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Certificate of Need

CONCertificate of Need (CON) programs are aimed at restraining health care facility costs and allowing coordinated planning of new services and construction. The basic assumption underlying CON regulation is that excess capacity (in the form of facility overbuilding) directly results in health care price inflation.

Health planning agencies determine the most urgent health care needs and approval of a new or improved facility is based on reviewing the activities and resources of the areas hospitals. Once need is established the applicant group is granted permission to begin a project – these approvals are “Certificates of Need.” Currently, there are 27 states requiring ASCs to get a CON.

  • Alabama
  • Alaska
  • Connecticut
  • Delaware
  • Georgia
  • Hawaii
  • Illinois
  • Iowa
  • Kentucky
  • Maine
  • Maryland
  • Massachusetts
  • Michigan
  • Mississippi


  • Montana
  • Nevada
  • New Hampshire
  • New York
  • North Carolina
  • Rhode Island
  • South Carolina
  • Tennessee
  • Vermont
  • Virginia
  • Washington
  • West Virginia
  • District of Columbia (DC)

 *Disclaimer: Information provided by NCSL ( and subject to change. Please consult your state regulatory body for the most current requirements.