IPPS Measure Exceptions FormCenters for Medicare & Medicaid Services (CMS) Hospital Inpatient Qualit 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by filling out the 'IPPS Measure Exception Information' section. Select all applicable measures such as Perinatal Care, Emergency Department, and Surgical Procedures. Ensure you specify the relevant calendar year and quarters.
3. Complete the 'Specified CAUTI and CLABSI Requirements' section if applicable. Indicate whether your hospital has ICU locations or specific wards, and provide the necessary calendar year information.
4. In the 'Facility Contact Information' section, enter your CMS Certification Number, Facility Name, and contact details of the CEO or designee. All fields marked with an asterisk (*) are required.
5. Finally, review your entries for accuracy before submitting. Follow the submission instructions provided at the end of the form to ensure proper processing.

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