F51.12: Insufficient sleep syndrome
F51.12, insufficient sleep syndrome, is listed as a covered diagnosis in 8 Medicare billing and coding articles that apply to 15 HCPCS Level II codes, including G0017 (Psychotherapy for crisis furnished in an applicable site…), G0018 (Psychotherapy for crisis furnished in an applicable site…), G0410 (Group psychotherapy other than of a multiple-family group…). 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 F51.12 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| 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 | — | 4 |
| 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 | — | 4 |
| 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 | — | 3 |
| G0411 | Interactive group psychotherapy, in a partial hospitalization or intensive outpatient setting, approximately 45 to 50 minutes | Carrier judgment | — | 3 |
| G0399 | Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ecg/heart rate and 1 oxygen saturation | Carrier judgment | — | 1 |
| G0400 | Home sleep test (hst) with type iv portable monitor, unattended; minimum of 3 channels | Carrier judgment | — | 1 |
| G0398 | Home sleep study test (hst) with type ii portable monitor, unattended; minimum of 7 channels: eeg, eog, emg, ecg/heart rate, airflow, respiratory effort and oxygen saturation | Carrier judgment | — | 1 |
| G0451 | Development testing, with interpretation and report, per standardized instrument form | Carrier judgment | — | 3 |
| 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 | — | 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 |
| G0323 | Care management services for behavioral health conditions, at least 20 minutes of clinical psychologist, clinical social worker, mental health counselor, or marriage and family therapist time, per calendar month. (these services include the following required elements: initial assessment or follow-up monitoring, including the use of applicable validated rating scales; behavioral health care planning in relation to behavioral/psychiatric health problems, including revision for patients who are not progressing or whose status changes; facilitating and coordinating treatment such as psychotherapy, coordination with and/or referral to physicians and practitioners who are authorized by medicare to prescribe medications and furnish e/m services, counseling and/or psychiatric consultation; and continuity of care with a designated member of the care team) | Carrier judgment | — | 1 |
| G0409 | Social work and psychological services, directly relating to and/or furthering the patient's rehabilitation goals, each 15 minutes, face-to-face; individual (services provided by a corf-qualified social worker or psychologist in a corf) | Carrier judgment | — | 1 |
| G0570 | Care management services for behavioral health conditions, directed by a physician or other qualified health care professional, per calendar month, with the following required elements: initial assessment or follow-up monitoring, including the use of applicable validated rating scales, behavioral health care planning in relation to behavioral/psychiatric health problems, including revision for patients who are not progressing or whose status changes, facilitating and coordinating treatment such as psychotherapy, pharmacotherapy, counseling and/or psychiatric consultation, and continuity of care with a designated member of the care team (list separately in addition to advanced primary care management code) | Carrier judgment | — | 1 |
Medicare policy articles listing F51.12
- A56923: Billing and Coding: Outpatient Sleep Studies (Novitas Solutions, Inc. (MAC - Part A, MAC - Part B); 3 Level II codes). LCD with the same title: L35050
- 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
- A59723: Billing and Coding: Outpatient Psychotherapy (Palmetto GBA (MAC - Part A, MAC - Part B); 7 Level II codes). LCD with the same title: L39853
- A57520: Billing and Coding: Psychiatric Diagnostic Evaluation and Psychotherapy Services (First Coast Service Options, Inc. (MAC - Part A, MAC - Part B); 3 Level II codes). LCD with the same title: L33252
- 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
- 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 F51 diagnoses (Sleep disorders not due to a substance or known physiological condition)
- F51.11 — Primary hypersomnia
- F51.13 — Hypersomnia due to other mental disorder
- F51.19 — Other hypersomnia not due to a substance or known physiological…
- F51.01 — Primary insomnia
- F51.02 — Adjustment insomnia
- F51.03 — Paradoxical insomnia
- F51.04 — Psychophysiologic insomnia
- F51.05 — Insomnia due to other mental disorder
- F51.09 — Other insomnia not due to a substance or known physiological condition
- F51.3 — Sleepwalking [somnambulism]
- F51.4 — Sleep terrors [night terrors]
- F51.5 — Nightmare disorder
- F51.8 — Other sleep disorders not due to a substance or known physiological…
Frequently asked questions
Does Medicare cover F51.12 (Insufficient sleep syndrome)?
Medicare covers items and services, not diagnoses. 8 Medicare billing and coding articles list F51.12 as a covered diagnosis for 15 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 F51.12?
The Level II codes from the policies most specific to this diagnosis are G0017 (Psychotherapy for crisis furnished in an applicable site…, 4 articles); G0018 (Psychotherapy for crisis furnished in an applicable site…, 4 articles); G0410 (Group psychotherapy other than of a multiple-family group…, 3 articles); G0411 (Interactive group psychotherapy, in a partial…, 3 articles); G0399 (Home sleep test (hst) with type iii portable monitor…, 1 article). Code choice depends on the item supplied; check each code's descriptor.
Which Medicare policy articles list F51.12?
A56923 (Billing and Coding: Outpatient Sleep Studies); A57053 (Billing and Coding: Psychiatric Partial Hospitalization Programs); A59723 (Billing and Coding: Outpatient Psychotherapy), and 5 more articles.
What is ICD-10-CM code F51.12?
F51.12 is the ICD-10-CM code for insufficient sleep syndrome, in category F51 (Sleep disorders not due to a substance or known physiological condition), chapter 5: Mental, behavioral and neurodevelopmental disorders.
Next steps
- Run a reimbursement report for a device billed under G0017
- Watch G0017 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for G0017
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