Frequently Asked Questions
Practice Changes: Adding and Deleting Clinicians
Q: May we add or delete clinicians after we earn PCMH or PCSP recognition?
A: Yes, you may add or delete clinicians any time during the recognition period. NCQA encourages recognized practice sites to keep an up-to-date list of clinicians.
Note: This policy does not apply to DRP or HSRP recognition.
Q: Is there a fee to add or delete clinicians?
A: No. NCQA does not charge recognized medical home sites to add or delete clinicians. Practices must include all eligible clinicians with their applications.
Note: Subject to change. NCQA will notify recognized clinical sites of a change before it goes into effect.
Q: How do we add or delete a clinician from our practice site, and how long does it take?
A: To add or delete a clinician from your recognized practice site, use this form.
Clinician data received up to the 20th of the month are processed by the end of the month. Data received after the 20th of the month are processed for the following month.
Q: Where do we send the completed Add/Delete spreadsheet from the above link?
A: Submit the completed Add/Deleted spreadsheet to NCQA at firstname.lastname@example.org.
Q: What types of clinicians may we add to our medical home site?
A: PCMH eligibility criteria apply equally to clinicians listed on the initial application and to all clinicians who are added after recognition is achieved. You may add a clinician who can be selected as a personal clinician and who provides first-contact, comprehensive and continuous primary care services for the majority of their patients. Clinicians may be physicians, nurse practitioners and physician assistants. Check if your clinicians are eligible.
Q: What types of clinicians may we add to our specialty site?
A: PCSP eligibility criteria apply equally to clinicians listed on the initial application and to all clinicians who are added after recognition is achieved. You may add a clinician who receives referrals from PCPs and other non-primary care specialists who provide coordinated patient care and communicate with primary care colleagues, other specialists and the patient. Eligible clinicians are non-primary care specialty doctors of medicine, doctors of osteopathy, nurse practitioners, physician assistants, certified nurse midwives and any of the following behavioral healthcare practitioners. Check if your clinicians are eligible.
Q: When should we delete a clinician?
A: Delete a clinician who no longer maintains an assigned panel of patients at a site or who stops practicing at a site. Recognition does not transfer to another practice with the clinician. Notify NCQA of the deletion.
Q: When should we add a clinician?
A: Add a clinician who is assigned a panel of patients at your site and has implemented your practice’s PCMH or PCSP policies and procedures. Notify NCQA of the addition.
Q: How will we know when the changes have been made?
A: Changes appear in NCQA’s Recognition Directory 24 hours after they have been processed, and are included in the next monthly report to entities that have a data use agreement with NCQA to list recognized practices and clinicians.
Q: Clinicians in our recognized practice receive payment from our health plans and Medicaid agency. How soon after we give NCQA information about new clinicians will they begin to receive the additional payment?
A: NCQA has formal relationships with a number of public and private payer organizations who sponsor incentive programs to clinical sites to become NCQA-Recognized medical homes. Most sponsoring organizations pay a regular bonus or offer enhanced reimbursement to recognized clinical sites or clinicians.
NCQA sends sponsors an electronic list of recognized practices and during the first week of each month. Sponsors maintain their own program operations. Contact your sponsors about the timing of incentive payments for new clinicians.