BHI · ICD-10 Codes

BHI ICD-10
Codes.

One or more behavioral health conditions (depression, anxiety, PTSD, substance use disorders, etc.) requiring structured care management in a primary care setting.

282 codes · ICD-10-CM FY2026

All Programs RPM CCM PCM BHI RTM

What BHI actually requires

Minimum Conditions

1 chronic condition

Duration

No minimum duration

CPT Codes

99484 99492 99493 99494

BHI supports primary care-based management of behavioral health conditions including depression, anxiety, substance use disorders, and other mental health diagnoses. Services include behavioral health assessment, care planning, and ongoing management using validated screening tools (PHQ-9, GAD-7).

BHI Diagnoses

Every code, by condition.

282 billable ICD-10-CM codes across 15 conditions that can support Behavioral Health Integration. CMS does not approve codes for BHI, so treat this as the code set for those conditions rather than an eligibility list.

282 codes listed

Behavioral health and substance use

Depressive disorders

F32, F33, F34.120 codesbhiccm

PHQ-9 at defined intervals, with the score trend recorded in the care plan.

CMS other chronic or potentially disabling condition · CCW category: Depressive Disorders · Devices: Patient-reported outcome app (RTM)

Read the depressive disorders monitoring guide

Code	Official ICD-10-CM description	Programs	Risk adjustment
F32.0	Major depressive disorder, single episode, mild	bhiccm	not risk adjusted
F32.1	Major depressive disorder, single episode, moderate	bhiccm	HCC 155 · Major Depression, Moderate or Severe, without Psychosis
F32.2	Major depressive disorder, single episode, severe without psychotic features	bhiccm	HCC 155 · Major Depression, Moderate or Severe, without Psychosis
F32.3	Major depressive disorder, single episode, severe with psychotic features	bhiccm	HCC 152 · Psychosis, Except Schizophrenia
F32.4	Major depressive disorder, single episode, in partial remission	bhiccm	not risk adjusted
F32.5	Major depressive disorder, single episode, in full remission	bhiccm	not risk adjusted
F32.81	Premenstrual dysphoric disorder	bhiccm	not risk adjusted
F32.89	Other specified depressive episodes	bhiccm	not risk adjusted
F32.9	Major depressive disorder, single episode, unspecifiedlow specificity	bhiccm	not risk adjusted
F32.A	Depression, unspecifiedlow specificity	bhiccm	not risk adjusted
F33.0	Major depressive disorder, recurrent, mild	bhiccm	not risk adjusted
F33.1	Major depressive disorder, recurrent, moderate	bhiccm	HCC 155 · Major Depression, Moderate or Severe, without Psychosis
F33.2	Major depressive disorder, recurrent severe without psychotic features	bhiccm	HCC 155 · Major Depression, Moderate or Severe, without Psychosis
F33.3	Major depressive disorder, recurrent, severe with psychotic symptoms	bhiccm	HCC 152 · Psychosis, Except Schizophrenia
F33.40	Major depressive disorder, recurrent, in remission, unspecifiedlow specificity	bhiccm	not risk adjusted
F33.41	Major depressive disorder, recurrent, in partial remission	bhiccm	not risk adjusted
F33.42	Major depressive disorder, recurrent, in full remission	bhiccm	not risk adjusted
F33.8	Other recurrent depressive disorders	bhiccm	not risk adjusted
F33.9	Major depressive disorder, recurrent, unspecifiedlow specificity	bhiccm	not risk adjusted
F34.1	Dysthymic disorder	bhiccm	not risk adjusted

Bipolar and related disorders

F30, F31, F34.038 codesbhiccm

Mood tracking and medication adherence, with laboratory monitoring where a mood stabilizer requires it.

CMS other chronic or potentially disabling condition · CCW category: Bipolar Disorder · Devices: Patient-reported outcome app (RTM)

Code	Official ICD-10-CM description	Programs	Risk adjustment
F30.10	Manic episode without psychotic symptoms, unspecified	bhiccm	HCC 154 · Bipolar Disorders without Psychosis
F30.11	Manic episode without psychotic symptoms, mild	bhiccm	HCC 154 · Bipolar Disorders without Psychosis
F30.12	Manic episode without psychotic symptoms, moderate	bhiccm	HCC 154 · Bipolar Disorders without Psychosis
F30.13	Manic episode, severe, without psychotic symptoms	bhiccm	HCC 154 · Bipolar Disorders without Psychosis
F30.2	Manic episode, severe with psychotic symptoms	bhiccm	HCC 152 · Psychosis, Except Schizophrenia
F30.3	Manic episode in partial remission	bhiccm	HCC 154 · Bipolar Disorders without Psychosis
F30.4	Manic episode in full remission	bhiccm	not risk adjusted
F30.8	Other manic episodes	bhiccm	HCC 154 · Bipolar Disorders without Psychosis
F30.9	Manic episode, unspecified	bhiccm	HCC 154 · Bipolar Disorders without Psychosis
F31.0	Bipolar disorder, current episode hypomanic	bhiccm	HCC 154 · Bipolar Disorders without Psychosis
F31.10	Bipolar disorder, current episode manic without psychotic features, unspecified	bhiccm	HCC 154 · Bipolar Disorders without Psychosis
F31.11	Bipolar disorder, current episode manic without psychotic features, mild	bhiccm	HCC 154 · Bipolar Disorders without Psychosis
F31.12	Bipolar disorder, current episode manic without psychotic features, moderate	bhiccm	HCC 154 · Bipolar Disorders without Psychosis
F31.13	Bipolar disorder, current episode manic without psychotic features, severe	bhiccm	HCC 154 · Bipolar Disorders without Psychosis
F31.2	Bipolar disorder, current episode manic severe with psychotic features	bhiccm	HCC 152 · Psychosis, Except Schizophrenia
F31.30	Bipolar disorder, current episode depressed, mild or moderate severity, unspecified	bhiccm	HCC 154 · Bipolar Disorders without Psychosis
F31.31	Bipolar disorder, current episode depressed, mild	bhiccm	HCC 154 · Bipolar Disorders without Psychosis
F31.32	Bipolar disorder, current episode depressed, moderate	bhiccm	HCC 154 · Bipolar Disorders without Psychosis
F31.4	Bipolar disorder, current episode depressed, severe, without psychotic features	bhiccm	HCC 154 · Bipolar Disorders without Psychosis
F31.5	Bipolar disorder, current episode depressed, severe, with psychotic features	bhiccm	HCC 152 · Psychosis, Except Schizophrenia
F31.60	Bipolar disorder, current episode mixed, unspecified	bhiccm	HCC 154 · Bipolar Disorders without Psychosis
F31.61	Bipolar disorder, current episode mixed, mild	bhiccm	HCC 154 · Bipolar Disorders without Psychosis
F31.62	Bipolar disorder, current episode mixed, moderate	bhiccm	HCC 154 · Bipolar Disorders without Psychosis
F31.63	Bipolar disorder, current episode mixed, severe, without psychotic features	bhiccm	HCC 154 · Bipolar Disorders without Psychosis
F31.64	Bipolar disorder, current episode mixed, severe, with psychotic features	bhiccm	HCC 152 · Psychosis, Except Schizophrenia
F31.70	Bipolar disorder, currently in remission, most recent episode unspecifiedlow specificity	bhiccm	not risk adjusted
F31.71	Bipolar disorder, in partial remission, most recent episode hypomanic	bhiccm	HCC 154 · Bipolar Disorders without Psychosis
F31.72	Bipolar disorder, in full remission, most recent episode hypomanic	bhiccm	not risk adjusted
F31.73	Bipolar disorder, in partial remission, most recent episode manic	bhiccm	HCC 154 · Bipolar Disorders without Psychosis
F31.74	Bipolar disorder, in full remission, most recent episode manic	bhiccm	not risk adjusted
F31.75	Bipolar disorder, in partial remission, most recent episode depressed	bhiccm	HCC 154 · Bipolar Disorders without Psychosis
F31.76	Bipolar disorder, in full remission, most recent episode depressed	bhiccm	not risk adjusted
F31.77	Bipolar disorder, in partial remission, most recent episode mixed	bhiccm	HCC 154 · Bipolar Disorders without Psychosis
F31.78	Bipolar disorder, in full remission, most recent episode mixed	bhiccm	not risk adjusted
F31.81	Bipolar II disorder	bhiccm	HCC 154 · Bipolar Disorders without Psychosis
F31.89	Other bipolar disorder	bhiccm	HCC 154 · Bipolar Disorders without Psychosis
F31.9	Bipolar disorder, unspecified	bhiccm	HCC 154 · Bipolar Disorders without Psychosis
F34.0	Cyclothymic disorder	bhiccm	not risk adjusted

Anxiety and fear-related disorders

F40, F4128 codesbhiccm

GAD-7 at defined intervals.

CMS other chronic or potentially disabling condition · CCW category: Anxiety Disorders · Devices: Patient-reported outcome app (RTM)

Code	Official ICD-10-CM description	Programs	Risk adjustment
F40.00	Agoraphobia, unspecified	bhiccm	not risk adjusted
F40.01	Agoraphobia with panic disorder	bhiccm	not risk adjusted
F40.02	Agoraphobia without panic disorder	bhiccm	not risk adjusted
F40.10	Social phobia, unspecified	bhiccm	not risk adjusted
F40.11	Social phobia, generalized	bhiccm	not risk adjusted
F40.210	Arachnophobia	bhiccm	not risk adjusted
F40.218	Other animal type phobia	bhiccm	not risk adjusted
F40.220	Fear of thunderstorms	bhiccm	not risk adjusted
F40.228	Other natural environment type phobia	bhiccm	not risk adjusted
F40.230	Fear of blood	bhiccm	not risk adjusted
F40.231	Fear of injections and transfusions	bhiccm	not risk adjusted
F40.232	Fear of other medical care	bhiccm	not risk adjusted
F40.233	Fear of injury	bhiccm	not risk adjusted
F40.240	Claustrophobia	bhiccm	not risk adjusted
F40.241	Acrophobia	bhiccm	not risk adjusted
F40.242	Fear of bridges	bhiccm	not risk adjusted
F40.243	Fear of flying	bhiccm	not risk adjusted
F40.248	Other situational type phobia	bhiccm	not risk adjusted
F40.290	Androphobia	bhiccm	not risk adjusted
F40.291	Gynephobia	bhiccm	not risk adjusted
F40.298	Other specified phobia	bhiccm	not risk adjusted
F40.8	Other phobic anxiety disorders	bhiccm	not risk adjusted
F40.9	Phobic anxiety disorder, unspecified	bhiccm	not risk adjusted
F41.0	Panic disorder [episodic paroxysmal anxiety]	bhiccm	not risk adjusted
F41.1	Generalized anxiety disorder	bhiccm	not risk adjusted
F41.3	Other mixed anxiety disorders	bhiccm	not risk adjusted
F41.8	Other specified anxiety disorders	bhiccm	not risk adjusted
F41.9	Anxiety disorder, unspecified	bhiccm	not risk adjusted

Trauma and stressor-related disorders

F4314 codesbhiccm

PCL-5 or an equivalent validated instrument.

CMS other chronic or potentially disabling condition · CCW category: Post-Traumatic Stress Disorder (PTSD) · Devices: Patient-reported outcome app (RTM)

Code	Official ICD-10-CM description	Programs	Risk adjustment
F43.0	Acute stress reaction	bhiccm	not risk adjusted
F43.10	Post-traumatic stress disorder, unspecified	bhiccm	not risk adjusted
F43.11	Post-traumatic stress disorder, acute	bhiccm	not risk adjusted
F43.12	Post-traumatic stress disorder, chronic	bhiccm	not risk adjusted
F43.20	Adjustment disorder, unspecified	bhiccm	not risk adjusted
F43.21	Adjustment disorder with depressed mood	bhiccm	not risk adjusted
F43.22	Adjustment disorder with anxiety	bhiccm	not risk adjusted
F43.23	Adjustment disorder with mixed anxiety and depressed mood	bhiccm	not risk adjusted
F43.24	Adjustment disorder with disturbance of conduct	bhiccm	not risk adjusted
F43.25	Adjustment disorder with mixed disturbance of emotions and conduct	bhiccm	not risk adjusted
F43.29	Adjustment disorder with other symptoms	bhiccm	not risk adjusted
F43.81	Prolonged grief disorder	bhiccm	not risk adjusted
F43.89	Other reactions to severe stress	bhiccm	not risk adjusted
F43.9	Reaction to severe stress, unspecified	bhiccm	not risk adjusted

Obsessive-compulsive, somatic and personality disorders

F42, F44, F45, F48, F60, F68, F6947 codes in familybhi

Structured symptom follow-up in the primary care setting.

CMS other chronic or potentially disabling condition · CCW category: Personality Disorders · Devices: Patient-reported outcome app (RTM)

This family runs to 47 codes that differ mainly by anatomic site and laterality, which does not change whether the condition supports care management. The codes are not listed one by one here. Code to the site and side documented in the record, within F42, F44, F45, F48, F60, F68, F69.

Schizophrenia and other psychotic disorders

F20, F21, F22, F23, F24, F25, F28, F2918 codesbhiccm

Adherence and metabolic surveillance, since antipsychotics drive weight and glucose change.

CMS other chronic or potentially disabling condition · CCW category: Schizophrenia and Other Psychotic Disorders · Devices: Patient-reported outcome app (RTM)

Code	Official ICD-10-CM description	Programs	Risk adjustment
F20.0	Paranoid schizophrenia	bhiccm	HCC 151 · Schizophrenia
F20.1	Disorganized schizophrenia	bhiccm	HCC 151 · Schizophrenia
F20.2	Catatonic schizophrenia	bhiccm	HCC 151 · Schizophrenia
F20.3	Undifferentiated schizophrenia	bhiccm	HCC 151 · Schizophrenia
F20.5	Residual schizophrenia	bhiccm	HCC 151 · Schizophrenia
F20.81	Schizophreniform disorder	bhiccm	HCC 151 · Schizophrenia
F20.89	Other schizophrenia	bhiccm	HCC 151 · Schizophrenia
F20.9	Schizophrenia, unspecified	bhiccm	HCC 151 · Schizophrenia
F21	Schizotypal disorder	bhiccm	HCC 153 · Personality Disorders; Anorexia/Bulimia Nervosa
F22	Delusional disorders	bhiccm	HCC 152 · Psychosis, Except Schizophrenia
F23	Brief psychotic disorder	bhiccm	HCC 152 · Psychosis, Except Schizophrenia
F24	Shared psychotic disorder	bhiccm	HCC 152 · Psychosis, Except Schizophrenia
F25.0	Schizoaffective disorder, bipolar type	bhiccm	HCC 151 · Schizophrenia
F25.1	Schizoaffective disorder, depressive type	bhiccm	HCC 151 · Schizophrenia
F25.8	Other schizoaffective disorders	bhiccm	HCC 151 · Schizophrenia
F25.9	Schizoaffective disorder, unspecified	bhiccm	HCC 151 · Schizophrenia
F28	Other psychotic disorder not due to a substance or known physiological condition	bhiccm	HCC 152 · Psychosis, Except Schizophrenia
F29	Unspecified psychosis not due to a substance or known physiological condition	bhiccm	HCC 152 · Psychosis, Except Schizophrenia

Feeding and eating disorders

F5030 codesbhiccm

Weight monitoring under an explicit protocol, with behavioral follow-up.

Added by CCN Health · Devices: Connected weight scale

F50.2 is no longer valid. Bulimia nervosa is now F50.20 through F50.25.

Code	Official ICD-10-CM description	Programs	Risk adjustment
F50.00	Anorexia nervosa, unspecified	bhiccm	HCC 153 · Personality Disorders; Anorexia/Bulimia Nervosa
F50.010	Anorexia nervosa, restricting type, mild	bhiccm	HCC 153 · Personality Disorders; Anorexia/Bulimia Nervosa
F50.011	Anorexia nervosa, restricting type, moderate	bhiccm	HCC 153 · Personality Disorders; Anorexia/Bulimia Nervosa
F50.012	Anorexia nervosa, restricting type, severe	bhiccm	HCC 153 · Personality Disorders; Anorexia/Bulimia Nervosa
F50.013	Anorexia nervosa, restricting type, extreme	bhiccm	HCC 153 · Personality Disorders; Anorexia/Bulimia Nervosa
F50.014	Anorexia nervosa, restricting type, in remission	bhiccm	HCC 153 · Personality Disorders; Anorexia/Bulimia Nervosa
F50.019	Anorexia nervosa, restricting type, unspecified	bhiccm	HCC 153 · Personality Disorders; Anorexia/Bulimia Nervosa
F50.020	Anorexia nervosa, binge eating/purging type, mild	bhiccm	HCC 153 · Personality Disorders; Anorexia/Bulimia Nervosa
F50.021	Anorexia nervosa, binge eating/purging type, moderate	bhiccm	HCC 153 · Personality Disorders; Anorexia/Bulimia Nervosa
F50.022	Anorexia nervosa, binge eating/purging type, severe	bhiccm	HCC 153 · Personality Disorders; Anorexia/Bulimia Nervosa
F50.023	Anorexia nervosa, binge eating/purging type, extreme	bhiccm	HCC 153 · Personality Disorders; Anorexia/Bulimia Nervosa
F50.024	Anorexia nervosa, binge eating/purging type, in remission	bhiccm	HCC 153 · Personality Disorders; Anorexia/Bulimia Nervosa
F50.029	Anorexia nervosa, binge eating/purging type, unspecified	bhiccm	HCC 153 · Personality Disorders; Anorexia/Bulimia Nervosa
F50.20	Bulimia nervosa, unspecified	bhiccm	HCC 153 · Personality Disorders; Anorexia/Bulimia Nervosa
F50.21	Bulimia nervosa, mild	bhiccm	HCC 153 · Personality Disorders; Anorexia/Bulimia Nervosa
F50.22	Bulimia nervosa, moderate	bhiccm	HCC 153 · Personality Disorders; Anorexia/Bulimia Nervosa
F50.23	Bulimia nervosa, severe	bhiccm	HCC 153 · Personality Disorders; Anorexia/Bulimia Nervosa
F50.24	Bulimia nervosa, extreme	bhiccm	HCC 153 · Personality Disorders; Anorexia/Bulimia Nervosa
F50.25	Bulimia nervosa, in remission	bhiccm	HCC 153 · Personality Disorders; Anorexia/Bulimia Nervosa
F50.810	Binge eating disorder, mild	bhiccm	not risk adjusted
F50.811	Binge eating disorder, moderate	bhiccm	not risk adjusted
F50.812	Binge eating disorder, severe	bhiccm	not risk adjusted
F50.813	Binge eating disorder, extreme	bhiccm	not risk adjusted
F50.814	Binge eating disorder, in remission	bhiccm	not risk adjusted
F50.819	Binge eating disorder, unspecifiedlow specificity	bhiccm	not risk adjusted
F50.82	Avoidant/restrictive food intake disorder	bhiccm	not risk adjusted
F50.83	Pica in adults	bhiccm	not risk adjusted
F50.84	Rumination disorder in adults	bhiccm	not risk adjusted
F50.89	Other specified eating disorder	bhiccm	not risk adjusted
F50.9	Eating disorder, unspecifiedlow specificity	bhiccm	not risk adjusted

Alcohol-related disorders

F1058 codesbhiccm

AUDIT-C and structured relapse-risk follow-up.

CMS other chronic or potentially disabling condition · CCW category: Alcohol Use Disorders · Devices: Patient-reported outcome app (RTM)

Code	Official ICD-10-CM description	Programs	Risk adjustment
F10.10	Alcohol abuse, uncomplicated	bhiccm	not risk adjusted
F10.11	Alcohol abuse, in remission	bhiccm	not risk adjusted
F10.120	Alcohol abuse with intoxication, uncomplicated	bhiccm	not risk adjusted
F10.121	Alcohol abuse with intoxication delirium	bhiccm	not risk adjusted
F10.129	Alcohol abuse with intoxication, unspecifiedlow specificity	bhiccm	not risk adjusted
F10.130	Alcohol abuse with withdrawal, uncomplicated	bhiccm	HCC 139 · Alcohol Use Disorder, Moderate/Severe, or Alcohol Use with Specified Non-Psychotic Complications
F10.131	Alcohol abuse with withdrawal delirium	bhiccm	HCC 136 · Alcohol Use with Psychotic Complications
F10.132	Alcohol abuse with withdrawal with perceptual disturbance	bhiccm	HCC 136 · Alcohol Use with Psychotic Complications
F10.139	Alcohol abuse with withdrawal, unspecified	bhiccm	HCC 139 · Alcohol Use Disorder, Moderate/Severe, or Alcohol Use with Specified Non-Psychotic Complications
F10.14	Alcohol abuse with alcohol-induced mood disorder	bhiccm	HCC 139 · Alcohol Use Disorder, Moderate/Severe, or Alcohol Use with Specified Non-Psychotic Complications
F10.150	Alcohol abuse with alcohol-induced psychotic disorder with delusions	bhiccm	HCC 136 · Alcohol Use with Psychotic Complications
F10.151	Alcohol abuse with alcohol-induced psychotic disorder with hallucinations	bhiccm	HCC 136 · Alcohol Use with Psychotic Complications
F10.159	Alcohol abuse with alcohol-induced psychotic disorder, unspecified	bhiccm	HCC 136 · Alcohol Use with Psychotic Complications
F10.180	Alcohol abuse with alcohol-induced anxiety disorder	bhiccm	HCC 139 · Alcohol Use Disorder, Moderate/Severe, or Alcohol Use with Specified Non-Psychotic Complications
F10.181	Alcohol abuse with alcohol-induced sexual dysfunction	bhiccm	HCC 139 · Alcohol Use Disorder, Moderate/Severe, or Alcohol Use with Specified Non-Psychotic Complications
F10.182	Alcohol abuse with alcohol-induced sleep disorder	bhiccm	HCC 139 · Alcohol Use Disorder, Moderate/Severe, or Alcohol Use with Specified Non-Psychotic Complications
F10.188	Alcohol abuse with other alcohol-induced disorder	bhiccm	HCC 139 · Alcohol Use Disorder, Moderate/Severe, or Alcohol Use with Specified Non-Psychotic Complications
F10.19	Alcohol abuse with unspecified alcohol-induced disorderlow specificity	bhiccm	not risk adjusted
F10.20	Alcohol dependence, uncomplicated	bhiccm	HCC 139 · Alcohol Use Disorder, Moderate/Severe, or Alcohol Use with Specified Non-Psychotic Complications
F10.21	Alcohol dependence, in remission	bhiccm	HCC 139 · Alcohol Use Disorder, Moderate/Severe, or Alcohol Use with Specified Non-Psychotic Complications
F10.220	Alcohol dependence with intoxication, uncomplicated	bhiccm	HCC 139 · Alcohol Use Disorder, Moderate/Severe, or Alcohol Use with Specified Non-Psychotic Complications
F10.221	Alcohol dependence with intoxication delirium	bhiccm	HCC 139 · Alcohol Use Disorder, Moderate/Severe, or Alcohol Use with Specified Non-Psychotic Complications
F10.229	Alcohol dependence with intoxication, unspecified	bhiccm	HCC 139 · Alcohol Use Disorder, Moderate/Severe, or Alcohol Use with Specified Non-Psychotic Complications
F10.230	Alcohol dependence with withdrawal, uncomplicated	bhiccm	HCC 139 · Alcohol Use Disorder, Moderate/Severe, or Alcohol Use with Specified Non-Psychotic Complications
F10.231	Alcohol dependence with withdrawal delirium	bhiccm	HCC 136 · Alcohol Use with Psychotic Complications
F10.232	Alcohol dependence with withdrawal with perceptual disturbance	bhiccm	HCC 136 · Alcohol Use with Psychotic Complications
F10.239	Alcohol dependence with withdrawal, unspecified	bhiccm	HCC 139 · Alcohol Use Disorder, Moderate/Severe, or Alcohol Use with Specified Non-Psychotic Complications
F10.24	Alcohol dependence with alcohol-induced mood disorder	bhiccm	HCC 139 · Alcohol Use Disorder, Moderate/Severe, or Alcohol Use with Specified Non-Psychotic Complications
F10.250	Alcohol dependence with alcohol-induced psychotic disorder with delusions	bhiccm	HCC 136 · Alcohol Use with Psychotic Complications
F10.251	Alcohol dependence with alcohol-induced psychotic disorder with hallucinations	bhiccm	HCC 136 · Alcohol Use with Psychotic Complications
F10.259	Alcohol dependence with alcohol-induced psychotic disorder, unspecified	bhiccm	HCC 136 · Alcohol Use with Psychotic Complications
F10.26	Alcohol dependence with alcohol-induced persisting amnestic disorder	bhiccm	HCC 136 · Alcohol Use with Psychotic Complications
F10.27	Alcohol dependence with alcohol-induced persisting dementia	bhiccm	HCC 136 · Alcohol Use with Psychotic Complications
F10.280	Alcohol dependence with alcohol-induced anxiety disorder	bhiccm	HCC 139 · Alcohol Use Disorder, Moderate/Severe, or Alcohol Use with Specified Non-Psychotic Complications
F10.281	Alcohol dependence with alcohol-induced sexual dysfunction	bhiccm	HCC 139 · Alcohol Use Disorder, Moderate/Severe, or Alcohol Use with Specified Non-Psychotic Complications
F10.282	Alcohol dependence with alcohol-induced sleep disorder	bhiccm	HCC 139 · Alcohol Use Disorder, Moderate/Severe, or Alcohol Use with Specified Non-Psychotic Complications
F10.288	Alcohol dependence with other alcohol-induced disorder	bhiccm	HCC 139 · Alcohol Use Disorder, Moderate/Severe, or Alcohol Use with Specified Non-Psychotic Complications
F10.29	Alcohol dependence with unspecified alcohol-induced disorder	bhiccm	HCC 139 · Alcohol Use Disorder, Moderate/Severe, or Alcohol Use with Specified Non-Psychotic Complications
F10.90	Alcohol use, unspecified, uncomplicatedlow specificity	bhiccm	not risk adjusted
F10.91	Alcohol use, unspecified, in remissionlow specificity	bhiccm	not risk adjusted
F10.920	Alcohol use, unspecified with intoxication, uncomplicatedlow specificity	bhiccm	not risk adjusted
F10.921	Alcohol use, unspecified with intoxication deliriumlow specificity	bhiccm	not risk adjusted
F10.929	Alcohol use, unspecified with intoxication, unspecifiedlow specificity	bhiccm	not risk adjusted
F10.930	Alcohol use, unspecified with withdrawal, uncomplicated	bhiccm	HCC 139 · Alcohol Use Disorder, Moderate/Severe, or Alcohol Use with Specified Non-Psychotic Complications
F10.931	Alcohol use, unspecified with withdrawal delirium	bhiccm	HCC 136 · Alcohol Use with Psychotic Complications
F10.932	Alcohol use, unspecified with withdrawal with perceptual disturbance	bhiccm	HCC 136 · Alcohol Use with Psychotic Complications
F10.939	Alcohol use, unspecified with withdrawal, unspecified	bhiccm	HCC 139 · Alcohol Use Disorder, Moderate/Severe, or Alcohol Use with Specified Non-Psychotic Complications
F10.94	Alcohol use, unspecified with alcohol-induced mood disorder	bhiccm	HCC 139 · Alcohol Use Disorder, Moderate/Severe, or Alcohol Use with Specified Non-Psychotic Complications
F10.950	Alcohol use, unspecified with alcohol-induced psychotic disorder with delusions	bhiccm	HCC 136 · Alcohol Use with Psychotic Complications
F10.951	Alcohol use, unspecified with alcohol-induced psychotic disorder with hallucinations	bhiccm	HCC 136 · Alcohol Use with Psychotic Complications
F10.959	Alcohol use, unspecified with alcohol-induced psychotic disorder, unspecified	bhiccm	HCC 136 · Alcohol Use with Psychotic Complications
F10.96	Alcohol use, unspecified with alcohol-induced persisting amnestic disorder	bhiccm	HCC 136 · Alcohol Use with Psychotic Complications
F10.97	Alcohol use, unspecified with alcohol-induced persisting dementia	bhiccm	HCC 136 · Alcohol Use with Psychotic Complications
F10.980	Alcohol use, unspecified with alcohol-induced anxiety disorder	bhiccm	HCC 139 · Alcohol Use Disorder, Moderate/Severe, or Alcohol Use with Specified Non-Psychotic Complications
F10.981	Alcohol use, unspecified with alcohol-induced sexual dysfunction	bhiccm	HCC 139 · Alcohol Use Disorder, Moderate/Severe, or Alcohol Use with Specified Non-Psychotic Complications
F10.982	Alcohol use, unspecified with alcohol-induced sleep disorder	bhiccm	HCC 139 · Alcohol Use Disorder, Moderate/Severe, or Alcohol Use with Specified Non-Psychotic Complications
F10.988	Alcohol use, unspecified with other alcohol-induced disorder	bhiccm	HCC 139 · Alcohol Use Disorder, Moderate/Severe, or Alcohol Use with Specified Non-Psychotic Complications
F10.99	Alcohol use, unspecified with unspecified alcohol-induced disorderlow specificity	bhiccm	not risk adjusted

Opioid-related disorders

F1145 codesbhiccm

Medication-assisted therapy adherence and structured follow-up.

CMS other chronic or potentially disabling condition · CCW category: Opioid Use Disorder (OUD) · Devices: Patient-reported outcome app (RTM)

Code	Official ICD-10-CM description	Programs	Risk adjustment
F11.10	Opioid abuse, uncomplicated	bhiccm	HCC 138 · Drug Use Disorder, Mild, Uncomplicated, Except Cannabis
F11.11	Opioid abuse, in remission	bhiccm	HCC 138 · Drug Use Disorder, Mild, Uncomplicated, Except Cannabis
F11.120	Opioid abuse with intoxication, uncomplicated	bhiccm	HCC 137 · Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications
F11.121	Opioid abuse with intoxication delirium	bhiccm	HCC 137 · Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications
F11.122	Opioid abuse with intoxication with perceptual disturbance	bhiccm	HCC 137 · Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications
F11.129	Opioid abuse with intoxication, unspecified	bhiccm	HCC 137 · Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications
F11.13	Opioid abuse with withdrawal	bhiccm	HCC 137 · Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications
F11.14	Opioid abuse with opioid-induced mood disorder	bhiccm	HCC 137 · Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications
F11.150	Opioid abuse with opioid-induced psychotic disorder with delusions	bhiccm	HCC 135 · Drug Use with Psychotic Complications
F11.151	Opioid abuse with opioid-induced psychotic disorder with hallucinations	bhiccm	HCC 135 · Drug Use with Psychotic Complications
F11.159	Opioid abuse with opioid-induced psychotic disorder, unspecified	bhiccm	HCC 135 · Drug Use with Psychotic Complications
F11.181	Opioid abuse with opioid-induced sexual dysfunction	bhiccm	HCC 137 · Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications
F11.182	Opioid abuse with opioid-induced sleep disorder	bhiccm	HCC 137 · Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications
F11.188	Opioid abuse with other opioid-induced disorder	bhiccm	HCC 137 · Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications
F11.19	Opioid abuse with unspecified opioid-induced disorder	bhiccm	HCC 137 · Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications
F11.20	Opioid dependence, uncomplicated	bhiccm	HCC 137 · Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications
F11.21	Opioid dependence, in remission	bhiccm	HCC 137 · Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications
F11.220	Opioid dependence with intoxication, uncomplicated	bhiccm	HCC 137 · Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications
F11.221	Opioid dependence with intoxication delirium	bhiccm	HCC 137 · Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications
F11.222	Opioid dependence with intoxication with perceptual disturbance	bhiccm	HCC 137 · Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications
F11.229	Opioid dependence with intoxication, unspecified	bhiccm	HCC 137 · Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications
F11.23	Opioid dependence with withdrawal	bhiccm	HCC 137 · Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications
F11.24	Opioid dependence with opioid-induced mood disorder	bhiccm	HCC 137 · Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications
F11.250	Opioid dependence with opioid-induced psychotic disorder with delusions	bhiccm	HCC 135 · Drug Use with Psychotic Complications
F11.251	Opioid dependence with opioid-induced psychotic disorder with hallucinations	bhiccm	HCC 135 · Drug Use with Psychotic Complications
F11.259	Opioid dependence with opioid-induced psychotic disorder, unspecified	bhiccm	HCC 135 · Drug Use with Psychotic Complications
F11.281	Opioid dependence with opioid-induced sexual dysfunction	bhiccm	HCC 137 · Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications
F11.282	Opioid dependence with opioid-induced sleep disorder	bhiccm	HCC 137 · Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications
F11.288	Opioid dependence with other opioid-induced disorder	bhiccm	HCC 137 · Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications
F11.29	Opioid dependence with unspecified opioid-induced disorder	bhiccm	HCC 137 · Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications
F11.90	Opioid use, unspecified, uncomplicatedlow specificity	bhiccm	not risk adjusted
F11.91	Opioid use, unspecified, in remissionlow specificity	bhiccm	not risk adjusted
F11.920	Opioid use, unspecified with intoxication, uncomplicated	bhiccm	HCC 137 · Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications
F11.921	Opioid use, unspecified with intoxication delirium	bhiccm	HCC 137 · Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications
F11.922	Opioid use, unspecified with intoxication with perceptual disturbance	bhiccm	HCC 137 · Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications
F11.929	Opioid use, unspecified with intoxication, unspecified	bhiccm	HCC 137 · Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications
F11.93	Opioid use, unspecified with withdrawal	bhiccm	HCC 137 · Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications
F11.94	Opioid use, unspecified with opioid-induced mood disorder	bhiccm	HCC 137 · Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications
F11.950	Opioid use, unspecified with opioid-induced psychotic disorder with delusions	bhiccm	HCC 135 · Drug Use with Psychotic Complications
F11.951	Opioid use, unspecified with opioid-induced psychotic disorder with hallucinations	bhiccm	HCC 135 · Drug Use with Psychotic Complications
F11.959	Opioid use, unspecified with opioid-induced psychotic disorder, unspecified	bhiccm	HCC 135 · Drug Use with Psychotic Complications
F11.981	Opioid use, unspecified with opioid-induced sexual dysfunction	bhiccm	HCC 137 · Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications
F11.982	Opioid use, unspecified with opioid-induced sleep disorder	bhiccm	HCC 137 · Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications
F11.988	Opioid use, unspecified with other opioid-induced disorder	bhiccm	HCC 137 · Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications
F11.99	Opioid use, unspecified with unspecified opioid-induced disorder	bhiccm	HCC 137 · Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications

Other substance-related disorders

F12, F13, F14, F15, F16, F18, F19335 codes in familybhiccm

Structured follow-up and relapse-risk assessment.

CMS other chronic or potentially disabling condition · CCW category: Drug Use Disorders · Devices: Patient-reported outcome app (RTM)

This family runs to 335 codes that differ mainly by anatomic site and laterality, which does not change whether the condition supports care management. The codes are not listed one by one here. Code to the site and side documented in the record, within F12, F13, F14, F15, F16, F18, F19.

Tobacco-related disorders

F17, Z87.89121 codesbhiccm

Cessation counselling and relapse follow-up.

CMS other chronic or potentially disabling condition · CCW category: Tobacco Use Disorders

Code	Official ICD-10-CM description	Programs	Risk adjustment
F17.200	Nicotine dependence, unspecified, uncomplicated	bhiccm	not risk adjusted
F17.201	Nicotine dependence, unspecified, in remission	bhiccm	not risk adjusted
F17.203	Nicotine dependence unspecified, with withdrawal	bhiccm	not risk adjusted
F17.208	Nicotine dependence, unspecified, with other nicotine-induced disorders	bhiccm	not risk adjusted
F17.209	Nicotine dependence, unspecified, with unspecified nicotine-induced disorders	bhiccm	not risk adjusted
F17.210	Nicotine dependence, cigarettes, uncomplicated	bhiccm	not risk adjusted
F17.211	Nicotine dependence, cigarettes, in remission	bhiccm	not risk adjusted
F17.213	Nicotine dependence, cigarettes, with withdrawal	bhiccm	not risk adjusted
F17.218	Nicotine dependence, cigarettes, with other nicotine-induced disorders	bhiccm	not risk adjusted
F17.219	Nicotine dependence, cigarettes, with unspecified nicotine-induced disorders	bhiccm	not risk adjusted
F17.220	Nicotine dependence, chewing tobacco, uncomplicated	bhiccm	not risk adjusted
F17.221	Nicotine dependence, chewing tobacco, in remission	bhiccm	not risk adjusted
F17.223	Nicotine dependence, chewing tobacco, with withdrawal	bhiccm	not risk adjusted
F17.228	Nicotine dependence, chewing tobacco, with other nicotine-induced disorders	bhiccm	not risk adjusted
F17.229	Nicotine dependence, chewing tobacco, with unspecified nicotine-induced disorders	bhiccm	not risk adjusted
F17.290	Nicotine dependence, other tobacco product, uncomplicated	bhiccm	not risk adjusted
F17.291	Nicotine dependence, other tobacco product, in remission	bhiccm	not risk adjusted
F17.293	Nicotine dependence, other tobacco product, with withdrawal	bhiccm	not risk adjusted
F17.298	Nicotine dependence, other tobacco product, with other nicotine-induced disorders	bhiccm	not risk adjusted
F17.299	Nicotine dependence, other tobacco product, with unspecified nicotine-induced disorders	bhiccm	not risk adjusted
Z87.891	Personal history of nicotine dependence	bhiccm	not risk adjusted

ADHD, conduct and neurodevelopmental disorders

F90, F91, F80, F81, F82, F88, F8927 codes in familybhi

Structured rating scales and medication follow-up.

CMS other chronic or potentially disabling condition · CCW category: ADHD, Conduct Disorders, and Hyperkinetic Syndrome · Devices: Patient-reported outcome app (RTM)

This family runs to 27 codes that differ mainly by anatomic site and laterality, which does not change whether the condition supports care management. The codes are not listed one by one here. Code to the site and side documented in the record, within F90, F91, F80, F81, F82, F88, F89.

Autism spectrum and intellectual disabilities

F84, F70, F71, F72, F73, F78, F7913 codes in familybhiccm

Care coordination and caregiver support rather than device data.

CMS other chronic or potentially disabling condition · CCW category: Autism Spectrum Disorders

This family runs to 13 codes that differ mainly by anatomic site and laterality, which does not change whether the condition supports care management. The codes are not listed one by one here. Code to the site and side documented in the record, within F84, F70, F71, F72, F73, F78, F79.

Neurologic and cognitive

Traumatic brain injury sequelae

F06, F07, G93.1, G93.424 codes in familyccmbhipcm

Cognitive and behavioural follow-up with structured instruments.

CMS other chronic or potentially disabling condition · CCW category: Traumatic Brain Injury and Nonpsychotic Mental Disorders due to Brain Damage · Devices: Patient-reported outcome app (RTM)

This family runs to 24 codes that differ mainly by anatomic site and laterality, which does not change whether the condition supports care management. The codes are not listed one by one here. Code to the site and side documented in the record, within F06, F07, G93.1, G93.4.

Musculoskeletal and pain

Chronic pain and fibromyalgia

M79.7, G89.2, G89.4, R52, G93.310 codesrtmccmbhi

Pain scores, sleep and function, with behavioural support where indicated.

CMS other chronic or potentially disabling condition · CCW category: Fibromyalgia, Chronic Pain and Fatigue · Devices: Patient-reported outcome app (RTM)

G89.4 (chronic pain syndrome) and G89.29 (other chronic pain) are secondary codes. Code the underlying condition alongside.

Code	Official ICD-10-CM description	Programs	Risk adjustment
G89.21	Chronic pain due to trauma	rtmccmbhi	not risk adjusted
G89.22	Chronic post-thoracotomy pain	rtmccmbhi	not risk adjusted
G89.28	Other chronic postprocedural pain	rtmccmbhi	not risk adjusted
G89.29	Other chronic pain	rtmccmbhi	not risk adjusted
G89.4	Chronic pain syndrome	rtmccmbhi	not risk adjusted
G93.31	Postviral fatigue syndrome	rtmccmbhi	not risk adjusted
G93.32	Myalgic encephalomyelitis/chronic fatigue syndrome	rtmccmbhi	not risk adjusted
G93.39	Other post infection and related fatigue syndromes	rtmccmbhi	not risk adjusted
M79.7	Fibromyalgia	rtmccmbhi	not risk adjusted
R52	Pain, unspecified	rtmccmbhi	not risk adjusted

By Specialty

BHI codes by medical specialty.

Pulmonology

21 qualifying codes

Geriatrics

48 qualifying codes

Internal Medicine

264 qualifying codes

Behavioral Health

282 qualifying codes

Physical Medicine & Rehab

10 qualifying codes

FAQ

BHI eligibility questions.

Which ICD-10 codes are used for BHI?

CMS publishes no list of ICD-10 codes that qualify a patient for BHI, so the test is the condition rather than the code. The patient needs a behavioral health condition being managed in the primary care setting, such as depression, anxiety, PTSD or a substance use disorder. The codes below are every billable ICD-10-CM code for the conditions BHI manages, taken from the official FY2026 code set.

How does CCN Health help with BHI patient eligibility?

CCN Health reviews your patient population to identify conditions that support BHI, handles enrollment documentation, and manages ongoing BHI services including clinical monitoring, care coordination, and Medicare billing.

Can BHI be billed alongside other Medicare programs?

Yes, BHI can be billed alongside other Medicare care management programs for the same patient, provided each service addresses distinct clinical needs with separate time documentation.

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Sources & Compliance

Code set. Every code on this page is drawn from the official ICD-10-CM ICD-10-CM FY2026 (valid 2025-10-01 through 2026-09-30) released by CDC/NCHS, and only codes flagged valid for submission are listed. ICD-10-CM is published by the federal government and is in the public domain, so the descriptions here are the official long descriptors reproduced verbatim rather than summarized. The next code set, ICD-10-CM FY2027 (valid from 2026-10-01), is already reflected in the change flags.

Eligibility is not a code list. CMS does not publish a list of ICD-10 codes that qualify a patient for RPM, CCM, PCM, BHI, or RTM. Eligibility turns on the condition and on documented medical necessity. The programs shown against each condition are CCN Health’s clinical assessment of which programs that condition can support, not a statement of CMS approval.

Risk adjustment. HCC labels and category assignments come from the CMS-HCC V28 model for the 2026 payment year. Risk adjustment depends on the full encounter record, not on a single code, and the flags here are a prompt to check specificity rather than a payment guarantee.

CPT® notice. CPT is a registered trademark of the American Medical Association. CPT codes, descriptions, and other data only are copyright 2026 American Medical Association. All rights reserved. CPT is provided “as is” without warranty of any kind.

Sources. ICD-10-CM files, CDC/NCHS (cdc.gov); CMS Chronic Conditions Data Warehouse condition categories (ccwdata.org); CMS-HCC risk adjustment model software and ICD-10 mappings (cms.gov); AHRQ Clinical Classifications Software Refined (ahrq.gov).

Disclaimer. This page is informational and does not constitute billing, clinical, or legal advice. Diagnosis coding must reflect the documentation in the medical record. Verify all codes against the official CMS and CDC/NCHS publications and your contracted payer agreements before billing.

BHI ICD-10Codes.