Patient presents with a primary diagnosis of Schizoaffective Disorder, Depressive Type (F25.1 per ICD-10-CM), substantiated by clinical interview, mental status examination, and review of psychosocial history.  The patient exhibits prominent and persistent mood symptoms meeting criteria for a major depressive episode, concurrent with psychotic symptoms consistent with schizophrenia.  These psychotic features, including auditory hallucinations (patient reports hearing derogatory voices) and delusional beliefs (persecutory in nature), are present with and without the presence of the major depressive episode, fulfilling the diagnostic criteria for schizoaffective disorder.  Differential diagnoses considered include major depressive disorder with psychotic features, bipolar disorder with psychotic features, and schizophrenia.  These were ruled out based on the longitudinal course of illness and symptom presentation.  Current symptoms significantly impact the patient's functioning in social, occupational, and interpersonal domains.  Treatment plan includes initiation of aripiprazole for management of psychotic and mood symptoms, individual psychotherapy focusing on cognitive behavioral therapy (CBT) techniques, and referral to a psychiatrist for ongoing medication management.  Patient education provided regarding schizoaffective disorder, medication side effects, and importance of treatment adherence.  Prognosis guarded but hopeful with adherence to the treatment plan.  Follow-up scheduled in two weeks to assess treatment response and adjust medication as needed.  Medical billing codes will reflect the evaluation and management (E/M) services provided, psychiatric diagnostic evaluation, and pharmacotherapy management.