North Carolina certificate of need
North Carolina has a certificate of need program, run by NC Department of Health and Human Services, Division of Health Service Regulation, Healthcare Planning and Certificate of Need Section. It covers 8 kinds of services, listed below.
- CON program
- Yes
- Services covered
- 8
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North Carolina CON program
North Carolina has a certificate of need program, run by NC Department of Health and Human Services, Division of Health Service Regulation, Healthcare Planning and Certificate of Need Section. It covers 8 kinds of services, listed below.
- CON program
- Yes
- Program
- Certificate of Need
- Application fee
- $5,000 plus 0.3% of proposed capital expenditure above $1,000,000, capped at $50,000; nonrefundable (G.S. 131E-182(c)).
- Review timeline
- 90-day review from the review start date set by rule; written comments due within 30 days; public hearing within 20 days after comments close when required (competitive review, $5M+ projects, or request by an affected party). The Department may extend review by up to 60 days (G.S. 131E-185).
- Recent changes
- S.L. 2023-7 (2023 Medicaid expansion law) amended the CON definitions in G.S. 131E-176. Ambulatory surgical facilities in counties over 125,000 people ('qualified urban ambulatory surgical facilities') are now carved out of parts of review, and MRI scanners are reviewed only in counties of 125,000 or fewer (2020 census).
- Statute
- N.C.G.S. Chapter 131E, Article 9 (§§131E-175 to 131E-190); State Medical Facilities Plan
Services that need a certificate of need
- new health service facilities (hospitals, nursing homes, adult care homes, kidney disease treatment centers, long-term care hospitals, psychiatric and chemical dependency facilities as defined)
- changes in bed capacity
- capital expenditures over $4,000,000 to develop or expand a health service
- dialysis and home health services new to a facility
- home health agency and hospice offices; hospice, hospice inpatient and hospice residential facilities
- major medical equipment over $2,000,000 and specified services (e.g., MRI only in counties of 125,000 or fewer)
- operating rooms and GI endoscopy rooms; specialty-to-multispecialty ASC conversions
- relocation between service areas; mobile medical equipment
Frequently asked questions
Does North Carolina have a certificate of need law?
North Carolina has a certificate of need program, run by NC Department of Health and Human Services, Division of Health Service Regulation, Healthcare Planning and Certificate of Need Section. It covers 8 kinds of services, listed below.
How long does a North Carolina CON review take?
90-day review from the review start date set by rule; written comments due within 30 days; public hearing within 20 days after comments close when required (competitive review, $5M+ projects, or request by an affected party). The Department may extend review by up to 60 days (G.S. 131E-185).
How much is a North Carolina CON application?
$5,000 plus 0.3% of proposed capital expenditure above $1,000,000, capped at $50,000; nonrefundable (G.S. 131E-182(c)).