Version 5.18a – Discharges 01/01/2026 through 12/31/2026

The Specifications Manual for National Hospital Inpatient Quality Measures (Specifications Manual) contains abstraction guidance and technical specifications to successfully submit the Centers for Medicare & Medicaid Services (CMS) hospital inpatient quality measures.

Over time, it will be necessary to present more than one version of the manual on this Web page so that a specific data collection time period (i.e., based on hospital discharge dates) can be associated with the applicable manual. Find the appropriate data collection period below and select the associated Specifications Manual.

The Release Notes for each version of the manual outline the changes associated with that specific release and include corrections and clarifications based on ongoing alignment discussions between the Centers for Medicare & Medicaid Services and the Joint Commission.

Paper tools for use in abstracting data for each collection (discharge) period are provided with the Specifications Manual, beginning with Version 2.3b.

Sepsis Resources

File Name File Type File Size
Coming Soon      

Complete Manual

File Name File Type File Size
Version 5.18a - Specifications Manual for discharges 01/01/2026 through 12/31/2026 (Updated September 2025)  ZIP 5.1 MB Download
Version 5.18a - Specifications Manual for discharges 01/01/2026 through 12/31/2026 PDF 1.2 MB Download
Release Notes, Version 5.18 PDF 232 KB Download
Release Notes, Version 5.18a PDF 257 KB Download

*NOTE: For enhanced accessibility, the formatting of the manual has changed. Some documents contained in this manual are for use by technical staff. Persons using assistive technology may not be able to fully access all documents. If you need assistance in accessing a specific document, contact the QualityNet Service Center.

Manual By Section

View and/or download individual sections of the Specifications Manual, (PDF documents, unless noted), listed below.

Acknowledgement
Table Of Contents (Updated September 2025)
Introduction
Using the Manual

Section 1 - Data Dictionary

Introduction to the Data Dictionary

Alphabetical Data Dictionary (Updated September 2025)

Section 2 - Measurement Information
Section 2.1 - Severe Sepsis and Septic Shock (SEP)
Section 2.2 through 2.6 - Reserved for Future Use
Section 3 - Missing and Invalid Data
Section 4 - Population and Sampling Specifications
Sections 5, 6, 7 and 8 - Reserved for Future Use
Section 9 - Data Transmission

Transmission Alphabetical Data Dictionary

Hospital Clinical Data XML File Layout, XLSX

Hospital Initial Patient Population Data XML File Layout, XLSX
Section 10 - CMS Outcome/Inpatient Structural Measures
Section 10.1 - Outcome Measures (Updated September 2025)
  • CMS Patient Safety Indicators (CMS PSIs)
  • National Healthcare Safety Network (NHSN)
  • Risk-Standardized Measures:
    • Mortality and Complication
    • Payment
    • Excess Days in Acute Care (EDAC)
    • Claims and Electronic Data
Section 10.2 - Inpatient Structural Measures (Updated September 2025)
Appendices

Version 5.17b – Discharges 01/01/2025 through 12/31/2025

The Specifications Manual for National Hospital Inpatient Quality Measures (Specifications Manual) contains abstraction guidance and technical specifications to successfully submit the Centers for Medicare & Medicaid Services (CMS) hospital inpatient quality measures.

Over time, it will be necessary to present more than one version of the manual on this Web page so that a specific data collection time period (i.e., based on hospital discharge dates) can be associated with the applicable manual. Find the appropriate data collection period below and select the associated Specifications Manual.

The Release Notes for each version of the manual outline the changes associated with that specific release and include corrections and clarifications based on ongoing alignment discussions between the Centers for Medicare & Medicaid Services and the Joint Commission.

Paper tools for use in abstracting data for each collection (discharge) period are provided with the Specifications Manual, beginning with Version 2.3b.

Sepsis Resources

File Name File Type File Size
Coming Soon      

Complete Manual

File Name File Type File Size
Version 5.17b - Specifications Manual for discharges 01/01/2025 through 12/31/2025 ZIP 4.8 MB Download
Version 5.17b - Specifications Manual for discharges 01/01/2025 through 12/31/2025 PDF 1.9 MB Download
Release Notes, Version 5.17 PDF 203 KB Download
Release Notes, Version 5.17a PDF 185 KB Download
Release Notes, Version 5.17b PDF 264 KB Download

*NOTE: For enhanced accessibility, the formatting of the manual has changed. Some documents contained in this manual are for use by technical staff. Persons using assistive technology may not be able to fully access all documents. If you need assistance in accessing a specific document, contact the QualityNet Service Center.

Manual By Section

View and/or download individual sections of the Specifications Manual, (PDF documents, unless noted), listed below.

Acknowledgement
Table Of Contents (Updated August 2025)
Introduction
Using the Manual

Section 1 - Data Dictionary

Introduction to the Data Dictionary

Alphabetical Data Dictionary (Updated August 2025)

Section 2 - Measurement Information
Section 2.1 - Severe Sepsis and Septic Shock (SEP)
Section 2.2 through 2.6 - Reserved for Future Use
Section 3 - Missing and Invalid Data
Section 4 - Population and Sampling Specifications
Sections 5, 6, 7 and 8 - Reserved for Future Use
Section 9 - Data Transmission

Transmission Alphabetical Data Dictionary

Hospital Clinical Data XML File Layout, XLSX

Hospital Initial Patient Population Data XML File Layout, XLSX
Section 10 - CMS Outcome/Inpatient Structural Measures
Section 10.1 - Outcome Measures (Updated August 2025)
  • CMS Patient Safety Indicators (CMS PSIs)
  • National Healthcare Safety Network (NHSN)
  • Risk-Standardized Measures:
    • Mortality and Complication
    • Payment
    • Excess Days in Acute Care (EDAC)
    • Claims and Electronic Data
Section 10.2 - Inpatient Structural Measures (Updated August 2025)
Appendices

Version 5.16 – Discharges 07/01/2024 through 12/31/2024

The Specifications Manual for National Hospital Inpatient Quality Measures (Specifications Manual) contains abstraction guidance and technical specifications to successfully submit the Centers for Medicare & Medicaid Services (CMS) hospital inpatient quality measures.

Over time, it will be necessary to present more than one version of the manual on this Web page so that a specific data collection time period (i.e., based on hospital discharge dates) can be associated with the applicable manual. Find the appropriate data collection period below and select the associated Specifications Manual.

The Release Notes for each version of the manual outline the changes associated with that specific release and include corrections and clarifications based on ongoing alignment discussions between the Centers for Medicare & Medicaid Services and the Joint Commission.

Paper tools for use in abstracting data for each collection (discharge) period are provided with the Specifications Manual, beginning with Version 2.3b.

Sepsis Resources

File Name File Type File Size
Coming Soon      

Complete Manual

File Name File Type File Size
Version 5.16 - Specifications Manual for discharges 07/01/2024 through 12/31/2024 (Updated July 2024) ZIP 5.1 MB Download
Version 5.16 - Specifications Manual for discharges 07/01/2024 through 12/31/2024 (Updated July 2024) EXE 5.3 MB Download
Release Notes, Version 5.16 PDF 252 KB Download

*NOTE: For enhanced accessibility, the formatting of the manual has changed. Some documents contained in this manual are for use by technical staff. Persons using assistive technology may not be able to fully access all documents. If you need assistance in accessing a specific document, contact the QualityNet Service Center.

Manual By Section

View and/or download individual sections of the Specifications Manual, (PDF documents, unless noted), listed below.

Acknowledgement
Table Of Contents
Introduction
Using the Manual

Section 1 - Data Dictionary

Introduction to the Data Dictionary

Alphabetical Data Dictionary

Section 2 - Measurement Information
Section 2.1 - Severe Sepsis and Septic Shock (SEP) (Updated July 2024)
Section 2.2 through 2.6 - Reserved for Future Use
Section 3 - Missing and Invalid Data
Section 4 - Population and Sampling Specifications
Sections 5, 6, 7 and 8 - Reserved for Future Use
Section 9 - Data Transmission

Transmission Alphabetical Data Dictionary

Hospital Clinical Data XML File Layout, XLSX

Hospital Initial Patient Population Data XML File Layout, XLSX
Section 10 - CMS Outcome/Inpatient Structural Measures (Updated December 2023)
Section 10.1 - Outcome Measures 
  • CMS Patient Safety Indicators (CMS PSIs)
  • National Healthcare Safety Network (NHSN)
  • Risk-Standardized Measures:
    • Mortality and Complication
    • Payment
    • Excess Days in Acute Care (EDAC)
    • Claims and Electronic Data
Section 10.2 - Inpatient Structural Measures (Updated December 2023)
Appendices

Version 5.15a – Discharges 01/01/2024 through 06/30/2024

The Specifications Manual for National Hospital Inpatient Quality Measures (Specifications Manual) contains abstraction guidance and technical specifications to successfully submit the Centers for Medicare & Medicaid Services (CMS) hospital inpatient quality measures.

Over time, it will be necessary to present more than one version of the manual on this Web page so that a specific data collection time period (i.e., based on hospital discharge dates) can be associated with the applicable manual. Find the appropriate data collection period below and select the associated Specifications Manual.

The Release Notes for each version of the manual outline the changes associated with that specific release and include corrections and clarifications based on ongoing alignment discussions between the Centers for Medicare & Medicaid Services and the Joint Commission.

Paper tools for use in abstracting data for each collection (discharge) period are provided with the Specifications Manual, beginning with Version 2.3b.

Sepsis Resources

File Name File Type File Size
Coming Soon      

Complete Manual

File Name File Type File Size
Version 5.15a - Specifications Manual for discharges 01/01/24 - 06/30/24 (Updated July 2024) ZIP 5 MB Download
Version 5.15a - Specifications Manual for discharges 01/01/24 - 06/30/24 (Updated July 2024) EXE 4.8 MB Download
Release Notes, Version 5.15 PDF 414 KB Download
Release Notes, Version 5.15a PDF 198 KB Download

*NOTE: For enhanced accessibility, the formatting of the manual has changed. Some documents contained in this manual are for use by technical staff. Persons using assistive technology may not be able to fully access all documents. If you need assistance in accessing a specific document, contact the QualityNet Service Center.

Manual By Section

View and/or download individual sections of the Specifications Manual, (PDF documents, unless noted), listed below.

Acknowledgement
Table Of Contents (Updated December 2023)
Introduction
Using the Manual (Updated December 2023)

Section 1 - Data Dictionary

Introduction to the Data Dictionary

Alphabetical Data Dictionary (Updated December 2023)

Section 2 - Measurement Information
Section 2.1 - Severe Sepsis and Septic Shock (SEP) (Updated July 2024)
Section 2.2 through 2.6 - Reserved for Future Use
Section 3 - Missing and Invalid Data
Section 4 - Population and Sampling Specifications
Sections 5, 6, 7 and 8 - Reserved for Future Use
Section 9 - Data Transmission

Transmission Alphabetical Data Dictionary

Hospital Clinical Data XML File Layout, XLSX

Hospital Initial Patient Population Data XML File Layout, XLSX
Section 10 - CMS Outcome/Inpatient Structural Measures (Updated December 2023)
Section 10.1 - Outcome Measures 
  • CMS Patient Safety Indicators (CMS PSIs)
  • National Healthcare Safety Network (NHSN)
  • Risk-Standardized Measures:
    • Mortality and Complication
    • Payment
    • Excess Days in Acute Care (EDAC)
    • Claims and Electronic Data
Section 10.2 - Inpatient Structural Measures (Updated December 2023)
Appendices

 

Version 5.14a – Discharges 07/01/2023 through 12/31/2023

The Specifications Manual for National Hospital Inpatient Quality Measures (Specifications Manual) contains abstraction guidance and technical specifications to successfully submit the Centers for Medicare & Medicaid Services (CMS) hospital inpatient quality measures.

Over time, it will be necessary to present more than one version of the manual on this Web page so that a specific data collection time period (i.e., based on hospital discharge dates) can be associated with the applicable manual. Find the appropriate data collection period below and select the associated Specifications Manual.

The Release Notes for each version of the manual outline the changes associated with that specific release and include corrections and clarifications based on ongoing alignment discussions between the Centers for Medicare & Medicaid Services and the Joint Commission.

Paper tools for use in abstracting data for each collection (discharge) period are provided with the Specifications Manual, beginning with Version 2.3b.

Sepsis Resources

File Name File Type File Size
Sepsis Frequently Asked Questions: v5.14  PDF 586 KB Download

Complete Manual

File Name File Type File Size
Version 5.14a - Specifications Manual for discharges 07/01/23 - 12/31/23 (updated 08/2023) ZIP 2.9 MB Download
Version 5.14a - Specifications Manual for discharges 07/01/23 - 12/31/23 EXE 2.9 MB Download
Release Notes, Version 5.14 PDF 262 KB Download
Release Notes, Version 5.14a PDF 186 KB Download

*NOTE: For enhanced accessibility, the formatting of the manual has changed. Some documents contained in this manual are for use by technical staff. Persons using assistive technology may not be able to fully access all documents. If you need assistance in accessing a specific document, contact the QualityNet Service Center.

Manual By Section

View and/or download individual sections of the Specifications Manual, (PDF documents, unless noted), listed below.

Acknowledgement
Table Of Contents
Introduction
Using the Manual

Section 1 - Data Dictionary

Introduction to the Data Dictionary

Alphabetical Data Dictionary 

Section 2 - Measurement Information
Section 2.1 - Severe Sepsis and Septic Shock (SEP)
Section 2.2 through 2.6 - Reserved for Future Use
Section 3 - Missing and Invalid Data
Section 4 - Population and Sampling Specifications
Sections 5, 6, 7 and 8 - Reserved for Future Use
Section 9 - Data Transmission

Transmission Alphabetical Data Dictionary

Hospital Clinical Data XML File Layout, XLSX

Hospital Initial Patient Population Data XML File Layout, XLSX
Section 10 - CMS Outcome/Inpatient Web-Based Measures
Section 10.1 - Outcome Measures 
  • CMS Patient Safety Indicators (CMS PSIs)
  • National Healthcare Safety Network (NHSN)
  • Risk-Standardized Measures:
    • Mortality
    • Payment
    • Readmission and Excess Days in Acute Care (EDAC)
Section 10.2 - Inpatient Web-Based Measures 
Appendices

Version 5.13 – Discharges 01/01/2023 through 06/30/2023

The Specifications Manual for National Hospital Inpatient Quality Measures (Specifications Manual) contains abstraction guidance and technical specifications to successfully submit the Centers for Medicare & Medicaid Services (CMS) hospital inpatient quality measures.

Over time, it will be necessary to present more than one version of the manual on this Web page so that a specific data collection time period (i.e., based on hospital discharge dates) can be associated with the applicable manual. Find the appropriate data collection period below and select the associated Specifications Manual.

The Release Notes for each version of the manual outline the changes associated with that specific release and include corrections and clarifications based on ongoing alignment discussions between the Centers for Medicare & Medicaid Services and the Joint Commission.

Paper tools for use in abstracting data for each collection (discharge) period are provided with the Specifications Manual, beginning with Version 2.3b.

Sepsis Resources

File Name File Type File Size
Coming Soon      

Complete Manual

File Name File Type File Size
Version 5.13 - Specifications Manual for discharges 01/01/23 - 06/30/23 ZIP 2.5 MB Download
Version 5.13 - Specifications Manual for discharges 01/01/23 - 06/30/23 EXE 1.6 MB Download
Release Notes, Version 5.13 PDF 371 KB Download

*NOTE: For enhanced accessibility, the formatting of the manual has changed. Some documents contained in this manual are for use by technical staff. Persons using assistive technology may not be able to fully access all documents. If you need assistance in accessing a specific document, contact the QualityNet Service Center.

Manual By Section

View and/or download individual sections of the Specifications Manual, (PDF documents, unless noted), listed below.

Acknowledgement
Table Of Contents
Introduction
Using the Manual

Section 1 - Data Dictionary

Introduction to the Data Dictionary

Alphabetical Data Dictionary 

Section 2 - Measurement Information
Section 2.1 - Severe Sepsis and Septic Shock (SEP)
Section 2.2 through 2.6 - Reserved for Future Use
Section 3 - Missing and Invalid Data
Section 4 - Population and Sampling Specifications
Sections 5, 6, 7 and 8 - Reserved for Future Use
Section 9 - Data Transmission

Transmission Alphabetical Data Dictionary

Hospital Clinical Data XML File Layout XLSX

Hospital Initial Patient Population Data XML File Layout, XLSX
Section 10 - CMS Outcome/Inpatient Web-Based Measures
Section 10.1 - Outcome Measures 
  • CMS Patient Safety Indicators (CMS PSIs)
  • National Healthcare Safety Network (NHSN)
  • Risk-Standardized Measures:
    • Mortality
    • Payment
    • Readmission and Excess Days in Acute Care (EDAC)
Section 10.2 - Inpatient Web-Based Measures 
Appendices

Version 5.12 – Discharges 07/01/2022 through 12/31/2022

The Specifications Manual for National Hospital Inpatient Quality Measures (Specifications Manual) contains abstraction guidance and technical specifications to successfully submit the Centers for Medicare & Medicaid Services (CMS) hospital inpatient quality measures.

Over time, it will be necessary to present more than one version of the manual on this Web page so that a specific data collection time period (i.e., based on hospital discharge dates) can be associated with the applicable manual. Find the appropriate data collection period below and select the associated Specifications Manual.

The Release Notes for each version of the manual outline the changes associated with that specific release and include corrections and clarifications based on ongoing alignment discussions between the Centers for Medicare & Medicaid Services and the Joint Commission.

Paper tools for use in abstracting data for each collection (discharge) period are provided with the Specifications Manual, beginning with Version 2.3b.

Sepsis Resources

File Name File Type File Size
Overview of SEP-1 Bundle-Level Results for Q3 and Q4 2022
PDF 255 KB Download
Sepsis Bundle Algorithm for Q3 and Q4 2022 PDF 783 KB Download

Complete Manual

File Name File Type File Size
Version 5.12 - Specifications Manual for discharges 07/01/22 - 12/31/22 ZIP 1.7 MB Download
Version 5.12 - Specifications Manual for discharges 07/01/22 - 12/31/22 EXE 1.6 MB Download
Release Notes, Version 5.12 PDF 371 KB Download

*NOTE: For enhanced accessibility, the formatting of the manual has changed. Some documents contained in this manual are for use by technical staff. Persons using assistive technology may not be able to fully access all documents. If you need assistance in accessing a specific document, contact the QualityNet Service Center.

Manual By Section

View and/or download individual sections of the Specifications Manual, (PDF documents, unless noted), listed below.

Acknowledgement
Table Of Contents
Introduction
Using the Manual

Section 1 - Data Dictionary

Introduction to the Data Dictionary

Alphabetical Data Dictionary 

Section 2 - Measurement Information
Section 2.1 - Severe Sepsis and Septic Shock (SEP)
Section 2.2 through 2.6 - Reserved for Future Use
Section 3 - Missing and Invalid Data
Section 4 - Population and Sampling Specifications
Sections 5, 6, 7 and 8 - Reserved for Future Use
Section 9 - Data Transmission

Transmission Alphabetical Data Dictionary

Hospital Clinical Data XML File Layout XLSX

Hospital Initial Patient Population Data XML File Layout, XLSX
Section 10 - CMS Outcome/Inpatient Web-Based Measures
Section 10.1 - Outcome Measures 
  • CMS Patient Safety Indicators (CMS PSIs)
  • National Healthcare Safety Network (NHSN)
  • Risk-Standardized Measures:
    • Mortality
    • Payment
    • Readmission and Excess Days in Acute Care (EDAC)
Section 10.2 - Inpatient Web-Based Measures 
Appendices

Archived Specifications Manuals

File Name File Type
Version 5.11a – Specifications Manual for discharges 01/01/22 – 06/30/22 ZIP Download
Version 5.10a – Specifications Manual for discharges 07/01/21 – 12/31/21 ZIP Download
Version 5.9 - Specifications Manual for discharges 01/01/21 - 06/30/21  ZIP Download
Version 5.8 – Specifications Manual for discharges 07/01/2020 – 12/31/2020 ZIP Download
Version 5.7 – Specifications Manual for discharges 01/01/2020 – 06/30/2020 ZIP Download
Version 5.6a - Specifications Manual for discharges 07/01/2019 - 12/31/2019 ZIP Download
Version 5.5a – Specifications Manual for discharges 01/01/2019 - 06/30/2019 ZIP Download
Version 5.4a – Specifications Manual for discharges 07/01/2018 – 12/31/2018  ZIP Download
Version 5.3a - Specifications Manual for discharges 01/01/2018 - 06/30/2018 (10/31/17) ZIP Download
Version 5.2b - Specifications Manual for discharges 01/01/2017 - 12/31/2017 (09/30/16) ZIP Download
Version 5.1 - Specifications Manual for discharges 07/01/2016 - 12/31/2016 (09/30/16) ZIP Download
Version 5.0b - Specifications Manual for discharges 10/01/2015 - 06/30/2016 (11/12/15) ZIP Download
Version 4.4a - Specifications Manual for discharges 01/01/2015 - 09/30/2015 (02/09/15) ZIP Download
Version 4.3b - Specifications Manual for discharges 01/01/2014 - 12/31/2014 (01/27/15) ZIP Download
Version 4.2b - Specifications Manual for discharges 01/01/2013 - 12/31/2013 (12/14/12) EXE Download
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