PCSP Recognition Pricing

The following pricing goes into effect for PCSP Recognition on January 11, 2024.

Practices may be eligible for single-entity or multi-entity pricing. An “entity” is defined as the body that earns recognition – i.e. the specialty at a practice site.

Single-entity pricing applies to a single entity seeking recognition OR several entities that do not meet multi-entity pricing requirements (see below).

Multi-entity pricing applies to entities that:

• Have three or more entities operating under the same legal organization;
• Share an EHR system; AND
• Have at least some of the same policies and procedures.

What is an “entity”? 

Recognition is earned at the specialty level at each practice site. If a practice includes more than one specialty, each specialty within that practice site seeking recognition must complete an evaluation to earn recognition, as they will be recognized as different entities. Similarly, if a specialty group practices at multiple sites, each specialty at each site would earn a recognition.

• Example – Recognitions at a single site: If a practice site has cardiologists, rheumatologists and endocrinologists at the same site and all wanted to earn recognition, three different PCSP Recognitions would be earned – one for the cardiologists, one for the rheumatologists and one for the endocrinologists. If only the cardiologists wanted to earn recognition, they could do so for the cardiology specialty without earning recognition for the whole practice site.
• Example – Recognitions at multiple sites: An OB/GYN group has five sites. To earn recognition across all five sites, the organization would seek recognition for the specialty level at each site for a total of five Recognitions.

Jump To:

• Single Entity Pricing
• Multi-Entity Pricing
• Pricing Extra Check-In
• Refund Policy
• Partners in Quality Discount

Pricing: Single Entity

Single entity pricing is for organizations with fewer than three entities seeking recognition, or for organizations with three or more entities that do not meet multi-entity criteria. Practices seeking recognition for the first time pay the initial recognition fee at enrollment. Thereafter, they pay the recognition fee at Annual Reporting. Fees apply to each clinician associated with the entity’s recognition.

Example: The example below will provide you some context as to how pricing is applied. For this example, an organization has 1 entity: a single practice site, 1 specialty, with 16 clinicians.

 The organization pays $7,338 for its Initial Recognition Fee.

The organization pays $2,168 each year during its annual reporting period.

Pricing: Multi-Entity

Multi-entity pricing is for practices that:

• Have three or more entities operating under the same legal organization;
• Share an EHR system; AND
• Have at least some of the same policies and procedures.

Entities seeking recognition for the first time pay the recognition fee at enrollment. Thereafter, they pay the recognition fee at their Annual Reporting.

Organizations that bring entities through the multi-entity process pay an organization multi-entity fee of $1,785 during initial recognition, as well as a per clinician fee for each entity. The organization multi-entity fee allows you to bring through as many entities as you want for one year at the multi-entity rate. If you wish to add new entities after that year time frame, you must pay a new multi-entity fee.

Entities seeking recognition for the first time pay the initial recognition fee at enrollment. Thereafter, they pay an Annual Reporting fee each year for their Annual Reporting period. Fees apply to each clinician associated with the entity’s recognition.

Example: The example below will provide you some context as to how pricing is applied. For this example, an organization has 1 practice site with three different specialties. Entity A has 14 clinicians, Entity B has 6 clinicians, Entity C has 16 clinicians.

The organization pays $10,519 for its Initial Recognition Fee.

The organization pays $5,352 each year during its annual reporting period.

Pricing: Extra Check-In

Entities that have not achieved recognition after the third check-in or have not completed recognition within the 12-month allotted time frame can purchase an extra check-in. The pricing for the extra check-in is 50% of the initial per clinician fee paid by the entity. Fees apply to each clinician associated with the entity’s recognition.

Refund Policy

NCQA will refund 80% of the Initial Recognition Fee paid by an entity if the practice cancels their application with NCQA within 45 calendar days of payment. After this time, there is no right to a refund. For refund requests submitted within 5 calendar days of payment, NCQA will refund the Initial Recognition fee in full.  All refund requests must be in writing and should be submitted via My NCQA. There is no right to a refund for any other fees or costs paid to NCQA.

MAC REVIEW

A fee is charged for a MAC review. MAC reviews will be priced when they are initiated and will be 50% of the current recognition fee for the practice(s) or site(s) being reviewed. The recognition fee is based on the current number of clinicians or sites and the recognition price at the time of the MAC review. This may be the initial recognition fee, the standard survey price, or the full application fee as each is described in the fee schedule for the applicable recognition program.

Partners In Quality Discount Pricing

The Partners in Quality discount* is available for both single and multi-entity practices pursuing recognition for the first time. NCQA offers a discount to applicants sponsored by NCQA Partners in Quality (health plans, employers and other organizations that provide resources and services to support practices in pursuit of PCMH transformation).

Entities that use a Partner In Quality discount code receive 20% OFF their initial recognition fee.

To get this discount, request a discount code from your Partners in Quality sponsor organization and apply it when you pay during enrollment.

*Applies to initial recognition fees only.