Credentialing Accreditation & Certification Programs

NCQA Credentialing programs help improve credentialing practices and protect consumers by helping to ensure a consistent, effective and diligent credentialing process.

Get started today with the 2025 Credentialing Standards & Guidelines

EFFECTIVE FOR SURVEYS WITH A START DATE OF JULY 1, 2025–JUNE 30, 2026

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A QUALITY IMPROVEMENT FRAMEWORK

Credentialing is an essential safety component of the health care system. Organizations must establish the qualifications of their licensed medical professionals by assessing their background and legitimacy to provide care.

NCQA Credentialing programs focus on improving consumer protection and customer service. They provide a framework for implementing industry best practices that help organizations credential and recredential health care professionals accurately and effectively.

Understanding that not all standards apply to every organization’s credentialing needs, NCQA offers two different tailored program tracks.

  • NCQA Credentialing Accreditation evaluates the operations of organizations providing full-scope credentialing services, which includes verifying practitioner credentials and credentialing/recredentialing committee review of practitioners.
  • NCQA Credentialing Certification assesses organizations that verify practitioner credentials. Verification is accomplished through the primary source, a recognized source or a contracted agent of the primary source.
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Resource Guide

A Comprehensive Guide to NCQA Credentialing Programs

An in-depth look at NCQA’s Credentialing Accreditation and Certification Programs.

Credentialing is more than a “check the box” regulatory burden, it is an essential safety component of health care. NCQA Credentialing Accreditation can help your organization improve its credentialing/recredentialing processes—and our newest eBook, A Comprehensive Guide to NCQA Credentialing Programs, contains the information you need to begin.

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Why Credentialing?

  • Delivers accurate, efficient services

    Applying industry best practices improves the credentialing process. Standards provide a framework for implementing best practices:

  • Elevate your organization’s reputation

    Demonstrate the quality of your organization’s programs to employers, regulatory agencies, health plans and MBHOs.

  • Align with state requirements

    Adopting industry best practices improves the likelihood that your organization’s operations align with state requirements.

  • Expands revenue streams and secures new contracts

    Earning an Accreditation from NCQA, the largest accreditor of health plans, increases your potential client base.

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