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Conversion Requirements for PCMH 2014

About Converting to PCMH 2014

Practices that have achieved NCQA PCMH 2011 Level 3 Recognition are eligible for conversion to PCMH 2014 by completing the survey and submitting documentation for specific elements. Practices must submit documentation in order to be scored. 

Organizations that want to convert must have a current NCQA PCMH Recognition at the time of submission. Conversion will extend a practice site’s recognition by 1 year from its current recognition end date. PCMH 2014 Recognition level is a result of the scoring achieved on the conversion survey. Please see the PCMH 2014 Conversion vs. Streamlined Renewal Requirements page for more information comparing the two processes.

Practices seeking conversion:

  • Purchase a PCMH 2014 survey license for each site.
  • Submit an application for each site.
  • Pay the Add-On Survey fee.
  • Complete and submit the survey with the required documentation.
  • Receive their converted PCMH 2014 Recognition Level within 30-60 days.
  • Are issued a new NCQA Recognition Certificate.

Requirements for Converting to PCMH 2014

Organizations and practices with Level 3 Recognition must attest that their survey responses reflect current operations. Attestation does not require that every factor in an element is met, but that a positive response to a factor is supported by documentation if audited. The attestation is located on the "Conversion" tab in the "Organization Background" section of the Survey Tool for each practice site.

Sample attestation for organizations/practice sites with Level 3 Recognition: "Our practice achieved Level 3 Recognition as a patient-centered medical home. We attest that our responses reflect our practice's current operations. Documentation to support these responses will be provided upon request."

Documentation Requirements

Through the conversion process, practices are responsible for submitting documentation* for only 6 out of 27 elements:

  • Element 1A: Patient-Centered Appointment Access
  • Element 2D: The Practice Team
  • Element 3E: Implement Evidence-Based Decision Support
  • Element 4A: Identify Patients for Care Management
  • Element 4B: Care Planning and Self-Care Support (examples only, no record review or report required)
  • Element 6B: Measure Resource Use and Care Coordination

*Please see the PCMH 2014 Standards and Guidelines publication for details on documentation requirements for each element.