F45.9: Somatoform disorder, unspecified
F45.9, somatoform disorder, unspecified, is listed as a covered diagnosis in 6 Medicare billing and coding articles that apply to 18 HCPCS Level II codes, including G0410 (Group psychotherapy other than of a multiple-family group…), G0411 (Interactive group psychotherapy, in a partial…), G0129 (Occupational therapy services requiring the skills of a…). The articles come from 6 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 F45.9 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| G0410 | Group psychotherapy other than of a multiple-family group, in a partial hospitalization or intensive outpatient setting, approximately 45 to 50 minutes | Carrier judgment | — | 2 |
| G0411 | Interactive group psychotherapy, in a partial hospitalization or intensive outpatient setting, approximately 45 to 50 minutes | Carrier judgment | — | 2 |
| G0129 | Occupational therapy services requiring the skills of a qualified occupational therapist, furnished as a component of a partial hospitalization or intensive outpatient treatment program, per session (45 minutes or more) | Carrier judgment | — | 1 |
| G0176 | Activity therapy, such as music, dance, art or play therapies not for recreation, related to the care and treatment of patient's disabling mental health problems, per session (45 minutes or more) | Special coverage instructions apply | — | 1 |
| G0177 | Training and educational services related to the care and treatment of patient's disabling mental health problems per session (45 minutes or more) | Special coverage instructions apply | — | 1 |
| G0451 | Development testing, with interpretation and report, per standardized instrument form | Carrier judgment | — | 2 |
| 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 |
| G0480 | Drug 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 performed | Carrier judgment | — | 1 |
| G0483 | Drug 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 performed | Carrier judgment | — | 1 |
| G0482 | Drug 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 performed | Carrier judgment | — | 1 |
| G0481 | Drug 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 performed | Carrier judgment | — | 1 |
| G0659 | Drug 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 classes | Carrier judgment | — | 1 |
Medicare policy articles listing F45.9
- A57053: Billing and Coding: Psychiatric Partial Hospitalization Programs (CGS Administrators, LLC (MAC - Part A, MAC - Part B); 5 Level II codes). LCD with the same title: L33626, L34196
- A56756: Billing and Coding: Home Health - Psychiatric Care (Palmetto GBA (HHH MAC); 5 Level II codes). LCD with the same title: L34561
- A57480: Billing and Coding: Psychiatry and Psychology Services (WPS Insurance Corporation (MAC - Part A, MAC - Part B); 4 Level II codes). LCD with the same title: L33632, L34616
- A56645: Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing (Novitas Solutions, Inc. (MAC - Part A, MAC - Part B); 5 Level II codes). LCD with the same title: L35006, L36393
- 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
- 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 F45 diagnoses (Somatoform disorders)
- F45.0 — Somatization disorder
- F45.1 — Undifferentiated somatoform disorder
- F45.20 — Hypochondriacal disorder, unspecified
- F45.21 — Hypochondriasis
- F45.22 — Body dysmorphic disorder
- F45.29 — Other hypochondriacal disorders
- F45.41 — Pain disorder exclusively related to psychological factors
- F45.42 — Pain disorder with related psychological factors
- F45.8 — Other somatoform disorders
Frequently asked questions
Does Medicare cover F45.9 (Somatoform disorder, unspecified)?
Medicare covers items and services, not diagnoses. 6 Medicare billing and coding articles list F45.9 as a covered diagnosis for 18 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 F45.9?
The Level II codes from the policies most specific to this diagnosis are G0410 (Group psychotherapy other than of a multiple-family group…, 2 articles); G0411 (Interactive group psychotherapy, in a partial…, 2 articles); G0129 (Occupational therapy services requiring the skills of a…, 1 article); G0176 (Activity therapy, such as music, dance, art or play…, 1 article); G0177 (Training and educational services related to the care and…, 1 article). Code choice depends on the item supplied; check each code's descriptor.
Which Medicare policy articles list F45.9?
A57053 (Billing and Coding: Psychiatric Partial Hospitalization Programs); A56756 (Billing and Coding: Home Health - Psychiatric Care); A57480 (Billing and Coding: Psychiatry and Psychology Services), and 3 more articles.
What is ICD-10-CM code F45.9?
F45.9 is the ICD-10-CM code for somatoform disorder, unspecified, in category F45 (Somatoform disorders), chapter 5: Mental, behavioral and neurodevelopmental disorders.
Next steps
- Run a reimbursement report for a device billed under G0410
- Watch G0410 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for G0410
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