NCQA Updates PCMH Grace Period Policy: New Fees for Late Submissions

Grace period changes start on Jan 1 

The National Committee for Quality Assurance (NCQA) has announced an important change to the submission process for annual reporting under the Patient-Centered Medical Home (PCMH) recognition program. Beginning Jan. 1, NCQA will charge fees for late annual reporting submissions: 

• $50 per site will be charged if a site submits after its reporting date without prior communication or extension approval. 

• Sites may proactively request an extension for a $35 per-site fee, allowing up to 90 additional days past the reporting date. Extensions are limited to a maximum of five sites per organization. 

Previously, NCQA allowed an approximately 60-day “flex period” beyond the reporting date at no charge. This courtesy will no longer apply as of 2026. 

Why timely submission matters 

Submitting on time is now more critical than ever. Failing to meet your reporting date can lead to more than just site fees. It can jeopardize your recognition status and the financial incentives tied to it. 

Late or missed submissions can result in: 

• A break in recognition, potentially disrupting payer incentives and quality-based reimbursements. 

• A loss of recognition will require the site to restart the transformation phase, which is time-consuming and costly. 

How to avoid fees and sustain recognition 

To avoid fees and ensure continued recognition, take these three measures. Remember that timely annual reporting not only protects your recognition but also supports your commitment to continuous quality improvement in patient care. 

• Measure one: Review your site’s anniversary and reporting dates in Q-PASS. 

• Measure two: Plan submissions well ahead of the 30-day reporting deadline. Submission preparation should be managed over a 6-month period and should not be rushed; it should be a thorough representation of the practice's ongoing achievement. 

• Measure three: If an extension is needed, submit your request early to avoid higher fees or recognition lapses. 

Remember these annual reporting basics 

Under the PCMH recognition model, each site earns recognition for one year once it completes the transformation stage. To maintain this recognition, every site must complete annual reporting, submitting updated documentation through Q-PASS that demonstrates continued compliance with NCQA’s current year requirements. 

Each site has two key dates to track: 

• Anniversary date: The date (month/day/year) when the site’s current recognition expires. 

• Reporting date: The date 30 days prior to the anniversary date, marking the deadline to submit documentation for review by an NCQA evaluator. 

Note: Both dates can be easily located in Q-PASS under the “Manage Evaluations” tile. See the image below for a sample of dates. 

How DataGen can help 

If you’re a current DataGen client using our Medical Practice Consulting solution, reach out to Mandi Diamond, senior practice transformation advisor at DataGen, directly. They can help you with any questions you may have. 

If you’re not currently working with DataGen but would like consulting, please contact us through our patient-centered medical home solutions page, and we can see if we’re a good fit to help navigate you through NCQA PCMH recognition and sustainment.