FAQ Directory: Patient-Centered Specialty Practice Recognition Program (PCSP)

This applies to the following Programs and Years:

This applies to the following Programs and Years:

This applies to the following Programs and Years:

This applies to the following Programs and Years:

This applies to the following Programs and Years:

No. There is no percentage threshold for diagnostic test tracking measures. The expectation is that practices track all diagnostic tests routinely; if performance is lower than expected, the practice should enter the rationale for their low percentage in the Notes from the Organization section in QPASS.

For example, if data show a 30% return rate, that means 70% of the practice’s ordered tests never had a report returned to their PCP. 
 

This applies to the following Programs and Years:

It depends. If the AR requirement aligns with a PCSP criteria that explicitly specifies a threshold, then that value would be the minimum threshold. However, if a threshold is not explicitly stated in the criteria, then 80% or more is expected to ensure consistent application of the process. Please note that there may be some cases where it’s acceptable for the rate to fall below 80%. 

An explanation in the Note section of Q-PASS is required for practices that report a rate less than 80% for the following criteria: AR-AC 01 [Timely Clinical Advice by Telephone], AR-CC 04 [Tracking Lab Test Results], and AR-CC 05 [Tracking Imaging Test Results].

This applies to the following Programs and Years:

Practices should submit an explanation when their performance falls below 80% for the following AR criteria:
•    AR-AC 1: Timely Clinical Advice by Telephone
•    AR-CC 4 (Option): Diagnostic Test Tracking (2 rates)

Practices should submit an explanation when their performance falls below 30% for the following AR criteria:
•    AR-CC 5: Secondary Referral Tracking

If the practice does not submit an explanation, NCQA will contact the practice and request context for their performance rates.

This applies to the following Programs and Years:

Yes. AR-KM 01 confirms that practices meet PCSP Transform KM 09, in which more than 80% compliance is required for medication lists. A rate less than or equal to 80% does not meet criteria.
 

This applies to the following Programs and Years:

No. There is no minimum denominator requirement. A sample of 30 (or more, because this increases the reliability of the sample) is expected to ensure statistical soundness, but there may be cases where it may be appropriate for the denominator to be <30. NCQA requests practices enter an explanation in the Notes from the Organization section in QPASS in this case.

If a practice reports a denominator <30 without a note, the evaluator may contact the practice to confirm data accuracy and to understand the data. The evaluation will be returned to the practice so they can enter an explanation in the Notes from the Organization section for the cited criteria.

This applies to the following Programs and Years:

It is to ensure patient safety and routine implementation of medical home activities. Depending on the population served and/or the reporting period, a small denominator is unexpected and may indicate issues (e.g., with data, documentation, implementation). Providing additional information allows the practice to explain—beyond the numbers—when performance is outside the expected range.
 

This applies to the following Programs and Years:

This applies to the following Programs and Years: