NCQA Virtual Care Accreditation: Frequently Asked Questions

What is NCQA Virtual Care Accreditation?

NCQA Virtual Care Accreditation is a credential awarded by the National Committee for Quality Assurance to organizations delivering or overseeing virtual primary and urgent care. It is purpose-built for virtual care — addressing clinical quality, care coordination, patient safety, technology infrastructure, and outcome measurement for virtual modalities. Organizations can pursue Delivery Accreditation, Oversight Accreditation, or both.

Maureen Plumstead leads IHS's NCQA accreditation work. Thomas G. Goddard, JD, PhD, leads program development to NCQA standards.

What are the two main accreditation tracks?

Virtual Care Delivery Accreditation is for organizations that directly deliver virtual care — virtual-only and hybrid organizations. Virtual Care Delivery Oversight Accreditation is for health plans and organizations overseeing contracted virtual care networks without directly delivering care. Both tracks can be pursued simultaneously.

What are the Primary Care and Urgent Care modules?

Organizations pursuing Delivery Accreditation choose one or both modules. Primary Care addresses longitudinal virtual primary care — chronic disease, preventive care, panel management, care coordination. Urgent Care addresses episodic virtual urgent care — triage, acute care delivery, follow-up, and escalation to in-person care when needed.

Who is eligible?

Virtual-only telehealth organizations, hybrid organizations delivering both virtual and in-person care, health plans overseeing virtual care networks (Oversight track), and employer-sponsored virtual care programs.

How long does accreditation take?

Typically 9 to 12 months from enrollment through accreditation decision. Enroll in Q-PASS approximately 6 to 9 months before your target date.

What does Virtual Care Accreditation evaluate?

Technology infrastructure, virtual clinical workflows, patient safety in remote care environments, care coordination across virtual and in-person touchpoints, QI programs designed for virtual care performance measurement, and health equity reporting including digital access considerations.

Does it address digital equity?

Yes. NCQA requires disparity driver reporting, and for virtual care organizations this includes digital access equity, language accessibility in virtual modalities, and managing the risk that virtual-only care exacerbates disparities for populations with limited technology access or digital literacy.

Can a hybrid organization pursue both tracks?

Yes — organizations can pursue Delivery and Oversight Accreditation simultaneously. A health system that both delivers virtual care and contracts with external virtual providers for network participants could pursue both. IHS evaluates organizational structure to determine the appropriate combination.

Why does Virtual Care Accreditation matter for payer contracting?

Payers, employers, and state regulators are differentiating virtual care vendors on quality dimensions as the market matures. NCQA accreditation provides an objective third-party quality signal used in payer network participation, employer benefit procurement, and state regulatory contexts.

Why do organizations pursue NCQA accreditation in general?

NCQA says it is an independent nonprofit founded in 1990 that began with health plan measurement and accreditation and has measured medical providers and practices since 2008 (NCQA, About NCQA, page opened October 4, 2026). NCQA's Health Plan Accreditation page lists several reasons to pursue it, including meeting state requirements and employer needs and improving care coordination (NCQA, Health Plan Accreditation, page opened October 4, 2026). Whether accreditation matters to you depends on who asks for it, such as a payer contract, a state rule or an employer purchaser, so check those requirements before you decide.

How does it relate to NCQA PCMH Recognition?

PCMH is for primary care practices delivering in-person or hybrid primary care. Virtual Care Accreditation (Primary Care module) is for organizations delivering primary care primarily or exclusively through virtual modalities. Virtual-only primary care organizations should pursue Virtual Care Accreditation, not PCMH.

How does IHS approach Virtual Care Accreditation consulting?

IHS starts with track and module selection, conducts a gap analysis, develops policy and infrastructure, designs the QI program for virtual modalities, integrates equity reporting, conducts a mock review, and supports Q-PASS submission. Maureen Plumstead leads IHS's NCQA accreditation work. Thomas G. Goddard, JD, PhD, former Chief Operating Officer and General Counsel of URAC, leads program development to NCQA standards.