NCQA Recognition for Comprehensive Primary Care Plus (CPC+) Practices
Reduced Documentation and Review for a Simplified Process
Practices participating in CMS’ Comprehensive Primary Care Plus (CPC+) program have achieved a significant transformation that aligns closely with the NCQA Patient-Centered Medical Home (PCMH) Recognition program. To acknowledge this accomplishment, NCQA awards automatic credit to CPC+ practices for many NCQA PCMH criteria. This means that practices with CPC+ status are ahead of the game to earn NCQA Recognition.
If you are a CPC+ practice:
- Only 7 of the 40 NCQA core criteria require review.
- 44 elective credits are eligible for automatic credit or attestation.
About NCQA Recognition Scoring
To achieve recognition, practices must:
- Meet all 40 core criteria and
- Earn 25 credits in elective criteria across 5 of 6 concepts.
NCQA has identified the reduced requirements CPC+ practices to earn NCQA Recognition. Each criterion is noted as one of three types:
- Credit: The practice receives automatic credit.
- Attestation: The practice must attest that it meets the criterion, but does not have to provide evidence for review.
- Review: The practice must provide evidence for NCQA review.
The NCQA evaluator might ask practices to verify a selection of attestation and automatic credit responses during a virtual review.
ELECTIVES
| Core | 1 Credit | 2 Credits | 3 Credits | |
|---|---|---|---|---|
| Credit | 13 criteria | 4 criteria | 5 criteria | n/a |
| Attestation | 20 criteria | 16 criteria | 7 criteria | 0 criteria |
| Review | 7 criteria | 18 criteria | 9 criteria | 1 criterion |
| Total (100 criteria) | 40 criteria | 38 criteria | 21 criteria | 1 criterion |
Frequently Asked Questions
How do I identify that I am a CPC+ practice in Q-PASS?
You can identify your practice site as participating in CPC+ by indicating so in the Transfer Credits section of Q-PASS (learn more about how to enroll in Q-PASS here).
- Click My Evaluations.
- Hover the cursor over Action and click Organization Dashboard.
- Click Transfer Credits.
- On the Select Program screen, click CPC+.
- Click to select the applicable practice sites.
- Using the evidence component, upload evidence of your participation in the CPC+ program.
- Click Submit for Review.
Your NCQA representative will review the information and approve automatic credit. Once transfer credit is approved, all eligible criteria with transfer credit are marked “Met.”
What is expected for “review” criteria?
For “review” criteria, submit evidence in Q-PASS, as indicated, and prepare to demonstrate eligible evidence during the virtual review.
What is expected for criteria that allow attestation?
For criteria marked “attestation,” attest that your practice performs specific NCQA PCMH activities and is not required to submit documentation or provide evidence.
Note: Although criteria align with many CPC+ domains, practices may have implemented CPC+ options that do not meet PCMH requirements. Practices attest only to fully met criteria.
For each attestable criterion, enter a title, label it “CPC+” and enter this text below:
Our practice currently participates in the CMS Comprehensive Primary Care Plus program. We attest that our responses reflect our practice’s current operations, and will provide documentation to support responses upon request.”
Practices are not required to enter the attestation text for each criterion. After entering it for the first criterion, click Link Evidence and type the title CPC+ into the text box for additional attestable criteria.
What is expected for criteria where credit is provided?
Practices that have completed at least two quarterly CPC+ reports for 2017 may bypass submission of evidence for credited criteria. Those criteria will be marked “Met” when you enroll in Q-PASS.
How do I access the NCQA CPC+ Credit Table to see which criteria is eligible for credit and attestation or require review?
Submit a request for a copy of the CPC+ Credit Table via My NCQA.
Questions?
Submit them through My NCQA and a representative will be in touch.