the payment segment). HCC 151 sits at the top of its hierarchy, so no other condition category supersedes it. See the full factor table on the HCC 151 category page.