NCQA Diabetes Recognition Program: Frequently Asked Questions
Last updated: April 2026
What is the NCQA Diabetes Recognition Program?
The NCQA Diabetes Recognition Program (DRP) recognizes clinicians who use evidence-based measures to provide high-quality care to patients with diabetes. Co-developed by NCQA and the American Diabetes Association, the DRP evaluates clinician performance against a defined set of diabetes care measures. Recognition is annual.
Who is eligible?
Any clinical setting caring for patients with diabetes — primary care physicians, endocrinologists, diabetes specialists, medical groups, FQHCs, ACO participants, and specialty clinics with significant diabetes co-management responsibilities. The refreshed program expanded eligibility beyond endocrinology and primary care internal medicine.
What patient sample size is required?
A random sample of at least 25 patients with diabetes per clinician. The 25-patient minimum makes the program accessible to clinicians with smaller diabetic patient panels while providing a meaningful statistical basis for performance assessment.
How is data submitted?
Digital submission — CSV file or FHIR format. Demographic data via questionnaire. Practices need EHR systems capable of generating the required formats. IHS helps prepare compliant data files and navigate the submission process.
What diabetes care measures does the DRP evaluate?
Core diabetes management processes: glycemic control, blood pressure management, lipid management, nephropathy assessment, retinal examination, foot examination, and smoking cessation counseling. For 2026, three new measures are added: Continuous Glucose Monitoring Utilization, Depression Screening and Follow-Up, and Statin Therapy Prescription — all effective January 2026.
What are the new 2026 DRP measures?
Three measures effective January 2026: (1) Continuous Glucose Monitoring Utilization — reflecting growing CGM adoption; (2) Depression Screening and Follow-Up — addressing diabetes/depression comorbidity; (3) Statin Therapy Prescription — addressing cardiovascular risk in diabetic patients. Practices planning 2026 recognition cycles should verify EHR capture capability now.
How often must recognition be renewed?
Annually. DRP recognition requires annual data submission and evaluation. This ensures credentials reflect current performance — not historical data from a prior recognition cycle.
What does NCQA DRP Recognition cost?
Contact NCQA directly for current per-clinician pricing — one of the most accessible fee structures in the NCQA recognition portfolio. Medical groups pursuing recognition for multiple clinicians should calculate total per-clinician cost in advance.
How does DRP Recognition help with value-based care?
Diabetes care quality measures are embedded in virtually every major value-based care program. DRP recognition demonstrates consistent evidence-based practice across the diabetic patient panel — a direct signal for ACO shared savings, Medicare Advantage quality contracts, and commercial value-based arrangements where diabetes measures affect financial outcomes.
Is the DRP co-developed with the ADA?
Yes. Co-developed with the American Diabetes Association, grounding the DRP measure set in the same evidence base as ADA's clinical practice guidelines.
Does DRP Recognition appear in provider directories?
Yes. NCQA publishes recognized clinicians, and payers and health systems reference DRP status in provider directories and quality reporting — providing a verifiable quality signal in health plan provider search tools used by patients selecting diabetes care providers.
How does IHS support DRP recognition?
Eligibility and readiness assessment, data submission preparation, measure performance gap analysis, 2026 measure transition planning, multi-clinician program management, and annual recognition maintenance. Thomas G. Goddard, JD, PhD, former Chief Operating Officer and General Counsel of URAC, leads IHS's recognition consulting practice.
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