Patient-Centered Medical Home (PCMH)

NCQA’s Patient-Centered Medical Home (PCMH) Recognition program is the most widely adopted PCMH evaluation program in the country. More than 10,000 practices (with 50,000+ clinicians) are recognized by NCQA. More than 95 organizations support NCQA Recognition through providing financial incentives, transformation support, care management, learning collaboratives or MOC credit.

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About PCMH

The patient-centered medical home is a model of care that puts patients at the forefront of care. PCMHs build better relationships between patients and their clinical care teams.

Research shows that PCMHs improve quality and the patient experience, and increase staff satisfaction—while reducing health care costs. Practices that earn recognition have made a commitment to continuous quality improvement and a patient-centered approach to care.

Policy Amendments

Annual Reporting Fee Structure:

Effective January 1, 2026, late fees will be applied to annual reporting submissions received after the reporting date. This change will help ensure timely and consistent reporting across all programs, and maintain program integrity, accurate Recognition tracking and operational efficiency.

To avoid late fees, please submit all required documentation by the designated reporting deadline.

If you anticipate submission delays, notify your assigned Recognition Programs Representative in advance.

You may also proactively request an extension through My NCQA. Extensions may be requested for up to 90 days beyond your anniversary date.

Annual Reporting Fee Structure for 2026-2027

Fee Type	Amount per Site	Conditions
Late Fee	$50	Applied to submissions received after the reporting date
Proactive Extension Fee	$35	Capped at 5 sites; must be requested in advance; maximum 90-day delay

Front Matter:

NCQA reserves the right to notify applicable regulatory agencies if aspects of the organization’s operations pose a potential imminent threat to the health and safety of its members and/or NCQA has reason to believe that information submitted to NCQA has been falsified or the organization is required to implement corrective action.

Language Removed:

Before NCQA notifies applicable regulatory agencies, it gives the organization 24 hours to correct the condition or rebut the findings.

New Guidance: Modifications to Scoring for NCQA Recognition Program Evaluations

To help organizations navigate evolving federal and state guidance, NCQA has updated how we score diversity criteria for the following programs:

PCMH (KM 09 and AR-KM 2).

PCSP (KM 06 and AR-KM 2).

Virtual Care Accreditation (EA 2, EA 5, EA 6).

Practices are now required to report on one driver of health outcome disparity (disability, veteran status, socioeconomic status, race, ethnicity, sexual orientation, etc.). Reporting on additional drivers is optional.  The selected data point must be collected directly during patient interactions. This change helps practices focus efforts while still identifying subpopulations with unique needs.

These changes are in effect for 2025 reporting and are reflected in the published 2026 Standards and Guidelines. Q-PASS scoring has been updated to reflect these changes for reporting in 2025. If your practice is preparing to submit evidence, please ensure that the relevant documents are attached before submitting. Multiple reports are allowed, but only one is required. 

Please submit questions via My NCQA.

White Paper

The Business Case for PCMH

Milliman, the world’s largest providers of actuarial services, provides the first comprehensive look at the business implications for earning PCMH Recognition.

Download White Paper
Paper at a Glance:

Reviews the operational and financial motivations for PCMH.
Overview of revenue sources and revenue potential.
Modeling of a hypothetical practice found between a 2% to 20% increase in revenue (dependent on payment models).

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Overview

Why PCMH?

Reduce Fragmentation

The PCMH model emphasizes team-based care, communication and coordination, which has been shown to lead to better care.
Align With Payers

Many payers acknowledge PCMH Recognition as a hallmark of high-quality care. As a result, many payers provide incentives for NCQA-Recognized practices.
Improve Staff Satisfaction

The PCMH model is associated with better staff satisfaction. One analysis found implementation of NCQA PCMH Recognition to increase staff work satisfaction while reported staff burnout decreased by more than 20%.¹
Improve Patient Experience

A Hartford Foundation study found that the PCMH model resulted in a better experience for patients, with 83% of patients saying being treated in a PCMH improved health.¹
Better Manage Chronic Conditions

The PCMH model has been shown to help better manage patients’ chronic conditions.
Align With State/Federal Initiatives

As more emphasis is placed on value-based care, many state and Federal programs are embracing the patient-centered model of care.
Lower Health Care Costs

PCMH Recognition is associated with lower overall health care costs.
Improve Patient-Centered Access

PCMHs emphasize the use of health information technology and after-hours access to improve overall access to care when and where patients need it.

Get Started with PCMH Recognition

Latest PCMH Blog Articles

Latest PCMH Videos

PCMH Distinction Programs

Distinction in Behavioral Health Integration

NCQA’s Distinction in Behavioral Health Integration recognizes primary care practices that put resources, protocols, tools and quality measures in place to support the broad needs of patients with behavioral health related conditions.

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URL: https://www.ncqa.org/programs/health-care-providers-practices/patient-centered-medical-home-pcmh/