UPDATE: PCMH Standards and Guidelines

February 1, 2019 · Karen Proffitt

Every so often, we update our standards and guidelines to clarify guidance, revise resources and refine expectations. Just like health care quality, we believe we should improve as well.

On January 29, NCQA updated the 2017 Patient-Centered Medical Home (PCMH) Standards & Guidelines, as well as the New York State PCMH (NYS PCMH) Standards & Guidelines. We wanted to make sure you were still in the loop.

What Has Changed?

  • Updated Fee Schedule to include any additional fees.
  • Clarified expectations for practices that don’t complete the Recognition process within 12 months or 3 check-ins.
  • Added guidance on purchasing and using an additional check-in.
  • Clarified the Audit and NCQA Investigation process to state that clinicians on the Review Oversight Committee make a final revocation decision.
  • Updated Reporting Results to state that information collected during evaluations may be used for NCQA education and research.
  • CM 03: Replaced “Report” with “Evidence of Implementation” in Required Evidence.
  • Appendix 5: Retired and added new measures to the Quality Measures Crosswalk.
  • Appendix 6: PCMH Distinction in Patient Experience Reporting will be retired after the April 2019 submission period.


When Do Changes Take Effect?

Updates go into effect for all enrolled and recognized practices on March 1. Refer to the Policies and Procedures in the Standards & Guidelines for details.


What Do You Need to Do?

If you downloaded the 2017 PCMH standards or the NYS PCMH standards before January 29, you should download Version 4 from the Download Center.

If you have not previously downloaded the 2017 PCMH standards or the NYS PCMH standards, you can order a free copy from the NCQA Store.


Have questions? Let us know through My NCQA.

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