FAQ Directory: Patient-Centered Medical Home (PCMH)

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7.01.2026 What changes were made to the PCMH Standards and Guidelines for Version 12?

KM 09   KM 09 is now titled Demographic Data Collection. 
KM 20: Clinical Decision Support   Added a clarification that screenings to not meet the intent of KM 20. 
AC 11: Patient Visits with Clinician/Team   Added a clarification that single-clinician sites automatically meet this criterion. 
CM 01: Identifying Patients for Care Management    Added pediatric-specific practice sites must include at least two categories instead of three. 
CM 01: Identifying Patients for Care Management    Changed from shared evidence to site-specific evidence. 
CM 02: Monitoring Patients for Care Management   Added, "At minimum, a practice must identify at least 30 patients for care management, or 1% of its total patient   population, whichever is smaller, to meet the criteria defined in CM 01." 
CM 04: Person-Centered Care Plans   Updated that care plans must include: 

  • Active problem list  
  • Expected clinical outcome/prognosis and patient treatment goal OR a SMART goal. 
  • Medication list and management. 
  • A schedule to review and revise the plan, as needed. 
CM 04: Person-Centered Care Plans   Added, "If your organization has 9 or more sites, please reach out to your PCMH Representative, via PCS,   regarding adjusting the sample size." 
MAC Policy (Appendix 6)   Added a new section for practices who change EHRs due to a MAC. 
Distinction BH 03: BH Clinician in the Practice   Added the clarification, "Simple co-location does not meet the requirement." 
PCMH AR    Clarified in Front Matter that the documented process must contain the date of implementation. 

 Clarified in Front Matter that a report upload submission must include the reporting period, numerator and   denominator descriptions, numerator and denominator data and the percentage. 

This applies to the following Programs and Years:
PCMH 2017