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1.08.2026 Deriving Measure Ratings From National Benchmarks How does NCQA derive measure ratings?

To calculate individual measure scores, NCQA truncates final raw rates and percentiles to 3 decimals and compares the rates submitted by plans to The National All Lines of Business 10th, 33.33rd, 66.67th and 90th measure benchmarks and percentiles, and then assigns the individual measure rating (calculated as whole numbers on a 1–5 scale) that the plans receive for each measure as follows:

5 = plans with a rate ≥ 90th percentile (top 10% of plans)

4 = plans in the top third but not in the top decile (66.67th percentile ≤ rate < 90th percentile)

3 = the middle one-third of plans or (33.33rd percentile ≤ rate < 66.67th percentile)

2 = plans above the bottom 10% of plans but in the bottom one-third of plans (10th percentile ≤ rate < 33.33rd percentile)

1 = plans with a rate < 10th percentile (in the bottom 10% of plans)

This applies to the following Programs and Years: