F16.90: Hallucinogen use, unspecified, uncomplicated

F16.90, hallucinogen use, unspecified, uncomplicated, is listed as a covered diagnosis in 7 Medicare billing and coding articles that apply to 11 HCPCS Level II codes, including G0017 (Psychotherapy for crisis furnished in an applicable site…), G0018 (Psychotherapy for crisis furnished in an applicable site…), G0451 (Development testing, with interpretation and report, per…). The articles come from 5 Medicare contractors. A listed diagnosis supports medical necessity only; coverage still depends on the LCD's criteria and on documentation in the medical record.

HCPCS Level II codes with F16.90 as a covered diagnosis

CodeDescriptionMedicare coverageDMEPOS fee 2026 (state range)Articles listing it
G0017Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); first 60 minutesCarrier judgment—3
G0018Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); each additional 30 minutes (list separately in addition to code for primary service)Carrier judgment—3
G0451Development testing, with interpretation and report, per standardized instrument formCarrier judgment—3
G0560Safety planning interventions, each 20 minutes personally performed by the billing practitioner, including assisting the patient in the identification of the following personalized elements of a safety plan: recognizing warning signs of an impending suicidal or substance use-related crisis; employing internal coping strategies; utilizing social contacts and social settings as a means of distraction from suicidal thoughts or risky substance use; utilizing family members, significant others, caregivers, and/or friends to help resolve the crisis; contacting mental health or substance use disorder professionals or agencies; and making the environment safeCarrier judgment—2
G0480Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 1-7 drug class(es), including metabolite(s) if performedCarrier judgment—2
G0483Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 22 or more drug class(es), including metabolite(s) if performedCarrier judgment—2
G0482Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 15-21 drug class(es), including metabolite(s) if performedCarrier judgment—2
G0481Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 8-14 drug class(es), including metabolite(s) if performedCarrier judgment—2
G0659Drug test(s), definitive, utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem), excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase), performed without method or drug-specific calibration, without matrix-matched quality control material, or without use of stable isotope or other universally recognized internal standard(s) for each drug, drug metabolite or drug class per specimen; qualitative or quantitative, all sources, includes specimen validity testing, per day, any number of drug classesCarrier judgment—2
G0410Group psychotherapy other than of a multiple-family group, in a partial hospitalization or intensive outpatient setting, approximately 45 to 50 minutesCarrier judgment—1
G0411Interactive group psychotherapy, in a partial hospitalization or intensive outpatient setting, approximately 45 to 50 minutesCarrier judgment—1

Medicare policy articles listing F16.90

A diagnosis listed as covered in a billing and coding article supports medical necessity for the article's codes; it does not guarantee payment. Coverage depends on the LCD's criteria, the contractor's jurisdiction and documentation in the medical record.

Other F16 diagnoses (Hallucinogen related disorders)

Frequently asked questions

Does Medicare cover F16.90 (Hallucinogen use, unspecified, uncomplicated)?

Medicare covers items and services, not diagnoses. 7 Medicare billing and coding articles list F16.90 as a covered diagnosis for 11 HCPCS Level II codes: the diagnosis can support medical necessity for those codes, but payment still depends on the LCD's coverage criteria and the medical record.

Which HCPCS codes can be billed with ICD-10 F16.90?

The Level II codes from the policies most specific to this diagnosis are G0017 (Psychotherapy for crisis furnished in an applicable site…, 3 articles); G0018 (Psychotherapy for crisis furnished in an applicable site…, 3 articles); G0451 (Development testing, with interpretation and report, per…, 3 articles); G0560 (Safety planning interventions, each 20 minutes personally…, 2 articles); G0480 (Drug test(s), definitive, utilizing (1) drug…, 2 articles). Code choice depends on the item supplied; check each code's descriptor.

Which Medicare policy articles list F16.90?

A57520 (Billing and Coding: Psychiatric Diagnostic Evaluation and Psychotherapy Services); A57480 (Billing and Coding: Psychiatry and Psychology Services); A56818 (Billing and Coding: Urine Drug Testing), and 4 more articles.

What is ICD-10-CM code F16.90?

F16.90 is the ICD-10-CM code for hallucinogen use, unspecified, uncomplicated, in category F16 (Hallucinogen related disorders), chapter 5: Mental, behavioral and neurodevelopmental disorders.

Next steps

Sources: CMS Medicare Coverage Database billing and coding articles (covered ICD-10 code lists and HCPCS links); ICD-10-CM FY2026; CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule 2026 (non-rural state fees). Not billing or legal advice.

Chapter 5: Mental, behavioral and neurodevelopmental disorders · All diagnoses · HCPCS lookup