Resources

Patient Safety Indicators (PSI) 2026 Resources

Basic Summary of Methods and Software in Each Program

Resources on the CMS PSIs

CMS produces two separate versions of PSI software and resources: 

• The CMS+VA version is used to calculate results for the Hospital IQR and Star Ratings programs (October 2025 Care Compare Public Reporting results) and is designed for general acute care hospitals that serve Medicare beneficiaries as well as Veterans Affairs hospitals.
• The CMS-only version is used to calculate results for the Hospital Acquired Conditions (HAC) Reduction Program, which is limited to subsection (d) general acute care hospitals that are paid under the Inpatient Prospective Payment System. 

The table below delineates resources as they apply to each of the two PSI software versions: 

Resources for Replicating CMS' Results

The following resource applies to hospitals replicating their results with individual claims data for:

• October 2025 Care Compare Public Reporting (using CMS+VA PSI software v15.0)
• FY 2026 HAC Reduction Program (using CMS-only PSI software v15.0)

The replication instructions provide a step-by-step guide for hospitals to replicate their Medicare population results using the CMS PSI software. The first step in replicating individual hospital results is to request the appropriate software version from the QualityNet Help Desk. The CMS PSI software is not publicly posted but is available by request from the QualityNet Question and Answer Tool. Select “Ask a Question,” choose “Inpatient Claims-Based Measures” in the Program list, then “Patient Safety Indicators (PSI)” in the Topic list, then “PSI 90 Software.”  

Resources for Patient Safety ISCMR Measure

The Thirty-Day Risk-Standardized Death Rate among Surgical Inpatients with Complications (Inpatient Surgical Complication Mortality Rate [ISCMR]) measure will be calculated beginning with the July 1, 2023 – June 30, 2025, reporting period, which impacts the FY 2027 payment determination. The measure replaces the PSI 04 measure.

The technical specifications for the ISCMR measure are available below:

Patient Safety Indicators (PSI) 2025 Resources

Basic Summary of Methods and Software in Each Program

Resources on the CMS PSIs

CMS produces two separate versions of PSI software and resources: 

• The CMS+VA version is used to calculate results for the Hospital IQR and Star Ratings programs (October 2024 Care Compare Public Reporting results) and is designed for general acute care hospitals that serve Medicare beneficiaries as well as Veterans Affairs hospitals.
• The CMS-only version is used to calculate results for the Hospital Acquired Conditions (HAC) Reduction Program, which is limited to subsection (d) general acute care hospitals that are paid under the Inpatient Prospective Payment System. 

The table below delineates resources as they apply to each of the two PSI software versions: 

Resources for Replicating CMS' Results

The following resource applies to hospitals replicating their results with individual claims data for:

• October 2024 Care Compare Public Reporting (using CMS+VA PSI software v14.0)
• FY 2025 HAC Reduction Program (using CMS-only PSI software v14.0)

The replication instructions provide a step-by-step guide for hospitals to replicate their Medicare population results using the CMS PSI software. The first step in replicating individual hospital results is to request the appropriate software version from the QualityNet Help Desk. The CMS PSI software is not publicly posted but is available by request from the QualityNet Question and Answer Tool. Select “Ask a Question,” choose “Inpatient Claims-Based Measures” in the Program list, then “Patient Safety Indicators (PSI)” in the Topic list, then “PSI 90 Software.”  

Patient Safety Indicators (PSI) 2024 Resources

Basic Summary of Methods and Software in Each Program

Resources on the CMS PSIs

CMS produces two separate versions of PSI software and resources: 

• The CMS+VA version is used to calculate results for the Hospital IQR and Star Ratings programs (January 2024 Care Compare Public Reporting results) and is designed for general acute care hospitals that serve Medicare beneficiaries as well as Veterans Health Administration hospitals.
• The CMS-only version is used to calculate results for the Hospital Acquired Conditions (HAC) Reduction Program, which is limited to subsection (d) general acute care hospitals that are paid under the Inpatient Prospective Payment System. 

The table below delineates resources as they apply to each of the two PSI software versions: 

Resources for Replicating CMS' Results

The following resource applies to hospitals replicating their results with individual claims data for:

• January 2024 Care Compare Public Reporting (using CMS+VA PSI software v13.0)
• FY 2024 HAC Reduction Program (using CMS-only PSI software v13.0)

The replication instructions provide a step-by-step guide for hospitals to replicate their Medicare population results using the CMS PSI software. The first step in replicating individual hospital results is to request the appropriate software version from the QualityNet Help Desk. The CMS PSI software is not publicly posted but is available by request from the QualityNet Question and Answer Tool. Select “Ask a Question,” choose “Inpatient Claims-Based Measures” in the Program list, then “Patient Safety Indicators (PSI)” in the Topic list, then “PSI 90 Software.”  

Patient Safety Indicators (PSI) 2023 Resources

Basic Summary of Methods and Software in Each Program

* CMS is not calculating PSI 90 measure scores or the Total HAC Score for any hospital in FY 2023 as finalized in the FY 2023 Inpatient Prospective Payment System/Long-Term Care Hospital Prospective Payment System (IPPS/LTCH PPS) final rule. No hospital is receiving a payment reduction for the HAC Reduction Program for FY 2023. CMS is still publicly reporting hospitals’ CMS PSI 90 results on the Care Compare website to provide transparency to the public on important patient safety metrics during the COVID-19 public health emergency.

Resources on the CMS PSIs

The following documents apply to CMS VA PSI v12.0 software, which was used for January 2023 Hospital Compare Public Reporting:

Resources for Replicating CMS' Results

The following resource applies to hospitals replicating their results with individual claims data for the January 2023 Hospital Compare Public Reporting using CMS VA PSI software v12.0. The replication instructions provide a step-by-step guide for hospitals to replicate their Medicare population results using the CMS PSI software available by request from the QualityNet Help Desk at qnetsupport@cms.hhs.gov.

Patient Safety Indicators (PSI) 2022 Resources

Basic Summary of Methods and Software in Each Program

* This performance period is specific to the CMS PSI 90 measure for FY 2022.

Note: CMS removed the Patient Safety for Selected Indicators Composite (PSI 90) from the Hospital Value-Based Purchasing Program in FY 2019-FY 2022 due to operational constraints from the International Classification of Diseases, Tenth Revision (ICD-10) transition. CMS adopted the updated ICD-10 version of the PSI 90 measure that will be used beginning with the FY 2023 Hospital VBP Program. For more information on the measure removal and adoption, reference the FY 2018 IPPS/LTCH PPS final rule (82 FR 38242-38244) and (82 FR 38251-38256).

CMS removed the CMS PSI 90 measure from the Hospital Inpatient Quality Reporting (IQR) Program for FY 2020 and subsequent fiscal years; however, the removal will not end or otherwise interfere with collection or public reporting of the measure. For more information on the Hospital IQR Program measure removal, reference the FY 2019 IPPS/LTCH PPS final rule (83 FR 41547-41553).

Resources on the CMS PSIs

July 2021 Hospital Compare Public Reporting and FY 2022 HAC Reduction Program used CMS v11.0 PSI software.

Users can find technical specifications for previous versions on AHRQ’s website under the Archives tab. The replication instructions below provide a step-by-step guide for hospitals to replicate their Medicare population results in the Hospital-Specific Reports.

The following documents apply to CMS PSI software version 11.0:

Resources for Replicating CMS' Results

The following resource applies to hospitals replicating their results with individual claims data for the July 2021 Hospital Compare Public Reporting and FY 2022 HAC Reduction Program using version 11.0. The replication instructions provide a step-by-step guide for hospitals to replicate their Medicare population results using the CMS PSI software available by request from the QualityNet Help Desk.

Patient Safety Indicators (PSI) 2021 Resources

Basic Summary of Methods and Software in Each Program

* This performance period is specific to the CMS PSI 90 measure for FY 2021.

Note: CMS removed the CMS PSI 90 measure from the Hospital IQR Program in FY 2020. The CMS PSI 90 will be added to the Hospital VBP Program beginning with FY2023 payment determination. 

Resources on the CMS PSIs

July 2020 Hospital Compare Public Reporting and FY 2021 HAC Reduction Program used CMS v10.0 PSI software.

Users can find technical specifications for previous versions on AHRQ’s website under the Archives tab. The replication instructions below provide a step-by-step guide for hospitals to replicate their Medicare population results in the Hospital-Specific Reports.

The following documents apply to CMS PSI software version 10.0:

Resources for Replicating CMS' Results

The following resource applies to hospitals replicating their results with individual claims data for the July 2020 Hospital Compare Public Reporting and FY 2021 HAC Reduction Program using version 10.0. The replication instructions provide a step-by-step guide for hospitals to replicate their Medicare population results using the CMS PSI software available by request from the QualityNet Help Desk.

Additional Resources

Patient Safety Indicators (PSI) 2020 Resources

Basic Summary of Methods and Software in Each Program

* This performance period is specific to the CMS PSI 90 measure for FY 2020.

Note:CMS removed the Patient Safety for Selected Indicators Composite (PSI 90) from the Hospital Value-Based Purchasing Program in FY 2019-FY 2022 due to operational constraints from the International Classification of Diseases, Tenth Revision (ICD-10) transition. CMS adopted the updated ICD-10 version of the PSI 90 measure that will be used beginning with the FY 2023 Hospital VBP Program. For more information on the measure removal and adoption, reference the FY 2018 IPPS/LTCH PPS final rule (82 FR 38242-38244) and (82 FR 38251-38256).

CMS removed the CMS PSI 90 measure from the Hospital Inpatient Quality Reporting (IQR) Program for FY 2020 and subsequent fiscal years; however, the removal will not end or otherwise interfere with collection or public reporting of the measure. For more information on the Hospital IQR Program measure removal, reference the FY 2019 IPPS/LTCH PPS final rule (83 FR 41547-41553).

Resources on the CMS PSIs

July 2019 Hospital Compare Public Reporting and FY 2020 HAC Reduction Program used CMS v9.0 PSI software.

Users can find more general documentation on the QI development process using all-payer data under the Modules/General tab, and PSI-specific documentation under the Modules/PSI Resources tab, on the AHRQ QI website. Users can find documentation for previous versions under the Archives tab. The replication instructions provide a step-by-step guide for hospitals to replicate their Medicare population results in the Hospital-Specific Reports.

The following documents apply to CMS PSI software version 9.0:

Resources for Replicating CMS's Results

The following resources apply to hospitals replicating their results with individual claims data for the July 2019 Hospital Compare Public Reporting and FY 2020 HAC Reduction Program using version 9.0. The replication instructions provide a step-by-step guide for hospitals to replicate their Medicare population results using the CMS PSI software available by request from the QualityNet Help Desk.

Replication Resources Specific to CMS PSI Software Versions

The following documents show the relationship between ICD-9-CM codes, ICD-10-CM codes, and the 2018 condition categories (CCs) used to adjust for patient risk factors in each mortality measure.

Additional Resources

Patient Safety Indicators (PSI) 2019 Resources

Mock Hospital-Specific Reports (HSRs)

FY 2019 Hospital IQR Program and HAC Reduction Program (Recalibrated Version 8.0 Resources)

Archived Patient Safety Indicators (PSI) Resources

Mock Hospital-Specific Reports (HSRs)

FY 2018 Hospital VBP (Recalibrated Version 5.0.1 Resources)

Mock Hospital-Specific Reports (HSRs)

FY 2017 Hospital IQR, FY 2017 HAC Reduction Program (Domain 1) (Recalibrated Version 5.0.1 Resources)

FY 2017 Hospital VBP (Partially Recalibrated Version 4.5a Resources)