Pricing: PCSP and Oncology Medical Home Recognition

 

Standard Survey Pricing: Single Sites

The standard survey fee is for practices undergoing the NCQA Recognition process for the first time, and for Renewal Surveys. Pricing is by individual practice site.

Number of Clinicians in the Practice Initial Fee for Practice to Obtain a Survey Tool License Application Fees for NCQA Review and Recognition Total License and Application Fees
1 $80 $550 $630
2 $80 $1,100 $1,180
3 $80 $1,650 $1,730
4 $80 $2,200 $2,280
5 $80 $2,750 2830
6 $80 $3,300 3380
7 $80 $3,850 3930
8 $80 $4,400 4480
9 $80 $4,950 $5,030
10 $80 $5,500 5580
11 $80 $6,050 6130
12 $80 $6,600 $6,680
13+ $80 $6,600 + $55 for each clinician $6,680 + $55 for each clinician

Multi-Site Group Survey Pricing

Several practice sites that share a common system or processes may be eligible for an NCQA Multi-Site Group Survey. Sites must meet eligibility requirements, complete a self-assessment and purchase a Survey Tool for each practice site, plus an additional Survey Tool for the Multi-Site Group Survey. NCQA reviews PCMH elements approved for the shared processes or systems first (the Multi-Site Group Survey), then applies the results to all practice sites in the multi-site group. The remaining elements are completed for each practice site.

There is a 50 percent discount on the standard survey fee for practice sites applying under a Multi-Site Group Survey. That is, the full cost for an organization to apply through the Multi-Site Group Survey process = Multi-Site Group Survey application fee (the first table below) and the application fees for each practice site (with a 50 percent discount on the standard survey fee; the second table below) + Survey Tool purchases for each site and the Multi-Site Group Survey.

Number of Clinicians at a Practice Site Practice Site Application Fee
1 $275
2 $550
3 $825
4 $1,100
5 $1,375
6 $1,650
7 $1,925
8 $2,200
9 $2,475
10 $2,750
11 $3,025
12 $3,300
 13+  $3,300 + $27.50 for each additional clinician

Number of Practice Sites in a Practice Group Multi-Site Group Survey Application Fee
3-5  $1,600
6-9  $2,700
10-15  $3,800
16-19  $4,900
20-24  $6,000
25-29  $7,100
30-34  $8,200
35-39  $9,300
40-44  $10,400
45-50  $11,500
51+  $12,600

Note: Practices may use only one PCSP pricing discount for a survey. If a practice uses a sponsored discount, it may not also use the Multi-Site Group Survey discount.

Add-On and Conversion Survey Pricing

Practices can apply for an Add-On Survey to advance to a higher PCSP recognition level. There is no need to purchase an additional Survey Tool; NCQA provides a Survey Tool based on the practice’s previous submission. The application fee for an Add-on Survey is discounted to 50 percent of the standard application fees, even if a practice paid the discounted fee for its Initial Survey.

Number of Clinicians in Practice  Add-On and Conversion Survey Application Fees
 1  $275
 2  $550
 3  $825
 4  $1,100
 5  $1,375
 6  $1,650
 7  $1,925
 8  $2,200
 9  $2,475
 10  $2,750
 11  $3,025
 12  $3,300
 13+  $3,300 + $27.50 for each additional clinician

Reconsideration

A practice may seek Reconsideration of a Recognition status decision, as described in the Policies and Procedures. A fee of $1,100 per site or the Add-On Survey fee, whichever is less, is payable when the practice requests Reconsideration.

Oncology Medical Home Recognition

Initial or renewing practices choosing to pursue both PCSP and Oncology Medical Home Recognitions will follow the fee schedule outlined for PCSP Recognition above.

Currently recognized practices with PCSP Level 2 or 3 who are eligible for Oncology Medical Home Recognition may purchase an add-on survey and will follow the fee scheduled outlined for PCSP add-on surveys above.

Recognition will rely on a hybrid review process that combines both desktop and virtual check-ins. In the case a practice requires more than three virtual check-ins to complete the survey, the practice will be required to pay an add-on survey fee (50% of the full survey price) consistent with the current add-on fee pricing.

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