FACIT-F (Functional Assessment of Chronic Illness Therapy-Fatigue): Scoring, Cutoffs & Calculator

FACIT stands for Functional Assessment of Chronic Illness Therapy. The FACIT-F is its fatigue questionnaire: 13 items about the past 7 days, each answered 0 (not at all) to 4 (very much). After reversing the negatively worded items, the total runs from 0 to 52, and a higher score means less fatigue. It was built to measure fatigue linked to anemia in people with cancer and is now used across many chronic conditions.

This guide gives clinicians what they need in one place: the FACIT meaning, the exact scoring rules (including which items are not reversed), published severity bands and norms, important-change estimates, where the scale has and has not been validated, and how to document it. Use the calculator below to score a form in seconds. Each figure is tied to its source at the end of the page.

FACIT-F at a glance

FACIT meaning: FACIT vs FACT vs FACIT-F

People searching for the FACIT meaning often meet three similar names. They describe different things, and mixing them causes scoring errors.

FACIT-F score calculator

How to score the FACIT-F

1. Give the form. Ask the patient to answer all 13 items about the past 7 days. Self-completion is preferred. Interview administration is allowed when the patient cannot complete it alone.
2. Reverse 11 items. For every item except 7 and 8, the score is 4 minus the answer. A patient who marks "very much" (4) for "I feel fatigued" scores 0.
3. Keep items 7 and 8 as marked. "I have energy" and "I am able to do my usual activities" are positive statements, so a mark of 4 stays 4.
4. Add the 13 scored items. If all items are answered, the sum is the total, from 0 to 52.
5. Prorate if items are blank. With at least 7 answered, multiply the sum by 13 and divide by the number answered. With fewer than 7, do not score the form.
6. Record and repeat. Note the total, the date and the version, then repeat at set points to track change.

Short labels are used here, not the full item text, which is copyrighted. Use the official FACIT-F form from facit.org with the patient; the download button on this page links to the English Version 4 PDF. To send and score it automatically, see SPRY PROMs.

FACIT-F score interpretation

There is no single universal cutoff for the FACIT-F. Published bands come from specific diseases, so name the source in your note. Two sets are summarised below.

The cold agglutinin disease bands came from an anchor-based receiver operating characteristic analysis using the Patient Global Impression of Fatigue Severity, with pooled data from two phase 3 trials (CARDINAL and CADENZA). Oncology studies often flag scores below 30 or below 34 as clinically significant fatigue, and a long COVID summary groups 0 to 20 as very severe, 21 to 30 severe, 31 to 40 moderate and 41 to 52 mild.

FACIT-F reference values for the general population

When a patient's total sits well below roughly 43, fatigue is heavier than the typical adult report. Because the norms are German, use them as a rough comparison, not a US cutoff.

Minimal important change on the FACIT-F

No single minimal clinically important difference applies to every population. Pick an estimate that matches your patient group and say which one you used.

FACIT-F reliability and validity

Figures are from the Physiopedia summary of published studies except the German alpha, which is from Montan 2018. Check the original paper before quoting a number in a study or a payer appeal.

Where the FACIT-F is validated and where it is not

For rehab teams this matters. In oncology, rheumatology and hematology the FACIT-F has strong support. In a general musculoskeletal caseload it is a sensible screening and tracking tool, but you should not cite it as validated there. Pair it with function measures such as the 6-Minute Walk Test and 30-Second Sit-to-Stand Test, and with mood and anxiety screens like the PHQ-9 and GAD-7.

FACIT-F vs other fatigue measures

If fatigue is one of several symptoms in a chronic pain presentation, our guides to the fibromyalgia diagnostic criteria and the Pain Catastrophizing Scale cover the usual companions, and the PROMs and functional outcome library lists more measures.

Documenting FACIT-F results and coding

Record the version, the total, whether it was prorated and the date. A score alone does not justify a plan of care, so tie it to function: what the patient can no longer do and what the treatment aims to change. Billing rules depend on the payer, so check policy first.

Confirm each code against the current ICD-10-CM code set and the treating provider's diagnosis before billing. For a PT, administering a PROM is usually part of the evaluation or re-evaluation. CPT 96127 (brief emotional or behavioral assessment) is sometimes used for scored instruments, but acceptance varies by payer and by license, so confirm in writing. See the ICD-10 code library, the CPT code library and our physical therapy CPT codes reference sheet. To keep scores in the chart and trend them, see SPRY documentation and reporting and analytics.

Frequently asked questions

What does FACIT stand for?

FACIT stands for Functional Assessment of Chronic Illness Therapy. It is a family of questionnaires that grew out of the Functional Assessment of Cancer Therapy (FACT) measures.

What is the FACIT-F scale?

The FACIT-F, or FACIT-Fatigue, is a 13-item self-report questionnaire about fatigue and its impact on daily activities over the past 7 days. Scores run from 0 to 52, and higher scores mean less fatigue.

How is the FACIT-F scored?

Each item is answered 0 to 4. Items 7 and 8 are scored as marked and the other 11 are reversed (4 minus the answer). Add the 13 scored items for a total from 0 to 52. If some items are blank but at least 7 are answered, multiply the sum by 13 and divide by the number answered.

What is a good or bad FACIT-F score?

Higher is better. The German general-population mean was 43.5 (SD 8.3). Commonly cited disease-specific bands treat above 40 as none or minimal fatigue and 21 or below as severe, but there is no universal cutoff.

What FACIT-F score indicates severe fatigue?

In bands summarised for axial spondyloarthritis, 21 or below is severe. In cold agglutinin disease, 0 to 28 is severe or very severe. Oncology studies often flag scores below 30 or below 34. Name the source you use.

Which FACIT-F items are reverse scored?

Eleven of the 13 are reversed. The two exceptions are item 7 (having energy) and item 8 (being able to do usual activities), which are positive statements and are scored as marked.

What is the minimal important difference for the FACIT-F?

It depends on the population. A 2023 registry study in PNH recommended 5 points, with an anchor-based range of 2.5 to 15.5. A summary across populations lists about 2.4 to 11 points.

Is the FACIT-F free to use?

Per facit.org, the English version needs no fee and license registration is recommended. Fees are usually not applied to clinical use, students or investigator-initiated research. Translations need formal permission.

How long does the FACIT-F take?

Facit.org lists 10 to 15 minutes for the full 40-item form, which includes the 27-item FACT-G. The 13-item fatigue scale alone is shorter.

Is the FACIT-F validated for physical therapy patients?

It is validated in cancer, several rheumatic conditions and some blood disorders, with limited validation in multiple sclerosis, Parkinson's disease and stroke. It is not established for general musculoskeletal outpatients, so use it as a screening and tracking tool there and say so in the note.

Sources and further reading

• FACIT.org: FACIT-F measure page (items, scoring, licensing)
• FACIT.org: interpretation and references
• Montan I, et al. General population norms for the FACIT-Fatigue Scale. Value in Health, 2018
• Clinically important change for the FACIT-Fatigue scale in PNH: International PNH Registry data. Journal of Patient-Reported Outcomes, 2023
• Cella D, et al. FACIT-Fatigue severity thresholds in cold agglutinin disease. EHA 2024 poster
• Physiopedia: Functional Assessment of Chronic Illness Therapy-Fatigue scale

This page is for clinicians and is informational. The FACIT-F screens and tracks fatigue and does not replace clinical judgment or explain its cause. Billing rules vary by payer, so verify them before submitting claims.