PPO Accreditation


NCQA's Preferred Provider Organization (PPO) Accreditation Program provides consumers, employers and others with information about the quality of the nation's preferred provider organizations. PPOs collectively cover more than 100 million Americans, making it critical that objective, comprehensive information about PPO quality be made available. NCQA's PPO Accreditation program includes a rigorous review against standards in the areas of access, service and qualified providers. In addition, PPOs must measure and report on their customers’ experiences and satisfaction in key areas such as access to care, claims payment and customer service.

Health Plan Accreditation MCO/PPO

NCQA has discontinued the separate MCO Accreditation Program and PPO Accreditation Program in favor of a single, consolidated set of standards and guidelines. This new, comprehensive program, Health Plan Accreditation, applies to HMO, POS and PPO health plans. To learn more about this new program, visit the Health Plan Accreditation Web page.

Other PPO-Related Programs

Medicare Advantage Deeming (MA)

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Market Your Quality

Health Plan Report Card

How does your Health Plan rate?

HEDIS Users Group (HUG)
HUG membership packages offer you access to the most up-to-date information on HEDIS specifications so you can begin planning for the future.

HEDIS and ICD-10
To accommodate the switch from ICD-9-CM to ICD-10, NCQA created a plan to identify a valid and appropriate set of ICD-10 codes for each HEDIS measure.