F40.00: Agoraphobia, unspecified
F40.00, agoraphobia, unspecified, is listed as a covered diagnosis in 4 Medicare billing and coding articles that apply to 9 HCPCS Level II codes, including G0451 (Development testing, with interpretation and report, per…), G0152 (Services performed by a qualified occupational therapist…), G0155 (Services of clinical social worker in home health or…). The articles come from 4 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 F40.00 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| G0451 | Development testing, with interpretation and report, per standardized instrument form | Carrier judgment | — | 3 |
| G0152 | Services performed by a qualified occupational therapist in the home health or hospice setting, each 15 minutes | Carrier judgment | — | 1 |
| G0155 | Services of clinical social worker in home health or hospice settings, each 15 minutes | Carrier judgment | — | 1 |
| G0156 | Services of home health/hospice aide in home health or hospice settings, each 15 minutes | Carrier judgment | — | 1 |
| G0299 | Direct skilled nursing services of a registered nurse (rn) in the home health or hospice setting, each 15 minutes | Carrier judgment | — | 1 |
| G0300 | Direct skilled nursing services of a licensed practical nurse (lpn) in the home health or hospice setting, each 15 minutes | Carrier judgment | — | 1 |
| G0017 | Psychotherapy 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 minutes | Carrier judgment | — | 1 |
| G0018 | Psychotherapy 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 | — | 1 |
| G0560 | Safety 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 safe | Carrier judgment | — | 1 |
Medicare policy articles listing F40.00
- A56756: Billing and Coding: Home Health - Psychiatric Care (Palmetto GBA (HHH MAC); 5 Level II codes). LCD with the same title: L34561
- A56937: Billing and Coding: Psychiatry and Psychology Services (Wellpoint Federal (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L33632, L34616
- A57130: Billing and Coding: Psychiatric Codes (Novitas Solutions, Inc. (MAC - Part A, MAC - Part B); 4 Level II codes). LCD with the same title: L35101
- A57780: Billing and Coding: Psychological and Neuropsychological Tests (First Coast Service Options, Inc. (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L34520
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 F40 diagnoses (Phobic anxiety disorders)
- F40.01 — Agoraphobia with panic disorder
- F40.02 — Agoraphobia without panic disorder
- F40.10 — Social phobia, unspecified
- F40.11 — Social phobia, generalized
- F40.210 — Arachnophobia
- F40.218 — Other animal type phobia
- F40.220 — Fear of thunderstorms
- F40.228 — Other natural environment type phobia
- F40.230 — Fear of blood
- F40.231 — Fear of injections and transfusions
- F40.232 — Fear of other medical care
- F40.233 — Fear of injury
- F40.240 — Claustrophobia
- F40.241 — Acrophobia
- F40.242 — Fear of bridges
- F40.243 — Fear of flying
- F40.248 — Other situational type phobia
- F40.290 — Androphobia
- F40.291 — Gynephobia
- F40.298 — Other specified phobia
- F40.8 — Other phobic anxiety disorders
Frequently asked questions
Does Medicare cover F40.00 (Agoraphobia, unspecified)?
Medicare covers items and services, not diagnoses. 4 Medicare billing and coding articles list F40.00 as a covered diagnosis for 9 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 F40.00?
The Level II codes from the policies most specific to this diagnosis are G0451 (Development testing, with interpretation and report, per…, 3 articles); G0152 (Services performed by a qualified occupational therapist…, 1 article); G0155 (Services of clinical social worker in home health or…, 1 article); G0156 (Services of home health/hospice aide in home health or…, 1 article); G0299 (Direct skilled nursing services of a registered nurse (rn)…, 1 article). Code choice depends on the item supplied; check each code's descriptor.
Which Medicare policy articles list F40.00?
A56756 (Billing and Coding: Home Health - Psychiatric Care); A56937 (Billing and Coding: Psychiatry and Psychology Services); A57130 (Billing and Coding: Psychiatric Codes), and 1 more article.
What is ICD-10-CM code F40.00?
F40.00 is the ICD-10-CM code for agoraphobia, unspecified, in category F40 (Phobic anxiety disorders), chapter 5: Mental, behavioral and neurodevelopmental disorders.
Next steps
- Run a reimbursement report for a device billed under G0451
- Watch G0451 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for G0451
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