The Psychiatric Inpatient Experience Survey: What you need to know

The Centers for Medicare & Medicaid Services (CMS) has introduced the Psychiatric Inpatient Experience (PIX) Survey as part of its ongoing efforts to improve the quality of psychiatric inpatient care. Starting in 2026, all Medicare-certified inpatient psychiatric hospitals must submit survey data, with voluntary data collection beginning in 2025.

What is the Psychiatric Inpatient Experience Survey? 

Developed by Yale University and Yale New Haven Psychiatric Hospital, the PIX Survey is a standardized instrument designed to capture patient experiences in psychiatric inpatient care settings. It evaluates critical aspects of care, including safety, trust, empathy, and overall well-being. By gathering this feedback, CMS aims to enhance transparency, promote best practices, and drive continuous improvement in psychiatric care facilities.

Who must participate in the PIX Survey?

Participation in the PIX Survey is required for facilities reimbursed under the inpatient psychiatric facility (IPF) prospective payment system (PPS). This includes inpatient psychiatric services provided by Medicare-participating entities classified as psychiatric hospitals or certified psychiatric units within acute care hospitals (ACHs), critical access hospitals (CAHs), long-term care hospitals (LTCHs), inpatient rehabilitation facilities (IRFs), cancer hospitals, and children’s hospitals.

What are the key domains of the PIX Survey and how will the data be used?

CMS will publicly report PIX Survey results on Medicare.gov via the CMS Compare tool. Results will be presented as five separate scores, covering overall experience, treatment team relationship, environment, treatment effectiveness, and nursing team presence. Publicly available data will let facilities benchmark their performance against national standards and identify areas for improvement. 

The survey consists of 23 items across four key domains:

• Treatment team relationship, which assesses patient trust and communication with care providers
• Environment, which evaluates cleanliness, safety, and overall atmosphere within the facility
• Treatment effectiveness, measuring patients' perceptions of the quality and impact of their treatment
• Nursing team presence, which gauges the responsiveness and support provided by the nursing staff

These domains focus on elements of care that are particularly critical in psychiatric settings, helping facilities better understand and address patients’ needs.

How is the PIX Survey administered?

The survey is distributed 24 hours before planned discharge and can be completed either on paper or electronically using a tablet. If the patient is unable to complete the survey before discharge, they are provided with a paper survey and a pre-addressed, stamped envelope for return by mail. CMS does not permit post-discharge electronic survey submissions.

What are the consequences of noncompliance?

Starting in 2026, the PIX Survey will be a mandatory reporting requirement. Facilities that fail to administer and report survey data may face a 2% reduction in their annual Medicare payment update. However, at this time, the IPFQR Program does not tie financial incentives or penalties to performance on the survey—only to reporting compliance.

Who is eligible for the survey?

Facilities reimbursed under the Inpatient Psychiatric Facility (IPF) Prospective Payment System (PPS) are required to participate as part of the IPFQR Program. IPF PPS applies to inpatient psychiatric services provided by Medicare- participating entities classified as psychiatric hospitals or certified psychiatric units that are part of the following: 

• Acute care hospitals (ACHs) 
• Critical access hospitals (CAHs) 
• Long-term care hospitals (LTCHs)
• Inpatient rehabilitation facilities (IRFs)
• Cancer hospitals
• Children’s hospitals 

All psychiatric inpatients age 13 years and older are eligible to participate in the PIX Survey, aside from those with cognitive or intellectual limitations that would prevent them from completing the survey. Facilities should provide reasonable modifications to ensure patients with disabilities can participate.

What are the sampling requirements?

To meet CMS requirements, facilities must collect at least 300 completed surveys per year. Smaller facilities without a large enough patient population to meet this threshold must submit data for all eligible patients discharged during the reporting period.

Facilities may add supplemental questions to the survey, but they can’t alter or remove any CMS-mandated elements. This allows hospitals to collect additional insights while maintaining compliance with CMS reporting requirements.

How can you prepare for the PIX Survey?

To prepare for the PIX Survey, facilities should begin by assessing their current processes for patient engagement and data collection. Identifying gaps early can help streamline implementation and avoid compliance issues. Staff training is also essential to ensure employees understand the survey process and encourage patient participation.

Key deadlines 

Leveraging Press Ganey’s expertise for seamless compliance and improvement

Press Ganey provides expert guidance and data solutions to support psychiatric facilities in meeting CMS compliance requirements. With seamless data submission processes, benchmarking capabilities, and advisory services, Press Ganey helps hospitals reduce administrative burden, compare performance with national standards, and implement data-driven improvement strategies.

The PIX Survey represents a significant step forward in improving psychiatric inpatient care by leveraging patient insights. While compliance is a key focus, the survey also gives facilities an opportunity to enhance the overall patient experience and care delivery. By preparing early and leveraging expert resources, hospitals can navigate CMS requirements with confidence while prioritizing quality improvements in psychiatric care.

Request a demo with Press Ganey to learn how we can support your care facility’s success.