Patient-Centered Medical Home (PCMH)

About PCMH

The patient-centered medical home is a model of care that puts patients at the forefront of care. PCMHs build better relationships between patients and their clinical care teams.

Research shows that PCMHs improve quality and the patient experience, and increase staff satisfaction—while reducing health care costs. Practices that earn recognition have made a commitment to continuous quality improvement and a patient-centered approach to care.

Policy Amendments

Annual Reporting Fee Structure:

Effective January 1, 2026, late fees will be applied to annual reporting submissions received after the reporting date. This change will help ensure timely and consistent reporting across all programs, and maintain program integrity, accurate Recognition tracking and operational efficiency.

To avoid late fees, please submit all required documentation by the designated reporting deadline.

If you anticipate submission delays, notify your assigned Recognition Programs Representative in advance.

You may also proactively request an extension through My NCQA. Extensions may be requested for up to 90 days beyond your anniversary date.

Annual Reporting Fee Structure for 2026-2027

Front Matter:

NCQA reserves the right to notify applicable regulatory agencies if aspects of the organization’s operations pose a potential imminent threat to the health and safety of its members and/or NCQA has reason to believe that information submitted to NCQA has been falsified or the organization is required to implement corrective action.

Language Removed:

Before NCQA notifies applicable regulatory agencies, it gives the organization 24 hours to correct the condition or rebut the findings.

New Guidance: Modifications to Scoring for NCQA Recognition Program Evaluations

To help organizations navigate evolving federal and state guidance, NCQA has updated how we score diversity criteria for the following programs:

• PCMH (KM 09 and AR-KM 2).

• PCSP (KM 06 and AR-KM 2).

• Virtual Care Accreditation (EA 2, EA 5, EA 6).

Practices are now required to report on one driver of health outcome disparity (disability, veteran status, socioeconomic status, race, ethnicity, sexual orientation, etc.). Reporting on additional drivers is optional.  The selected data point must be collected directly during patient interactions. This change helps practices focus efforts while still identifying subpopulations with unique needs.

These changes are in effect for 2025 reporting and are reflected in the published 2026 Standards and Guidelines. Q-PASS scoring has been updated to reflect these changes for reporting in 2025.  If your practice is preparing to submit evidence, please ensure that the relevant documents are attached before submitting. Multiple reports are allowed, but only one is required. 

Please submit questions via My NCQA.