Tennessee certificate of need
Tennessee has a certificate of need program, run by Tennessee Health Facilities Commission (HFC). It covers 11 kinds of services, listed below.
- CON program
- Yes
- Services covered
- 11
On this page
Tennessee CON program
Tennessee has a certificate of need program, run by Tennessee Health Facilities Commission (HFC). It covers 11 kinds of services, listed below.
- CON program
- Yes
- Program
- Certificate of Need
- Application fee
- $2.25 per $1,000 of estimated project cost, minimum $3,000 and maximum $45,000; nonrefundable.
- Review timeline
- Application and fee are due by the first of the month after the letter of intent. Once deemed complete, the review cycle is typically 30 days, after which the 15-member Commission hears the application. Commission decisions may be appealed within 15 days in limited circumstances (T.C.A. §68-11-1609(g), §68-11-1610).
- Recent changes
- Under the Commission's current list, ICF/ID institutional habilitation facilities, burn units and neonatal intensive care units no longer need a CON after December 1, 2025. Exceptions now exempt new hospitals in economically distressed counties with no licensed hospital (Lake and Pickett counties for FY2027) and certain limited-scope home health and hospice agencies. Mental health hospitals and residential treatment facilities are excluded from 'healthcare institution.'
- Statute
- T.C.A. §68-11-1601 et seq.; Tenn. Comp. R. & Regs. ch. 0720-10
Services that need a certificate of need
- hospitals
- nursing homes (and nursing home bed increases beyond the lesser of 10 beds or 10% once every 3 years)
- ambulatory surgical treatment centers
- home care organizations (home health and hospice)
- residential hospice
- outpatient diagnostic centers
- rehabilitation facilities
- nonresidential substitution-based opiate treatment centers
- open heart surgery, organ transplantation, cardiac catheterization, linear accelerators
- MRI/PET initiation in counties of 175,000 or fewer; pediatric MRI in larger counties
- bed redistribution/relocation, facility relocation, hospital satellite EDs and satellite inpatient facilities
Frequently asked questions
Does Tennessee have a certificate of need law?
Tennessee has a certificate of need program, run by Tennessee Health Facilities Commission (HFC). It covers 11 kinds of services, listed below.
How long does a Tennessee CON review take?
Application and fee are due by the first of the month after the letter of intent. Once deemed complete, the review cycle is typically 30 days, after which the 15-member Commission hears the application. Commission decisions may be appealed within 15 days in limited circumstances (T.C.A. §68-11-1609(g), §68-11-1610).
How much is a Tennessee CON application?
$2.25 per $1,000 of estimated project cost, minimum $3,000 and maximum $45,000; nonrefundable.