Centers for Medicare and Medicaid Services Seeks Public Comment on Inpatient Psychiatric Unit Criteria Work Sheet Collection

Introduction

The Centers for Medicare and Medicaid Services issued a notice in the Federal Register on November 2 2026 announcing a formal sixty-day public comment period for a proposed information collection activity. The agency intends to request approval from the Office of Management and Budget to reinstate and revise the Inpatient Psychiatric Unit Criteria Work Sheet under the identifier CMS-437 and OMB control number 0938-0358. This regulatory procedure falls under the statutory mandates of the Paperwork Reduction Act of 1995 which requires federal agencies to invite public scrutiny regarding proposed paperwork burdens and information collections.

Regulatory Background and Payment Mechanisms

Medicare reimburses inpatient hospital services through several distinct prospective payment systems depending on the facility type. Acute care hospitals typically receive reimbursement through the Inpatient Prospective Payment System. Conversely, Inpatient Psychiatric Facilities and distinct Inpatient Psychiatric Units are eligible for reimbursement through the Inpatient Psychiatric Facility Prospective Payment System. Because the psychiatric payment system generally provides higher reimbursement rates, qualifying units must demonstrate that they meet specific regulatory exemptions from the standard acute care payment structure.

To establish and maintain this exempt status, facilities utilize the CMS-437 form. New inpatient psychiatric units submit an initial form when applying for participation in the Medicare program while existing units submit the form annually to maintain their exclusion status as mandated by federal regulations under 42 CFR 412.25. Historically, state agency surveyors conducted onsite surveys to verify compliance before granting exclusion status. However, pursuant to a policy change initiated in November 2007 through Survey and Certification Memorandum 08-03, the agency suspended mandatory onsite surveys in favor of an annual self-attestation process where facilities complete and submit the CMS-437 form directly.

Proposed Changes to Form CMS-437

The current notice outlines specific non-substantive formatting and data field modifications intended to improve the accuracy and clarity of the information collected. In section 1 of the form the agency added separate data fields for the name street address city state and zip code of the psychiatric unit. Furthermore, the agency incorporated new dedicated data fields for the CMS Certification Number and telephone number. Section 2 of the form features updated text referencing specific Code of Federal Regulations sections to ensure legal and technical accuracy.

According to agency estimates, the proposed collection involves approximately 1534 respondents from the private sector business and for-profit community generating an equivalent number of annual responses. The total estimated annual reporting burden is calculated at 1551 hours. William N. Parham III serves as the Director of the Division of Information Collections and Regulatory Impacts within the Office of Strategic Operations and Regulatory Affairs for the agency.

Conclusion and Public Participation

Public comments regarding the necessity of the collection the accuracy of the estimated burden hours or ways to enhance data quality must be submitted by January 4 2027. Stakeholders may submit feedback electronically through the federal rulemaking portal at regulations.gov or by mail directed to the agency headquarters in Baltimore Maryland. The outcome of this notice-and-comment period will determine whether the Office of Management and Budget approves the revised information collection thereby shaping the regulatory compliance procedures for psychiatric units seeking specialized Medicare reimbursement through future operational cycles.