PCMH 11.1 updates 2026: FAQs for NCQA recognition and compliance

The release of NCQA Patient-Centered Medical Home (PCMH) Standards and Guidelines Version 11.1, effective Jan. 1, 2026, has prompted an important question for many practices. 

1. What actually changed, and what do we need to do now? 

While the core goals of PCMH remain the same, version 11.1 introduces updated thresholds, retired requirements and refined expectations that directly impact annual reporting, documentation workflows and day-to-day operations. For practices with existing PCMH recognition and those actively pursuing it, understanding these changes is essential to maintain compliance and avoid reporting gaps. 

This FAQ-based guide breaks down the most common and critical questions surrounding PCMH version 11.1 in clear, practical terms. Each answer is designed to help practices quickly identify what’s required, what’s optional and where strategic judgment (not just minimum compliance) matters most in 2026. 
 

2. Has NCQA released new PCMH standards for 2026? 

Yes. NCQA released PCMH Standards and Guidelines Version 11.1, effective Jan. 1, 2026. All practices with existing PCMH recognition or those pursuing recognition must align workflows, documentation and reporting to this latest version for annual reporting and ongoing compliance. 

3. Do practices need to follow the latest PCMH standards even if they were recognized under an earlier version? 

Yes. NCQA requires practices to mirror their workflows and reporting to the most current version of the PCMH standards at all times. Recognition under a prior version does not exempt a practice from meeting updated requirements in version 11.1. If a practice is audited, the current criteria will be requested. The annual reporting requirements are pulled from the latest version of the PCMH standards and guidelines. 

4. What are the most important PCMH core criteria changes for 2026? 

The most impactful core criteria updates in version 11.1 include: 

• reduced minimum frequency for care team huddles (TC 06); 

• retirement of required orientation materials (TC 09); 

• reduced diversity reporting to one driver of disparity (KM 09); 

• increased medication documentation thresholds to 90.1% (KM 14 & KM 15); 

• expanded documentation requirements for person-centered care plans (CM 04); and 

• annual internal performance reporting requirements (QI 15). 

Get the full recap in our NCQA 2026 standards and guidelines blog. 

5. Are daily huddles still required for PCMH recognition in 2026? 

No. Daily huddles are no longer required under TC 06. Practices must now conduct care team huddles at least twice per week. However, NCQA does not discourage daily huddles, and many practices continue them because of their positive impact on care coordination and gap closure. 

6. Are patient orientation materials still required for PCMH? 

No. Under TC 09, practice orientation materials have been retired as a required element and NCQA will no longer request documentation for this criterion. That said, many practices continue using orientation materials because they improve patient engagement, clarity and satisfaction. 

7. How many diversity or disparity drivers must practices report under PCMH Version 11.1? 

Practices are now required to assess and report on at least one driver of health outcome disparities under KM 09. Reporting on multiple drivers is no longer mandatory, though it may still support more culturally responsive care. 

What are the new medication documentation thresholds for PCMH in 2026? 

Both medication-related core criteria now require 90.1% compliance, up from 80.1%: 

• KM 14: Medication reconciliation after care transitions. 

• KM 15: Maintaining an up-to-date medication list. 

Practices should proactively run reports to identify workflow gaps and ensure consistent documentation. 

8. How often must person-centered care plans be updated under the new standards? 

Under CM 04, person-centered care plans must be reviewed and documented at least twice per year. Each care plan must include clinical goals, patient personal goals, self-management strategies and a defined timeframe for reassessment that must be shared with the patient in printed or electronic form. 

9. What performance data must be shared internally for PCMH compliance? 

Under QI 15, practices must share performance results with clinicians and staff at least annually, including: 

• one clinical quality measure; 

• one cost or care coordination measure; and 

• one patient experience measure. 

This requirement supports transparency, quality improvement, and an outcomes-focused culture. 

10. If a PCMH elective criterion is retired, what should a practice do? 

If an elective criterion previously used for credit has been retired, the practice must select and implement a replacement elective. It is the practice’s responsibility to ensure all credits earned still apply toward PCMH recognition under version 11.1. 

11. Should practices change workflows just because PCMH requirements changed? 

Not necessarily. NCQA standards define minimum requirements, not best practices. If an existing workflow is improving patient outcomes, reducing cost or strengthening team satisfaction, practices should carefully evaluate the impact before making changes solely for compliance. 
 

What PCMH version 11.1 means going forward 

PCMH Standards and Guidelines Version 11.1 reinforces a key message from NCQA: compliance alone is no longer enough. 

The 2026 updates reflect a shift toward outcome-driven care, patient engagement and internal accountability, while still giving practices flexibility in how they meet those goals. Requirements may have changed, but expectations around performance, documentation accuracy and transparency have not. 

Practices that will succeed under version 11.1 are those that: 

• align reporting to the latest standards without dismantling high-performing workflows; 

• use updated thresholds as an opportunity to strengthen care processes; and 

• treat PCMH reporting as a continuous improvement tool, not an annual scramble. 

By understanding the intent behind these FAQs and acting early, practices can move confidently into 2026, protecting their PCMH recognition while continuing to deliver meaningful, patient-centered care.