Quick links: MS-DRG Codes | HCAHPS Service Line and V.34 APR-DRG Crosswalk | 2019 QualityNet Maintenance and Downtime Schedule | Data Submission Deadlines Through 2021 | 25 Completed HCAHPS Surveys Required for Hospital HCAHPS Scores to be Publicly Reported on Hospital Compare | Submission of HCAHPS Administrative Data | Contacting QualityNet HelpDesk Regarding HCAHPS Data Submission Issues | HCAHPS Public Reporting Periods | IPPS and OPPS Rules | HCAHPS V4.3 Submission of "5 or Fewer Eligible HCAHPS Discharges in a Month" | HCAHPS V4.3 Submission of "Zero Cases | XML File Specifications Version 4.3 | HCAHPS V4.2 Submission of "5 or Fewer Eligible HCAHPS Discharges in a Month" | HCAHPS V4.2 Submission of "Zero Cases" | XML File Specifications Version 4.2
V.38 MS-DRG Codes Effective October 1, 2020 (10/07/2020)
CMS has adopted V.38 MS-DRG Codes effective October 1, 2020. Please click here for the Table of V.38 MS-DRG Codes and HCAHPS Service Line Categories.
V.37 MS-DRG Codes Effective October 1, 2019 (08/27/2019)
CMS has adopted V.37 MS-DRG Codes effective October 1, 2019. Please click here for the Table of V.37 MS-DRG Codes and HCAHPS Service Line Categories.
Previous MS-DRG Codes:
- V.36 MS-DRG Codes Effective October 1, 2018
- V.35 MS-DRG Codes Effective October 1, 2017
- V.34 MS-DRG Codes Effective October 1, 2016
HCAHPS Service Line and V.34 APR-DRG Crosswalk (08/31/2018)
Please click here for the Crosswalk of HCAHPS Service Line Categories and V.34 APR-DRG Codes
Previous APR-DRG HCAHPS Service Lines and Crosswalks:
2019 QualityNet Maintenance and Downtime Schedule (12/04/2019)
The HCAHPS Project Team is alerting approved HCAHPS Survey vendors and self-administering hospitals of upcoming regular QualityNet maintenance weekends. During this time organizations will not be able to upload HCAHPS data to the HCAHPS Data Warehouse. This alert is provided so that survey vendors and self-administering hospitals can plan data submission as needed.
Please see below for the 2019 schedule of upcoming regular QualityNet maintenance weekends.
- December 13 – 15
- December 27 – 29
Data Submission Deadlines Through April 2021
The HCAHPS Data Submission Deadlines through April 2021 are listed below. Following the HCAHPS Data Submission Deadline, hospitals self-administering the HCAHPS Survey and HCAHPS Survey vendors will have a one week opportunity to correct data previously submitted for the quarter. The Review and Correct Period is only for correcting previously submitted data and cannot be used to submit new data records.
The process for submitting corrected data will be the same as the current process used for correcting data. During the Review and Correct Period only administrative data and survey record data can be corrected.
The Review and Correct Report, which summarizes the data submitted to the HCAHPS Data Warehouse, is available to hospitals and survey vendors in the Review and Correction Period.
The 2020 through 2021 HCAHPS Data Submission Deadlines are as follows:
- January 2, 2020 is the data submission deadline for the patients discharged in July, August, and September 2019 (3Q19). September 2019 Dry Run data must also be submitted by this date.
- January 3 – 9, 2020 Review and Correct Period
- April 1, 2020 is the data submission deadline for the patients discharged in October, November, and December 2019 (4Q19). December 2019 Dry Run data must also be submitted by this date.
- April 2 – 8, 2020 Review and Correct Period
- July 1, 2020 is the data submission deadline for the patients discharged in January, February, March 2020 (1Q20).March 2020 Dry Run data must also be submitted by this date.
- July 2 – 8, 2020 Review and Correct Period
- October 7, 2020 is the data submission deadline for the patients discharged in April, May, and June 2020 (2Q20). June 2020 Dry Run data must also be submitted by this date.
- October 8 – 14, 2020 Review and Correct Period
- January 6, 2021 is the data submission deadline for the patients discharged in July, August, and September 2020 (3Q20). September 2020 Dry Run data must also be submitted by this date.
- January 7 – 13, 2021 Review and Correct Period
- January 7 – 13, 2021 Review and Correct Period
- April 7, 2021 is the data submission deadline for the patients discharged in October, November, and December 2020 (4Q20). December 2020 Dry Run data must also be submitted by this date.
- April 8 – 14, 2021 Review and Correct Period
25 Completed HCAHPS Surveys Required for Hospital HCAHPS Scores to be Publicly Reported on Hospital Compare (08/15/2018)
Beginning with the December 2016 Hospital Compare refresh, HCAHPS scores based on fewer than 25 completed surveys will no longer be publicly reported. From December forward, the Hospital Compare Web site will report “Not Applicable” and Footnote 1: "The number of cases/patients is too few to report," for hospitals that have fewer than 25 completed HCAHPS Surveys. However, the Public Reporting Preview Report, which a hospital can access during the preview period, will continue to include the hospital’s HCAHPS scores and number of completed surveys.
Submission of HCAHPS Administrative Data (03/31/2016)
The HCAHPS Project Team would like to remind hospitals and survey vendors that hospitals are required to provide, in a timely manner, all patient administrative data required for the HCAHPS Survey, including service line and patient age; see FY 2014 IPPS Final Rule (Federal Register/Vol. 78, No. 160/Monday, August 19, 2013/Rules and Regulations, Section. 412.140). These data are required for Patient-Mix Adjustment. Failure to provide this information is considered a deviation from HCAHPS data collection protocols.
Contacting QualityNet HelpDesk Regarding HCAHPS Data Submission Issues (03/31/2016)
When contacting the QualityNet HelpDesk about issues related to HCAHPS data submission, the HCAHPS Project Team requests that the survey vendor or hospital copy the HCAHPS Project Team on these communications. Please “cc” HCAHPS Technical Assistance hcahps@hsag.com on data submission related emails sent to the QualityNet HelpDesk. Also be sure to provide HCAHPS Technical Assistance with any ticket number assigned by the QualityNet HelpDesk. In addition, if you contact the QualityNet HelpDesk via telephone, please send a follow-up email to the HCAHPS Technical Assistance as documentation of telephone conversation with QualityNet, and please include the ticket number.
HCAHPS Public Reporting Periods for January 2019 Through October 2021 Have Been Posted (11/13/2019)
Click here to view the HCAHPS Public Reporting Periods document. This document indicates which calendar quarters of HCAHPS results will be publicly reported on the Hospital Compare Web site through October 2021.
Please Note: The dates of future preview periods and public reporting are estimates based on current timetables and thus are subject to change.
FY 2021 IPPS Final Rule Has Been Published (09/18/2020)
The FY 2021 IPPS Final Rule, is now available on the Federal Register.
The Final Rule and related tables are available at the following URL: federalregister.gov/d/2020-19637
Previous IPPS Final Rules:
CY 2019 OPPS Final Rule Now Published (11/21/2018)
The CY 2019 OPPS Final Rule is now published.
The Final Rule and related tables are available at the following URL: https://www.gpo.gov/fdsys/pkg/FR-2018-11-21/pdf/2018-24243.pdf
Combating the Opioid Crisis
In response to recommendations from the President’s Commission on Combating Drug Addiction and the Opioid Crisis, to comply with the requirements of the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act (P.L. 115-271), and to avoid any potential unintended consequences, under the Hospital Inpatient Quality Reporting (IQR) Program, CMS is finalizing the proposal to update the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) patient experience of care survey measure by removing the three recently revised pain communication questions. The removal of these questions is effective with October 2019 discharges, for the FY 2021 payment determination and subsequent years, earlier than proposed. As a related modification, CMS will not publicly report the three revised Communication About Pain questions.
Previous OPPS Final Rules:
CMS is finalizing the removal of the Pain Management dimension from the scoring formula used in the Hospital Value-Based Purchasing Program (Hospital VBP), beginning with the FY 2018 payment adjustments. The Pain Management dimension is derived from Questions 12, 13 and 14 on the HCAHPS Survey.
HCAHPS V4.3 Submission of "5 or Fewer Eligible HCAHPS Discharges in a Month"
Below please find instructions for uploading "5 or Fewer Eligible HCAHPS Discharges in a Month" information via My QualityNet using the Online Data Entry Tool or the XML file format for July 1, 2020 patient discharges and forward.
Online Tool
Please note the following:
-
One header record must be completed for each month that an organization has "5 or Fewer Eligible HCAHPS Discharges in a Month"
-
The NPI element is not required at this time, but may be entered if the information is available
-
For "survey mode," select "Mail only"
-
For "determination of service line," select the method used to determine the patient's eligibility
-
For "number eligible discharge," enter actual count of eligible discharges for the month
-
For "sample size," enter zero
-
For "sample type," select "Simple Random Sample"
XML File Format
Below is an example of the header record layout that must be submitted for each month that an organization has "5 or Fewer Eligible HCAHPS Discharges in a Month."
<header>
<provider-name>Some Hospital</provider-name>
<provider-id>123456</provider-id>
(NPI is not required)
<discharge-yr>2020</discharge-yr>
<discharge-month>7</discharge-month> (for July)
<survey-mode>1</survey-mode> (for Mail only)
<determination-of-service-line>1</determination-of-service-line> (for V.38, V.37, V.36, V.35, V.34,
V.33, V.32, V.31, V.30, V.29, V.28, V.27, V.26, or V.25 MS-DRG codes)
<number-eligible-discharge>enter actual count i.e. 1, 2, 3, 4 or 5</number-eligible-discharge>
<sample-size>0</sample-size>
<sample-type>1</sample-type> (for Simple Random Sample)
</header>
Please contact HCAHPS Information and Technical Support by email at hcahps@hsag.com or by telephone at 1-888-884-4007 with any questions.
HCAHPS V4.3 Submission of "Zero Cases"
Below please find instructions for uploading "Zero Case" information via My QualityNet using the Online Data Entry Tool or the XML file format for July 1, 2020 patient discharges and forward.
Online Tool
Please note the following:
-
One header record must be completed for each month that an organization has "Zero Cases"
-
The NPI element is not required at this time, but may be entered if the information is available
-
For "survey mode," select "Mail only"
-
For "determination of service line," select "1 – V.38, V.37, V.36, V.35, V.34, V.33, V.32, V.31, V.30, V.29, V.28, V.27, V.26, or V.25 MS-DRG codes"
-
For "number eligible discharge," and "sample size" enter 0
-
For "sample type," select "Simple Random Sample"
XML File Format
Below is an example of the header record layout that must be submitted for each month that an organization has "Zero Cases."
<header>
<provider-name>Some Hospital</provider-name>
<provider-id>123456</provider-id>
(NPI is not required)
<discharge-yr>2020</discharge-yr>
<discharge-month>7</discharge-month> (for July)
<survey-mode>1</survey-mode> (for Mail only)
<determination-of-service-line>1</determination-of-service-line> (for V.38, V.37, V.36, V.35, V.34,
V.33, V.32, V.31, V.30, V.29, V.28, V.27, V.26, or V.25 MS-DRG codes)
<number-eligible-discharge>enter actual count i.e. 1, 2, 3, 4 or 5</number-eligible-discharge>
<sample-size>0</sample-size>
<sample-type>1</sample-type> (for Simple Random Sample)
</header>
Please contact HCAHPS Information and Technical Support by email at hcahps@hsag.com or by telephone at 1-888-884-4007 with any questions.
XML File Specifications Version 4.3
XML File Specifications Version 4.3 is effective beginning with third quarter 2020 patient discharges.
HCAHPS Survey data for eligible discharges from July 1, 2020 forward may now be submitted via XML format or the HCAHPS Online Data Entry Tool accessed from My QualityNet.
Click here for the XML File Specifications Version 4.3, the XML File Sample Layout without DSRS Version 4.3 and the XML File Sample Layout with DSRS Version 4.3.
HCAHPS V4.2 Submission of "5 or Fewer Eligible HCAHPS Discharges in a Month"
Below please find instructions for uploading "5 or Fewer Eligible HCAHPS Discharges in a Month" information via My QualityNet using the Online Data Entry Tool or the XML file format for October 1, 2019 patient discharges and forward.
Online Tool
Please note the following:
- One header record must be completed for each month that an organization has "5 or Fewer Eligible HCAHPS Discharges in a Month"
- The NPI element is not required at this time, but may be entered if the information is available
- For "survey mode," select "Mail only"
- For "determination of service line," select the method used to determine the patient's eligibility
- For "number eligible discharge," enter actual count of eligible discharges for the month
- For "sample size," enter zero
- For "sample type," select "Simple Random Sample"
XML File Format
Below is an example of the header record layout that must be submitted for each month that an organization has "5 or Fewer Eligible HCAHPS Discharges in a Month."
<header>
<provider-name>Some Hospital</provider-name>
<provider-id>123456</provider-id>
(NPI is not required)
<discharge-yr>2019</discharge-yr>
<discharge-month>10</discharge-month> (for October)
<survey-mode>1</survey-mode> (for Mail only)
<determination-of-service-line>1</determination-of-service-line> (for V.37, V.36, V.35, V.34, V.33,
V.32, V.31, V.30, V.29, V.28, V.27, V.26, or V.25 MS-DRG codes)
<number-eligible-discharge>enter actual count i.e. 1, 2, 3, 4 or 5</number-eligible-discharge>
<sample-size>0</sample-size>
<sample-type>1</sample-type> (for Simple Random Sample)
</header>
Please contact HCAHPS Information and Technical Support by email at hcahps@hsag.com or by telephone at 1-888-884-4007 with any questions.
HCAHPS V4.2 Submission of "Zero Cases"
Below please find instructions for uploading "Zero Case" information via My QualityNet using the Online Data Entry Tool or the XML file format for October 1, 2019 patient discharges and forward.
Online Tool
Please note the following:
- One header record must be completed for each month that an organization has "Zero Cases"
- The NPI element is not required at this time, but may be entered if the information is available
- For "survey mode," select "Mail only"
- For "determination of service line," select "1 – V.37, V.36, V.35, V.34, V.33, V.32, V.31, V.30, V.29, V.28, V.27, V.26, or V.25 MS-DRG codes"
- For "number eligible discharge," and "sample size" enter 0
- For "sample type," select "Simple Random Sample"
XML File Format
Below is an example of the header record layout that must be submitted for each month that an organization has "Zero Cases."
<header>
<provider-name>Some Hospital</provider-name>
<provider-id>123456</provider-id>
(NPI is not required)
<discharge-yr>2019</discharge-yr>
<discharge-month>10</discharge-month> (for October)
<survey-mode>1</survey-mode> (for Mail only)
<determination-of-service-line>1</determination-of-service-line> (for V.37, V.36, V.35, V.34, V.33,
V.32, V.31, V.30, V.29, V.28, V.27, V.26, or V.25 MS-DRG codes)
<number-eligible-discharge>enter actual count i.e. 1, 2, 3, 4 or 5</number-eligible-discharge>
<sample-size>0</sample-size>
<sample-type>1</sample-type> (for Simple Random Sample)
</header>
Please contact HCAHPS Information and Technical Support by email at hcahps@hsag.com or by telephone at 1-888-884-4007 with any questions.
XML File Specifications Version 4.2
XML File Specifications Version 4.2 is effective beginning with fourth quarter 2019 patient discharges.
HCAHPS Survey data for eligible discharges from October 1, 2019 forward may now be submitted via XML format or the HCAHPS Online Data Entry Tool accessed from My QualityNet.
Click here for the XML File Specifications Version 4.2, the XML File Sample Layout without DSRS Version 4.2 and the XML File Sample Layout with DSRS Version 4.2.
This page was last modified on (1/6/21)