PCMH PRIME Certification

Behavioral health issues can often first be identified in a primary care setting, and there is a growing consensus that behavioral health care needs to be well integrated into primary care. Behavioral health conditions (mental illnesses and substance use disorders) can be exacerbated by under- or delayed diagnosis. This is a serious public health problem nationally and across the Commonwealth.

The Massachusetts Health Policy Commission (HPC), in collaboration with NCQA, launched the PCMH PRIME Certification Program, which identifies criteria that are key to integrating behavioral health care into primary care and certifies practices that meet a majority of these criteria..

Available exclusively—and for no additional fee—to NCQA Recognized practices in Massachusetts, PCMH PRIME promotes best practices for integrating behavioral health care into a patient-centered primary care setting and:

  • Supports use of evidence-based guidelines in treating patients.
  • Helps increase patient access to behavioral health care services.
  • Recognizes practices that deliver comprehensive care by addressing both physical and behavioral health in the practice setting.
  • Provides opportunities for practices to receive technical assistance from the HPC.
  • Helps practices identify behavioral health issues before they become acute, resulting in better outcomes and improved patient experience.

The HPC is working with NCQA to determine how PCMH 2017’s new application process and standards may impact the PCMH PRIME program. Please see the HPC website for current information on how PCMH PRIME may be modified to align with PCMH 2017.

Practice Eligibility

  • Practices must be located in the Commonwealth of Massachusetts.
  • •Practices must have NCQA PCMH Recognition (any year/level except PCMH 2011 Level 1)
  • Practices must complete and submit an application to the Massachusetts Health Policy Commission.
  • Practices must submit documentation to NCQA for evaluation on the PCMH PRIME behavioral health criteria. Submission of these standards is at no additional fee to the practice.
  • Practices must meet at least 7 of 13 criteria to achieve PCMH PRIME certification.

Learn more about the PCMH PRIME program. Fill out the form to download an information sheet and FAQs or to speak with an NCQA representative. 

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For Massachusetts Practices That Demonstrate the Ability to Address Behavioral Health in Primary Care 

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