Importance of Registering and Authorizing Primary/Alternate CCN pairs on the ICH CAHPS Website
folder_openInformation for Dialysis Facilitiescalendar_todayPosted January 23, 2019

12/4/2023 UPDATE: As the data for a facility can only be entered into the End-Stage Renal Disease Quality Reporting System (EQRS) under one CCN, the guidance noted below regarding alternate CCNs is no longer applicable. Moving forward, a facility does not need to register and authorize multiple CCNs for a facility on the ICH CAHPS website, but should make sure that the CCN that they enter data under in EQRS is the CCN that is registered and authorized on the ICH CAHPS website. If a facility has registered/authorized alternate CCNs on the ICH CAHPS website in the past, no action is needed; it is okay to keep them registered with an authorized vendor.

As the ICH CAHPS Coordination Team (CT) prepares for the 2019 Spring Survey sampling process, we would like to remind ICH facilities about the importance of registering and authorizing all CCNs associated with their facility on the ICH CAHPS website. Many ICH facilities have both a primary and alternate CCN associated with their facility and CROWNWeb, the CMS database that provides sampling information to the CT, may include sample patients under both CCNs.

Please carefully review the following information on this important issue.

Definition of a Primary CCN and an Alternate CCN:

A CMS Certification Number (CCN) is a number assigned to a facility for billing and administrative purposes. The CCN is sometimes referred to as the “billing number,” “provider number,” or “Medicare provider ID number.”

Regarding the ICH CAHPS Survey, the CCN is a 6-digit number assigned to each Medicare-certified ICH facility for the purpose of billing CMS for providing outpatient hemodialysis care. Each facility has a primary CCN but may potentially submit claims under an alternate CCN(s); however, not every ICH facility will have an alternate CCN.

How can a facility determine if they have an alternate CCN?

If you are unsure whether you have an alternate CCN, we suggest checking with your billing department to obtain all CCNs that are associated with your facility and used for billing CMS for services provided to end-stage renal disease patients. We encourage you to do this prior to the deadlines for authorizing a vendor for the ICH CAHPS Survey, which are February 28th for the Spring Survey and August 31st for the Fall Survey, each year.

Please note that the CT does not always have current information on whether a facility has an alternate CCN.

If a facility has more than one assigned CCN number, how does this impact the ICH CAHPS Survey?

Sample Selection Impact: Patient samples for the ICH CAHPS Survey are selected using patient-level data from the CROWNWeb database. Sometimes patient-level information appears on CROWNWeb under a different (or alternate) CCN that is owned by a facility (for example, the CCN assigned to an acute care hospital) rather than to the CCN assigned to the provider’s outpatient hemodialysis unit (primary). In some cases, CROWNWeb will show survey eligible patients under both the facility’s primary and alternate CCN.

This means that an ICH CAHPS sample file of survey-eligible patients could be available under:

  • both the primary CCN and the alternate CCN,
  • only the primary CCN, or
  • only the alternate CCN.

If survey-eligible patients are available under both the primary and the alternate CCN, the CT then samples from both CCNs, as the CT is not permitted to consolidate sampled patients under one CCN. Please note that if CROWNWeb indicates that there are survey-eligible patients for both the primary and alternate CCN, the CT can only provide samples for both CCNs if both CCNs are registered and have authorized an approved survey vendor on the ICH CAHPS website.

Public Reporting Impact: Survey results are publicly reported for each ICH facility that had 30 or more completed surveys combined over the two most recent semiannual survey periods. If a facility has multiple CCNs under which patients were surveyed, data from patients at both CCNs are combined and results are publicly reported under only the primary CCN, which is determined by the Dialysis Facility Compare (DFC). Ensuring that all assigned CCNs have been registered and have an authorized survey vendor may result in more reportable survey responses from the facility’s patients and may mean the difference between whether a facility has publicly reportable ICH CAHPS data on DFC or not.

What steps should a facility take if they have a primary and alternate CCN and will not be participating in the ICH CAHPS Surveys?

If a facility has determined that they are not required to administer the ICH CAHPS Surveys in a calendar year or they choose not to administer the survey, the facility should submit an ICH CAHPS Non-Participation Form for both the primary and alternate CCNs. Doing so will ensure that if CROWNWeb indicates there are survey-eligible patients for the primary CCN or the alternate CCN, the CT will not send a sample file for either CCN to the facility’s authorized survey vendor.

As a reminder, the deadline for ICH facilities to either 1) authorize an approved survey vendor or 2) submit a Non-Participation Form for their assigned CCNs is 5:00 PM Eastern Time on February 28, 2019.

Please contact the ICH CAHPS Coordination Team at 1-866-245-8083 or via e-mail at if you have any questions.