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HCC 153: Personality Disorders; Anorexia/Bulimia Nervosa

HCC 153, Personality Disorders; Anorexia/Bulimia Nervosa, is one of the 115 payment categories in the CMS-HCC V28 model. 35 ICD-10-CM codes map to it in the payment year 2027 mapping, and a documented diagnosis in the category adds a relative factor of 0.396 to the risk score of a community, non-dual, aged beneficiary (0.290 disabled, 0.199 institutional). It is overridden when a more severe category in its hierarchy is present (HCC 151, HCC 152) and it in turn overrides HCC 154, HCC 155.

QuickIntell editorial content · Legacy registry date · Review not verified

Data effective
Data currency: ICD-10-CM to HCC mapping PY2027 initial (effective dates of service 2026, payment year 2027); CMS-HCC V28 model software V2826.115.T2 (effective payment year 2027). Next CMS release: PY2027 midyear final mapping (spring 2027) and PY2028 proposed model (February 2027).
Mapped ICD-10-CM codes
35
Factor, community non-dual aged
0.396
Factor, institutional
0.199
Hierarchy
Overridden by HCC 151, HCC 152
Disease group
Psychiatric

Relative factors by segment

Each segment is a separate regression; the factor is added to the beneficiary's demographic factors and other categories, then normalized and reduced by the coding intensity adjustment before it meets the plan's base rate. A factor of 1.000 equals the expected cost of an average beneficiary.

CMS-HCC V28 relative factors for HCC 153 by model segment
SegmentModel codeRelative factor
Community, non-dual, agedCNA_HCC1530.396
Community, non-dual, disabledCND_HCC1530.290
Community, full-benefit dual, agedCFA_HCC1530.420
Community, full-benefit dual, disabledCFD_HCC1530.255
Community, partial-benefit dual, agedCPA_HCC1530.464
Community, partial-benefit dual, disabledCPD_HCC1530.232
Long-term institutionalINS_HCC1530.199

Hierarchy

Hierarchical condition categories pay only the most severe manifestation of a disease. When HCC 151 (Schizophrenia) or HCC 152 (Psychosis, Except Schizophrenia) is also documented for the same beneficiary, HCC 153 is dropped from the score. When HCC 153 is present it drops HCC 154 (Bipolar Disorders without Psychosis), HCC 155 (Major Depression, Moderate or Severe, without Psychosis), so documenting the less severe condition alongside it adds nothing to payment but still matters for the clinical record.

HCC 151
Schizophrenia · 12 codes · factor 0.511
HCC 152
Psychosis, Except Schizophrenia · 12 codes · factor 0.484
HCC 154
Bipolar Disorders without Psychosis · 27 codes · factor 0.351
HCC 155
Major Depression, Moderate or Severe, without Psychosis · 371 codes · factor 0.299

ICD-10-CM codes that map to HCC 153

35 codes map to this category in the PY2027 initial mapping, concentrated in the F50 (19), F60 (11), F44 (3), F21 (1), F48 (1) code families. Descriptions are the CMS mapping descriptions for the FY2026 code set; a code that is deleted or split in the October code update stays valid for dates of service before the change.

ICD-10-CM codes mapped to HCC 153 in the CMS PY2027 initial mapping
ICD-10-CMDescription
F21Schizotypal disorder
F440Dissociative amnesia
F441Dissociative fugue
F4481Dissociative identity disorder
F481Depersonalization-derealization syndrome
F5000Anorexia nervosa, unspecified
F50010Anorexia nervosa, restricting type, mild
F50011Anorexia nervosa, restricting type, moderate
F50012Anorexia nervosa, restricting type, severe
F50013Anorexia nervosa, restricting type, extreme
F50014Anorexia nervosa, restricting type, in remission
F50019Anorexia nervosa, restricting type, unspecified
F50020Anorexia nervosa, binge eating/purging type, mild
F50021Anorexia nervosa, binge eating/purging type, moderate
F50022Anorexia nervosa, binge eating/purging type, severe
F50023Anorexia nervosa, binge eating/purging type, extreme
F50024Anorexia nervosa, binge eating/purging type, in remission
F50029Anorexia nervosa, binge eating/purging type, unspecified
F5020Bulimia nervosa, unspecified
F5021Bulimia nervosa, mild
F5022Bulimia nervosa, moderate
F5023Bulimia nervosa, severe
F5024Bulimia nervosa, extreme
F5025Bulimia nervosa, in remission
F600Paranoid personality disorder
F601Schizoid personality disorder
F602Antisocial personality disorder
F603Borderline personality disorder
F604Histrionic personality disorder
F605Obsessive-compulsive personality disorder
F606Avoidant personality disorder
F607Dependent personality disorder
F6081Narcissistic personality disorder
F6089Other specific personality disorders
F609Personality disorder, unspecified

Capturing and defending the category

A category counts for a payment year when a mapped diagnosis is documented at least once during the data collection year by an acceptable provider type at a face-to-face or audio-video encounter, and when the note shows the condition was monitored, evaluated, assessed or treated. Chronic conditions do not carry forward: a category that is not re-documented in the year drops out of the score, which is why annual wellness visits and problem-list reconciliation are where most recapture happens. Risk adjustment data validation audits sample enrollees and ask for the medical record behind each submitted category; an unsupported category is removed and, under the extrapolation rules, the error rate is applied across the contract. The QuickIntell risk adjustment product surfaces suspected and unsupported categories from the chart, and the HCC hub lists every V28 category with its factor and code count.

Frequently asked questions

Which ICD-10 codes map to HCC 153?

35 ICD-10-CM codes map to HCC 153 in the CMS PY2027 initial mapping, for example F21 Schizotypal disorder; F440 Dissociative amnesia; F441 Dissociative fugue; F4481 Dissociative identity disorder. The full list is on this page; a code counts only when it is documented at a face-to-face or video encounter in the data collection year and supported by the record.

How much does HCC 153 add to a risk score?

The V28 relative factor for HCC 153 is 0.396 for a community, non-dual, aged beneficiary, 0.420 for full-benefit dual aged, 0.290 for non-dual disabled and 0.199 for long-term institutional members. A factor of 1.000 equals the expected annual cost of an average beneficiary, so the category's share of the payment follows the plan's base rate for that segment.

Does HCC 153 count together with related categories?

No. Within a hierarchy only the most severe category is paid. HCC 153 is dropped when HCC 151 (Schizophrenia) or HCC 152 (Psychosis, Except Schizophrenia) is also present, and it drops HCC 154, HCC 155 when it is present.

What has to be documented for HCC 153 to be valid?

The diagnosis must be recorded by an acceptable provider type during a face-to-face or audio-video encounter in the service year, with the note showing that the condition was monitored, evaluated, assessed or treated. Risk adjustment data validation audits recover payment for categories the record does not support, so the code on the claim and the assessment in the note must match.

Sources

Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-02. Verify against the primary file before billing or contracting decisions.

Disclaimer

Relative factors and mappings are reproduced from the CMS risk adjustment model files as an operational reference. Payment depends on the plan's base rate, normalization, the coding intensity adjustment and the enrollee's segment. Not legal, clinical or billing advice.