{
  "name": "Certificate of need capital expenditure thresholds by US state",
  "description": "Capital expenditure dollar amounts that trigger certificate-of-need (CON) review in each US state with a CON program. Each record is one state, giving the expenditure threshold by facility type (hospital, long-term care, other), whether the threshold is inflation-adjusted, which facility types and services are covered, whether there is a moratorium on new facilities, and the statute citation. Answers 'how much can I spend on a healthcare facility project in [state] before I need a CON' and 'does [state] require a CON for [hospital beds / imaging equipment / ambulatory surgery centers]'.",
  "url": "https://referencesource.org/state-con-capital-expenditure-thresholds/",
  "licence": "Facts extracted from state government health department pages and NCSL legislative overview; statutory thresholds are not copyrightable",
  "last_verified": "2026-08-13",
  "stale_after": "2027-02-09",
  "sources": [
    "https://www.ncsl.org/health/certificate-of-need-state-laws",
    "https://rpcconsulting.com/potential-certificate-of-need-change-legislation/"
  ],
  "records": [
    {
      "state": "Alabama",
      "has_con_program": "yes",
      "capital_threshold_hospital": "$4,000,000",
      "capital_threshold_ltc": "$4,000,000",
      "capital_threshold_general": "$4,000,000",
      "major_equipment_threshold": "$2,000,000",
      "covered_services": "general hospitals, specialized hospitals, nursing facilities, intermediate care facilities, rehabilitation centers, hospice service providers, home health agencies, HMOs, ambulatory surgery centers, kidney disease treatment centers",
      "moratorium": "no",
      "statute_citation": "Ala. Code \u00a7 22-21-260",
      "id": "alabama",
      "url": "https://referencesource.org/state-con-capital-expenditure-thresholds/alabama/",
      "source": "https://www.ncsl.org/health/certificate-of-need-state-laws",
      "source_quote": "Capital expenditures greater than: $2,000,000 for major medical equipment. $800,000 for new annual operating costs. $4,000,000 for any other capital expenditures.",
      "verified_fields": [
        "capital_threshold_general",
        "capital_threshold_hospital",
        "capital_threshold_ltc",
        "major_equipment_threshold"
      ]
    },
    {
      "state": "Alaska",
      "has_con_program": "yes",
      "capital_threshold_hospital": "$1,000,000",
      "capital_threshold_ltc": "$1,000,000",
      "capital_threshold_general": "$1,000,000",
      "covered_services": "hospitals, psychiatric hospitals, independent diagnostic testing facilities, residential psychiatric treatment centers, skilled nursing facilities, kidney disease treatment centers, intermediate care facilities, ambulatory surgical facilities",
      "moratorium": "no",
      "statute_citation": "Alaska Stat. \u00a7 18-07-31 et seq.",
      "id": "alaska",
      "url": "https://referencesource.org/state-con-capital-expenditure-thresholds/alaska/",
      "source": "https://www.ncsl.org/health/certificate-of-need-state-laws",
      "source_quote": "Capital expenditures greater than $1 million that include: Constructing a new health care facility. Altering the bed capacity of a health care facility. Adding a new category of health services provided at the facility. Converting a building or part of a building to a nursing home requiring state licensure."
    },
    {
      "state": "Arizona",
      "has_con_program": "no",
      "moratorium": "no",
      "id": "arizona",
      "url": "https://referencesource.org/state-con-capital-expenditure-thresholds/arizona/",
      "source": "https://www.ncsl.org/health/certificate-of-need-state-laws",
      "source_quote": "Although Arizona does not operate an official CON program, the state requires an application for ambulance services and ambulances to be filed with the Department of Health Services, Bureau of Emergency Medical Services & Trauma System",
      "verified_fields": [
        "state"
      ]
    },
    {
      "state": "Arkansas",
      "has_con_program": "yes",
      "covered_services": "nursing home facilities, residential care facilities, assisted living facilities, post-acute head injury retraining facilities, home health care services agencies",
      "moratorium": "Constructing a new residential care facility. Replacing a residential care facility with 16 beds or more. Adding new beds or expanding existing bed capacity for residential care facilities.",
      "statute_citation": "Ark. Stat. Ann. \u00a7 20-8-109 et seq.",
      "id": "arkansas",
      "url": "https://referencesource.org/state-con-capital-expenditure-thresholds/arkansas/",
      "source": "https://www.ncsl.org/health/certificate-of-need-state-laws",
      "source_quote": "Constructing a nursing home. Adding new long-term care beds or expanding existing long-term care bed capacity. Adding or expanding home health services. Creating hospice programs."
    },
    {
      "state": "California",
      "has_con_program": "no",
      "moratorium": "no",
      "id": "california",
      "url": "https://referencesource.org/state-con-capital-expenditure-thresholds/california/",
      "source": "https://www.ncsl.org/health/certificate-of-need-state-laws",
      "source_quote": "Certificate of Need Law | No",
      "verified_fields": [
        "has_con_program",
        "moratorium"
      ]
    },
    {
      "state": "Colorado",
      "has_con_program": "no",
      "moratorium": "no",
      "id": "colorado",
      "url": "https://referencesource.org/state-con-capital-expenditure-thresholds/colorado/",
      "source": "https://www.ncsl.org/health/certificate-of-need-state-laws",
      "source_quote": "Certificate of Need Law | No",
      "verified_fields": [
        "has_con_program",
        "moratorium"
      ]
    },
    {
      "state": "Connecticut",
      "has_con_program": "yes",
      "covered_services": "hospitals, specialty hospitals, free-standing emergency departments, outpatient surgical facilities, mental health facilities, substance abuse treatment facilities, nursing homes, rest homes, residential care homes",
      "moratorium": "no",
      "statute_citation": "Conn. Gen. Stat. \u00a7 19a-638 (General Health Facilities) | Conn Gen. Stat. 17b-352 (Long Term Care Facilities)",
      "id": "connecticut",
      "url": "https://referencesource.org/state-con-capital-expenditure-thresholds/connecticut/",
      "source": "https://www.ncsl.org/health/certificate-of-need-state-laws",
      "source_quote": "Capital expenditures exceeding a certain statutory limit."
    },
    {
      "state": "Delaware",
      "has_con_program": "yes",
      "capital_threshold_hospital": "$5,800,000",
      "capital_threshold_ltc": "$5,800,000",
      "capital_threshold_general": "$5,800,000",
      "inflation_adjusted": "yes",
      "covered_services": "hospitals, nursing homes, free-standing birthing centers, free-standing surgical centers, free-standing acute inpatient rehabilitation hospitals, free-standing emergency centers, continual care community and other non-traditional long-term care facilities",
      "statute_citation": "Del. Code Ann. Tit. 16 \u00a7 9301 et seq.",
      "id": "delaware",
      "url": "https://referencesource.org/state-con-capital-expenditure-thresholds/delaware/",
      "source": "https://www.ncsl.org/health/certificate-of-need-state-laws",
      "source_quote": "Capital expenditures greater than $5.8 million or another amount adjusted for inflation."
    },
    {
      "state": "Florida",
      "has_con_program": "yes",
      "covered_services": "skilled nursing facilities, hospices, intermediate care facilities for the developmentally disabled",
      "statute_citation": "Fla. Stat. \u00a7 408.031 et seq.",
      "id": "florida",
      "url": "https://referencesource.org/state-con-capital-expenditure-thresholds/florida/",
      "source": "https://www.ncsl.org/health/certificate-of-need-state-laws",
      "source_quote": "Adding beds to community nursing homes or intermediate care facilities for the developmentally disabled. Constructing or establishing additional health care facilities. Converting from one type of health facility another. Establishing a hospice or hospice inpatient facility.",
      "verified_fields": [
        "covered_services"
      ]
    },
    {
      "state": "Georgia",
      "has_con_program": "yes",
      "capital_threshold_hospital": "$10,000,000",
      "capital_threshold_ltc": "$10,000,000",
      "capital_threshold_general": "$10,000,000",
      "covered_services": "hospitals, destination cancer hospitals, skilled nursing facilities, intermediate care facilities, personal care homes, ambulatory surgical facilities, obstetrical facilities, free-standing emergency departments, HMOs, home health agencies, diagnostic, treatment and rehabilitation centers",
      "statute_citation": "Ga. Code \u00a7 31-6-40 et seq.",
      "id": "georgia",
      "url": "https://referencesource.org/state-con-capital-expenditure-thresholds/georgia/",
      "source": "https://www.ncsl.org/health/certificate-of-need-state-laws",
      "source_quote": "Capital expenditures more than $10 million."
    },
    {
      "state": "Hawaii",
      "has_con_program": "yes",
      "covered_services": "hospitals, surgical centers, extended care and rehabilitation centers, nursing homes, skilled nursing facilities, intermediate care facilities, hospices, kidney disease treatment centers, outpatient clinics, ambulatory health care facilities, emergency care facilities, home health agencies, HMOs",
      "moratorium": "no",
      "statute_citation": "Hawaii Rev. Stat. \u00a7 323D-42 et seq.",
      "id": "hawaii",
      "url": "https://referencesource.org/state-con-capital-expenditure-thresholds/hawaii/",
      "source": "https://www.ncsl.org/health/certificate-of-need-state-laws",
      "source_quote": "Constructing, expanding, altering, converting, developing, initiating or modifying a health care facility or health care services that exceeds the capital expenditure minimum."
    },
    {
      "state": "Idaho",
      "has_con_program": "no",
      "moratorium": "no",
      "id": "idaho",
      "url": "https://referencesource.org/state-con-capital-expenditure-thresholds/idaho/",
      "source": "https://www.ncsl.org/health/certificate-of-need-state-laws",
      "source_quote": "Certificate of Need Law | No",
      "verified_fields": [
        "has_con_program",
        "moratorium"
      ]
    },
    {
      "state": "Illinois",
      "has_con_program": "yes",
      "covered_services": "hospitals, long-term care facilities, dialysis centers, ambulatory surgery centers, alternative health care delivery models, free-standing emergency centers, birthing centers",
      "moratorium": "no",
      "statute_citation": "Ill. Rev. Stat. ch. 20, \u00a7 3960/1 et. seq.",
      "id": "illinois",
      "url": "https://referencesource.org/state-con-capital-expenditure-thresholds/illinois/",
      "source": "https://www.ncsl.org/health/certificate-of-need-state-laws",
      "source_quote": "Constructing or modifying by or on behalf of a health care facility that exceeds the capital expenditure minimum. Acquiring and housing major medical equipment."
    },
    {
      "state": "Indiana",
      "has_con_program": "yes",
      "covered_services": "comprehensive care facilities (nursing homes)",
      "moratorium": "no",
      "statute_citation": "Ind. Code \u00a7 16-29-7 et seq.",
      "id": "indiana",
      "url": "https://referencesource.org/state-con-capital-expenditure-thresholds/indiana/",
      "source": "https://www.ncsl.org/health/certificate-of-need-state-laws",
      "source_quote": "Building, developing or establishing a new health care facility. Moving an existing health care facility to another county. Relocating beds from one facility to another. Changing the comprehensive bed capacity of a health care facility."
    },
    {
      "state": "Iowa",
      "has_con_program": "yes",
      "capital_threshold_hospital": "$1,500,000",
      "capital_threshold_ltc": "$1,500,000",
      "capital_threshold_general": "$1,500,000",
      "major_equipment_threshold": "$1,500,000",
      "covered_services": "hospitals, residential care facilities, nursing facilities, intermediate care facilities, outpatient surgical facilities, community mental health facilities, birthing centers",
      "moratorium": "no",
      "statute_citation": "Iowa Code \u00a7 135.61 et seq.",
      "id": "iowa",
      "url": "https://referencesource.org/state-con-capital-expenditure-thresholds/iowa/",
      "source": "https://www.ncsl.org/health/certificate-of-need-state-laws",
      "source_quote": "No | Additional Comments | After having initially repealed their CON program, Indiana re-established a CON program in 2018 pursuant to <http://iga.in.gov/legislative/2018/bills/senate/190#digest-heading> SB 190 . | Iowa Iowa Health Care Facility Licensing/Certification Agency |",
      "verified_fields": [
        "moratorium",
        "state"
      ]
    },
    {
      "state": "Kansas",
      "has_con_program": "no",
      "moratorium": "no",
      "id": "kansas",
      "url": "https://referencesource.org/state-con-capital-expenditure-thresholds/kansas/",
      "source": "https://www.ncsl.org/health/certificate-of-need-state-laws",
      "source_quote": "Certificate of Need Law | No",
      "verified_fields": [
        "has_con_program",
        "moratorium"
      ]
    },
    {
      "state": "Kentucky",
      "has_con_program": "yes",
      "covered_services": "hospitals, psychiatric hospitals, physical rehabilitation hospitals, chemical dependency programs, nursing facilities, nursing homes, personal care homes, intermediate care facilities, outpatient clinics, ambulatory care facilities, ambulatory surgical centers, emergency care centers, ambulance providers, hospices, community mental health centers, home health agencies, kidney disease treatment centers",
      "moratorium": "no",
      "statute_citation": "Ky. Rev. Stat. \u00a7 216B.020 et seq.",
      "id": "kentucky",
      "url": "https://referencesource.org/state-con-capital-expenditure-thresholds/kentucky/",
      "source": "https://www.ncsl.org/health/certificate-of-need-state-laws",
      "source_quote": "Obligating a capital expenditure which exceed the capital expenditure minimum."
    },
    {
      "state": "Louisiana",
      "has_con_program": "yes",
      "covered_services": "nursing facilities, intermediate care facilities for persons with developmental disabilities, home- and community-based service providers, hospice providers, pediatric day health care facilities, behavioral health services providers, opioid treatment programs",
      "moratorium": "Intermediate care facilities for the developmentally disabled. Nursing facilities (until July 1, 2027).",
      "statute_citation": "La. Rev. Stat. Ann. \u00a7 2116",
      "id": "louisiana",
      "url": "https://referencesource.org/state-con-capital-expenditure-thresholds/louisiana/",
      "source": "https://www.ncsl.org/health/certificate-of-need-state-laws",
      "source_quote": "The Louisiana Department of Health notes it operates a Facility Need Review (FNR) process rather than a Certificate of Need program. However, most researchers identify Louisiana as a CON state, because its FNR process operates similar to that of a CON program.",
      "verified_fields": [
        "state"
      ]
    },
    {
      "state": "Maine",
      "has_con_program": "yes",
      "capital_threshold_hospital": "$10,000,000",
      "capital_threshold_ltc": "$10,000,000",
      "capital_threshold_general": "$10,000,000",
      "covered_services": "hospitals, psychiatric hospitals, nursing facilities, kidney disease treatment centers, rehabilitation facilities, ambulatory surgical facilities, independent radiological service centers, independent cardiac catheterization centers, cancer treatment centers",
      "moratorium": "no",
      "statute_citation": "Me. Rev. Stat. Ann. Tit. 22, Chapter 103-A et seq.",
      "id": "maine",
      "url": "https://referencesource.org/state-con-capital-expenditure-thresholds/maine/",
      "source": "https://www.ncsl.org/health/certificate-of-need-state-laws",
      "source_quote": "Capital expenditures of $10 million or more."
    },
    {
      "state": "Maryland",
      "has_con_program": "yes",
      "capital_threshold_hospital": "lesser of 25% of the hospital's gross regulated charges for the preceding year or $50 million",
      "covered_services": "hospitals, limited-service hospitals, related institutions providing domiciliary, personal or nursing care, ambulatory surgical facilities, rehabilitation facilities, home health agencies, hospices",
      "moratorium": "no",
      "statute_citation": "Md. Health Code Ann. \u00a7 19-120 et seq.",
      "id": "maryland",
      "url": "https://referencesource.org/state-con-capital-expenditure-thresholds/maryland/",
      "source": "https://www.ncsl.org/health/certificate-of-need-state-laws",
      "source_quote": "No | Additional Comments | N/A | Maryland Maryland Health Care Facility Licensing/Certification Agency |",
      "verified_fields": [
        "moratorium",
        "state"
      ]
    },
    {
      "state": "Massachusetts",
      "has_con_program": "yes",
      "major_equipment_threshold": "$250,000",
      "covered_services": "hospitals or clinics, long-term care facilities, clinical laboratories, public medical institutions",
      "moratorium": "no",
      "statute_citation": "Mass. Gen. Laws Ann. ch. 111 \u00a725C et seq.",
      "id": "massachusetts",
      "url": "https://referencesource.org/state-con-capital-expenditure-thresholds/massachusetts/",
      "source": "https://www.ncsl.org/health/certificate-of-need-state-laws",
      "source_quote": "Substantial capital expenditures for constructing or substantially changing health services. Acquiring medical equipment for more than $250,000.",
      "verified_fields": [
        "major_equipment_threshold"
      ]
    },
    {
      "state": "Michigan",
      "has_con_program": "yes",
      "covered_services": "hospitals, psychiatric hospitals or psychiatric units, nursing homes or hospital long-term care units, free-standing surgical outpatient facilities, HMOs",
      "moratorium": "no",
      "statute_citation": "Mich. Comp. Laws \u00a7 333.22201 et seq.",
      "id": "michigan",
      "url": "https://referencesource.org/state-con-capital-expenditure-thresholds/michigan/",
      "source": "https://www.ncsl.org/health/certificate-of-need-state-laws",
      "source_quote": "Making a covered capital expenditure that exceeds the capital expenditure threshold."
    },
    {
      "state": "Minnesota",
      "has_con_program": "no",
      "moratorium": "Hospitals and hospital beds (Minn. Stat. \u00a7 144.551). Nursing home beds (Minn. Stat. \u00a7 144A.071). Intermediate care facilities for persons with developmental disabilities (Minn. Stat. \u00a7 252.291). Radiation therapy facilities in certain counties (Minn. Stat. \u00a7 144.5509).",
      "id": "minnesota",
      "url": "https://referencesource.org/state-con-capital-expenditure-thresholds/minnesota/",
      "source": "https://www.ncsl.org/health/certificate-of-need-state-laws",
      "source_quote": "Minnesota does not operate a CON program. However, the state maintains moratoriums and processes for exceptions to moratorium for several health facilities.",
      "verified_fields": [
        "state"
      ]
    },
    {
      "state": "Mississippi",
      "has_con_program": "yes",
      "covered_services": "hospitals, psychiatric hospitals, chemical dependency hospitals, skilled nursing facilities, end-stage renal disease facilities, intermediate care facilities, ambulatory surgical facilities, home health agencies, psychiatric residential treatment facilities, pediatric skilled nursing facilities, long-term care hospitals, comprehensive medical rehabilitation facilities",
      "moratorium": "Skilled nursing facilities. Intermediate care facilities. Converting hospitals beds to skilled or intermediate nursing home care. Medicaid-certified child/adolescent psychiatric or chemical dependency beds. Intermediate care facilities for the intellectually disabled.",
      "statute_citation": "Miss. Code Ann. \u00a7 41-7-171 et seq.",
      "id": "mississippi",
      "url": "https://referencesource.org/state-con-capital-expenditure-thresholds/mississippi/",
      "source": "https://www.ncsl.org/health/certificate-of-need-state-laws",
      "source_quote": "Constructing, developing or establishing a new health care facility. Relocating a health facility. Relocating major medical equipment to a site more than a mile away. Changing bed complement. Offering covered services not offered in previous 12 months.",
      "also_reported": [
        {
          "field": "capital_threshold_hospital",
          "value": "$5,000,000",
          "source": "https://rpcconsulting.com/potential-certificate-of-need-change-legislation/",
          "source_quote": "The new law raised the minimum dollar amount for capital expenditures requiring a CON from $2 million to $5 million, and the threshold for the acquisition of major medical equipment requiring a CON from $1.5 million to $3.5 million.",
          "as_of": "2026-08-13"
        },
        {
          "field": "capital_threshold_ltc",
          "value": "$5,000,000",
          "source": "https://rpcconsulting.com/potential-certificate-of-need-change-legislation/",
          "source_quote": "The new law raised the minimum dollar amount for capital expenditures requiring a CON from $2 million to $5 million, and the threshold for the acquisition of major medical equipment requiring a CON from $1.5 million to $3.5 million.",
          "as_of": "2026-08-13"
        },
        {
          "field": "capital_threshold_general",
          "value": "$5,000,000",
          "source": "https://rpcconsulting.com/potential-certificate-of-need-change-legislation/",
          "source_quote": "The new law raised the minimum dollar amount for capital expenditures requiring a CON from $2 million to $5 million, and the threshold for the acquisition of major medical equipment requiring a CON from $1.5 million to $3.5 million.",
          "as_of": "2026-08-13"
        },
        {
          "field": "major_equipment_threshold",
          "value": "$3,500,000",
          "source": "https://rpcconsulting.com/potential-certificate-of-need-change-legislation/",
          "source_quote": "The new law raised the minimum dollar amount for capital expenditures requiring a CON from $2 million to $5 million, and the threshold for the acquisition of major medical equipment requiring a CON from $1.5 million to $3.5 million.",
          "as_of": "2026-08-13"
        }
      ],
      "disagreements": []
    },
    {
      "state": "Missouri",
      "has_con_program": "yes",
      "covered_services": "hospitals, residential care facilities, assisted living facilities, intermediate care facilities, skilled nursing facilities, long-term care beds in a hospital, long-term care hospitals",
      "moratorium": "no",
      "statute_citation": "Mo. Rev. Stat. \u00a7 197.300 et seq.",
      "id": "missouri",
      "url": "https://referencesource.org/state-con-capital-expenditure-thresholds/missouri/",
      "source": "https://www.ncsl.org/health/certificate-of-need-state-laws",
      "source_quote": "Developing a new health care facility. Acquiring, including by lease, any health care facility or major medical equipment. Capital expenditures by or on behalf of a health care facility. Predevelopment activities costing more than $150,000."
    },
    {
      "state": "Montana",
      "has_con_program": "yes",
      "capital_threshold_ltc": "$1,500,000",
      "capital_threshold_general": "$1,500,000",
      "covered_services": "long-term care facilities",
      "moratorium": "no",
      "statute_citation": "Mont. Code Ann. \u00a7 50-5-301 et seq.",
      "id": "montana",
      "url": "https://referencesource.org/state-con-capital-expenditure-thresholds/montana/",
      "source": "https://www.ncsl.org/health/certificate-of-need-state-laws",
      "source_quote": "Capital expenditures over $1.5 million. Changing bed capacity of a capacity of a facility through an increase in number, or relocation, of beds. Adding health services associated with annual operating expenses of $150,000 or more."
    },
    {
      "state": "Nebraska",
      "has_con_program": "yes",
      "covered_services": "skilled nursing facilities, intermediate care facilities, nursing facilities, long-term care hospitals",
      "moratorium": "Long-term care beds.",
      "statute_citation": "Neb. Rev. Stat. \u00a7 71-5829 et seq.",
      "id": "nebraska",
      "url": "https://referencesource.org/state-con-capital-expenditure-thresholds/nebraska/",
      "source": "https://www.ncsl.org/health/certificate-of-need-state-laws",
      "source_quote": "Establishing long-term care beds. Increasing the long-term beds of a health facility by more than 10 or more than 10% of total beds in the facility. Establishing long-term beds through conversion by a hospital.",
      "verified_fields": [
        "moratorium"
      ]
    },
    {
      "state": "Nevada",
      "has_con_program": "yes",
      "capital_threshold_general": "$2,000,000",
      "covered_services": "health facilities broadly defined as a facility in or through which health services are provided",
      "moratorium": "no",
      "statute_citation": "Nev. Rev. Stat. \u00a7 439A.100 et seq.",
      "id": "nevada",
      "url": "https://referencesource.org/state-con-capital-expenditure-thresholds/nevada/",
      "source": "https://www.ncsl.org/health/certificate-of-need-state-laws",
      "source_quote": "Capital expenditures above $2 million for constructing a new health care facility in rural counties. Construction is defined to include increasing the square footage to an existing health care facility or redesigning/renovating an existing building currently not used by a health facility."
    },
    {
      "state": "New Hampshire",
      "has_con_program": "no",
      "moratorium": "no",
      "id": "new-hampshire",
      "url": "https://referencesource.org/state-con-capital-expenditure-thresholds/new-hampshire/",
      "source": "https://www.ncsl.org/health/certificate-of-need-state-laws",
      "source_quote": "New Hampshire repealed its CON program in 2016 pursuant to SB 481 and switched to a specialized licensure process for certain health facility projects, including establishing cardiac catheterization, open heart surgery and megavoltage radiation therapy services.",
      "verified_fields": [
        "state"
      ]
    },
    {
      "state": "New Jersey",
      "has_con_program": "yes",
      "capital_threshold_hospital": "$2,000,000",
      "capital_threshold_ltc": "$2,000,000",
      "capital_threshold_general": "$2,000,000",
      "major_equipment_threshold": "$2,000,000",
      "covered_services": "general hospitals, special hospitals, mental hospitals, public health centers, diagnostic centers, treatment centers, rehabilitation centers, extended care facilities, skilled nursing homes, intermediate care facilities, assisted living residences, comprehensive personal care facilities, outpatient clinics, home health care agencies, residential health care facilities, bioanalytical laboratories",
      "moratorium": "no",
      "statute_citation": "N.J. Rev. Stat. \u00a726-2H-7 et seq.",
      "id": "new-jersey",
      "url": "https://referencesource.org/state-con-capital-expenditure-thresholds/new-jersey/",
      "source": "https://www.ncsl.org/health/certificate-of-need-state-laws",
      "source_quote": "Purchasing major medical equipment exceeding $2 million. Capital expenditures exceeding $2 million."
    },
    {
      "state": "New Mexico",
      "has_con_program": "no",
      "moratorium": "no",
      "id": "new-mexico",
      "url": "https://referencesource.org/state-con-capital-expenditure-thresholds/new-mexico/",
      "source": "https://www.ncsl.org/health/certificate-of-need-state-laws",
      "source_quote": "Certificate of Need Law | No",
      "verified_fields": [
        "has_con_program",
        "moratorium"
      ]
    },
    {
      "state": "New York",
      "has_con_program": "yes",
      "covered_services": "hospitals, nursing homes, diagnostic and treatment centers, ambulatory surgery centers, certified home health agencies, long term home health care programs, hospices, adult care facilities, adult day health care programs",
      "moratorium": "no",
      "statute_citation": "N.Y. Public Health Law \u00a7 2802 et seq.",
      "id": "new-york",
      "url": "https://referencesource.org/state-con-capital-expenditure-thresholds/new-york/",
      "source": "https://www.ncsl.org/health/certificate-of-need-state-laws",
      "source_quote": "Establishing or constructing new facilities, agencies, programs or hospices. Renovating existing facilities, agencies, programs or hospices. Acquiring major medical equipment. Adding or deleting health care services."
    },
    {
      "state": "North Carolina",
      "has_con_program": "yes",
      "covered_services": "hospitals, long-term care hospitals, psychiatric facilities, rehabilitation facilities, nursing home facilities, adult care homes, kidney disease treatment centers, intermediate care facilities, home health agency offices, chemical dependency treatment facilities, diagnostic centers, hospice offices, hospice inpatient facilities, ambulatory surgical facilities",
      "moratorium": "no",
      "statute_citation": "N.C. Gen. Stat. \u00a7 131E-175 et seq.",
      "id": "north-carolina",
      "url": "https://referencesource.org/state-con-capital-expenditure-thresholds/north-carolina/",
      "source": "https://www.ncsl.org/health/certificate-of-need-state-laws",
      "source_quote": "No | Additional Comments | N/A | North Carolina North Carolina Health Care Facility Licensing/Certification Agency |",
      "verified_fields": [
        "moratorium",
        "state"
      ]
    },
    {
      "state": "North Dakota",
      "has_con_program": "no",
      "moratorium": "no",
      "id": "north-dakota",
      "url": "https://referencesource.org/state-con-capital-expenditure-thresholds/north-dakota/",
      "source": "https://www.ncsl.org/health/certificate-of-need-state-laws",
      "source_quote": "Certificate of Need Law | No",
      "verified_fields": [
        "has_con_program",
        "moratorium"
      ]
    },
    {
      "state": "Ohio",
      "has_con_program": "yes",
      "capital_threshold_ltc": "$4,000,000",
      "covered_services": "long-term care facilities",
      "moratorium": "Long-term care beds.",
      "statute_citation": "Ohio Rev. Code Ann. \u00a7 3701-12-01 et seq.",
      "id": "ohio",
      "url": "https://referencesource.org/state-con-capital-expenditure-thresholds/ohio/",
      "source": "https://www.ncsl.org/health/certificate-of-need-state-laws",
      "source_quote": "Renovating or adding to a long-term care facility involving a capital expenditure of $4 million or more."
    },
    {
      "state": "Oklahoma",
      "has_con_program": "yes",
      "capital_threshold_ltc": "$1,000,000",
      "capital_threshold_general": "$1,000,000",
      "covered_services": "long-term care facilities, specialized facilities for developmentally disabled clients, hospital-based skilled nursing units",
      "moratorium": "no",
      "statute_citation": "Okla. Stat. Tit. 63 \u00a7 1-850 et seq.",
      "id": "oklahoma",
      "url": "https://referencesource.org/state-con-capital-expenditure-thresholds/oklahoma/",
      "source": "https://www.ncsl.org/health/certificate-of-need-state-laws",
      "source_quote": "Capital expenditures greater than $1,000,000 or more.",
      "verified_fields": [
        "capital_threshold_general",
        "capital_threshold_ltc"
      ]
    },
    {
      "state": "Oregon",
      "has_con_program": "yes",
      "covered_services": "hospitals, skilled nursing facilities, intermediate care facilities, long-term care facilities, health facilities established by a health maintenance organization",
      "moratorium": "no",
      "statute_citation": "Or. Rev. Stat. \u00a7 442-015 et seq.",
      "id": "oregon",
      "url": "https://referencesource.org/state-con-capital-expenditure-thresholds/oregon/",
      "source": "https://www.ncsl.org/health/certificate-of-need-state-laws",
      "source_quote": "No | Additional Comments | N/A | Oregon Oregon Health Care Facility Licensing/Certification Agency |",
      "verified_fields": [
        "moratorium",
        "state"
      ]
    },
    {
      "state": "Pennsylvania",
      "has_con_program": "no",
      "moratorium": "no",
      "id": "pennsylvania",
      "url": "https://referencesource.org/state-con-capital-expenditure-thresholds/pennsylvania/",
      "source": "https://www.ncsl.org/health/certificate-of-need-state-laws",
      "source_quote": "Certificate of Need Law | No",
      "verified_fields": [
        "has_con_program",
        "moratorium"
      ]
    },
    {
      "state": "Rhode Island",
      "has_con_program": "yes",
      "covered_services": "hospitals, nursing facilities, home nursing-care providers, home care providers, hospice providers, inpatient rehabilitation centers, free-standing emergency care facilities, facilities providing surgical treatment to patients not requiring hospitalization, facilities providing inpatient hospice care",
      "moratorium": "New nursing facilities, nursing facility licensed beds, and increases in capacity of licensed nursing facilities (until July 1, 2022).",
      "statute_citation": "R.I. Gen. Laws \u00a7 23-15-2 et seq.",
      "id": "rhode-island",
      "url": "https://referencesource.org/state-con-capital-expenditure-thresholds/rhode-island/",
      "source": "https://www.ncsl.org/health/certificate-of-need-state-laws",
      "source_quote": "Developing or establishing a new health care facility above a specified capital expenditure threshold. Offering services with a new piece of health care equipment above a specified capital expenditure threshold."
    },
    {
      "state": "South Carolina",
      "has_con_program": "yes",
      "capital_threshold_hospital": "$5,000,000",
      "capital_threshold_ltc": "$5,000,000",
      "capital_threshold_general": "$5,000,000",
      "major_equipment_threshold": "$1,500,000",
      "covered_services": "hospitals (except hospital care at home programs), nursing homes",
      "moratorium": "no",
      "statute_citation": "S.C. Code Ann. \u00a7 44-7-110 et seq.",
      "id": "south-carolina",
      "url": "https://referencesource.org/state-con-capital-expenditure-thresholds/south-carolina/",
      "source": "https://www.ncsl.org/health/certificate-of-need-state-laws",
      "source_quote": "Capital expenditures greater than $5 million."
    },
    {
      "state": "South Dakota",
      "has_con_program": "no",
      "moratorium": "no",
      "id": "south-dakota",
      "url": "https://referencesource.org/state-con-capital-expenditure-thresholds/south-dakota/",
      "source": "https://www.ncsl.org/health/certificate-of-need-state-laws",
      "source_quote": "Certificate of Need Law | No",
      "verified_fields": [
        "has_con_program",
        "moratorium"
      ]
    },
    {
      "state": "Tennessee",
      "has_con_program": "yes",
      "covered_services": "nursing homes, recuperation centers, hospitals, ambulatory surgical treatment centers (to be exempted effective December 2027), mental health hospitals, intellectual disability institutional habilitation facilities (to be exempted effective December 2025), home care organizations, outpatient diagnostic centers, rehabilitation facilities, residential hospices, nonresidential substitution-based treatment center for opiate addiction, long-term care hospitals (to be exempted effective December 2027)",
      "moratorium": "no",
      "statute_citation": "Tenn. Code Ann. \u00a7 68-11-1602 et seq.",
      "id": "tennessee",
      "url": "https://referencesource.org/state-con-capital-expenditure-thresholds/tennessee/",
      "source": "https://www.ncsl.org/health/certificate-of-need-state-laws",
      "source_quote": "Constructing, developing or establishing a health care facility. Changing the licensed bed complement of a facility."
    },
    {
      "state": "Texas",
      "has_con_program": "no",
      "moratorium": "no",
      "id": "texas",
      "url": "https://referencesource.org/state-con-capital-expenditure-thresholds/texas/",
      "source": "https://www.ncsl.org/health/certificate-of-need-state-laws",
      "source_quote": "Certificate of Need Law | No",
      "verified_fields": [
        "has_con_program",
        "moratorium"
      ]
    },
    {
      "state": "Utah",
      "has_con_program": "no",
      "moratorium": "no",
      "id": "utah",
      "url": "https://referencesource.org/state-con-capital-expenditure-thresholds/utah/",
      "source": "https://www.ncsl.org/health/certificate-of-need-state-laws",
      "source_quote": "Certificate of Need Law | No",
      "verified_fields": [
        "has_con_program",
        "moratorium"
      ]
    },
    {
      "state": "Vermont",
      "has_con_program": "yes",
      "major_equipment_threshold": "$1,000,000",
      "covered_services": "general hospitals, mental hospitals, chronic disease facilities, birthing centers, maternity hospitals, psychiatric facilities, nursing homes, HMOs, home health agencies, outpatient diagnostic or therapy programs, kidney disease treatment centers, mental health agencies or centers, diagnostic imaging facilities, independent diagnostic laboratories, cardiac catheterizations laboratories, radiation therapy facilities, ambulatory surgical, diagnostic or treatment centers",
      "moratorium": "No certificate of need can be granted for the offering of home health services, which includes hospices or new home health agencies, through Jan. 1, 2025, or until the General Assembly lifts the moratorium.",
      "statute_citation": "Vt. Stat. Ann. Tit. 18 V.S.A., \u00a7 9432 et seq.",
      "id": "vermont",
      "url": "https://referencesource.org/state-con-capital-expenditure-thresholds/vermont/",
      "source": "https://www.ncsl.org/health/certificate-of-need-state-laws",
      "source_quote": "Purchasing, leasing or other comparable arrangement of a single piece of diagnostic and therapeutic equipment greater than $1 million. Offering a health care service or technology with an annual operating expense greater than $500,000."
    },
    {
      "state": "Virginia",
      "has_con_program": "yes",
      "capital_threshold_hospital": "$5,000,000",
      "capital_threshold_ltc": "$15,000,000",
      "capital_threshold_general": "$15,000,000",
      "covered_services": "general hospitals, sanitariums, nursing homes, intermediate care facilities, extended care facilities, mental hospitals, facilities for individuals with developmental disabilities, psychiatric hospitals, rehabilitation hospitals, ambulatory surgery centers, cardiac catheterization centers, CT scanning centers, MRI centers, PET scanning centers, radiation therapy centers",
      "moratorium": "None, but Certificates of Public Need for an increase in nursing beds are subject to the department issuing a request for applications for an increase in beds.",
      "statute_citation": "Va. Code \u00a732.1-102.1 et seq.",
      "id": "virginia",
      "url": "https://referencesource.org/state-con-capital-expenditure-thresholds/virginia/",
      "source": "https://www.ncsl.org/health/certificate-of-need-state-laws",
      "source_quote": "Capital expenditures of $15 million or more by a non-hospital facility and $5 million or more by a hospital."
    },
    {
      "state": "Washington",
      "has_con_program": "yes",
      "capital_threshold_ltc": "$2,830,000",
      "covered_services": "hospices, hospice care centers, hospitals, psychiatric hospitals, nursing homes, ambulatory surgical facilities, home health agencies",
      "moratorium": "no",
      "statute_citation": "Wash. Rev. Code \u00a770-38-025 et seq.",
      "id": "washington",
      "url": "https://referencesource.org/state-con-capital-expenditure-thresholds/washington/",
      "source": "https://www.ncsl.org/health/certificate-of-need-state-laws",
      "source_quote": "Nursing home capital expenditures greater than $2.83 million."
    },
    {
      "state": "Washington, D.C.",
      "has_con_program": "yes",
      "capital_threshold_hospital": "$6,000,000",
      "capital_threshold_ltc": "$3,500,000",
      "capital_threshold_general": "$3,500,000",
      "major_equipment_threshold": "$3,500,000 (hospital) / $2,000,000 (other facility) / $350,000 (physician or independent owner/operator)",
      "covered_services": "private general hospitals, psychiatric hospitals, other specialty hospitals, rehabilitation facilities, skilled nursing facilities, intermediate care facilities, ambulatory care centers or clinics, ambulatory surgical facilities, kidney disease treatment centers, free-standing hemodialysis facilities, diagnostic health care facilities, home health agencies, hospices",
      "statute_citation": "D.C. Code Ann. \u00a7 44-401 et seq.",
      "id": "washington-d-c",
      "url": "https://referencesource.org/state-con-capital-expenditure-thresholds/washington-d-c/",
      "source": "https://www.ncsl.org/health/certificate-of-need-state-laws",
      "source_quote": "Making capital expenditures of $6 million or more in connection with a hospital and $3.5 million in connection with a health service or health facility. Making a capital expenditure $3.5 million or more by a hospital, or $2 million by a health care facility to acquire major medical equipment. Acquiring by lease, purchase, donation or other comparable arrangement a single piece of diagnostic or therapeutic equipment by or on behalf of a physician, physician group or independent owner/operator. Applies to acquisitions above $350,000.",
      "verified_fields": [
        "major_equipment_threshold"
      ]
    },
    {
      "state": "West Virginia",
      "has_con_program": "yes",
      "covered_services": "public or private facility, agency or entity that offers or provides health services, whether a for-profit or nonprofit entity",
      "moratorium": "New intermediate care or skilled nursing beds. New skilled nursing facilities. New intermediate care beds for persons with intellectual disabilities. Opioid treatment programs (unless it is part of an approved clinical trial and registered with the Board of Pharmacy). In-home personal care services.",
      "statute_citation": "W. Va. Code \u00a716-2D-2 et seq.",
      "id": "west-virginia",
      "url": "https://referencesource.org/state-con-capital-expenditure-thresholds/west-virginia/",
      "source": "https://www.ncsl.org/health/certificate-of-need-state-laws",
      "source_quote": "Adding or expanding health care services. Activities exceeding a certain capital expenditures threshold. Obtaining major medical equipment valued above a certain amount. Developing or acquiring new health care facilities."
    },
    {
      "state": "Wisconsin",
      "has_con_program": "no",
      "moratorium": "Nursing homes are subject to a statewide bed limit. Hospital beds.",
      "id": "wisconsin",
      "url": "https://referencesource.org/state-con-capital-expenditure-thresholds/wisconsin/",
      "source": "https://www.ncsl.org/health/certificate-of-need-state-laws",
      "source_quote": "Wisconsin Wisconsin Health Care Facility Licensing/Certification Agency | <https://www.dhs.wisconsin.gov/regulations/index.htm> Wisconsin Department of Health Services | Certificate of Need Law | No* | Recent Legislative Activity | N/A | Facilities and Activities Overview | Facilities Regulated Under Certificate of Need Laws | N/A | Activities Regulated Under Certificate of Need Law | N/A | Other Requirements | Moratorium | Nursing homes are subject to a statewide bed limit. Hospital beds. |",
      "verified_fields": [
        "has_con_program",
        "moratorium",
        "state"
      ]
    },
    {
      "state": "Wyoming",
      "has_con_program": "no",
      "moratorium": "no",
      "id": "wyoming",
      "url": "https://referencesource.org/state-con-capital-expenditure-thresholds/wyoming/",
      "source": "https://www.ncsl.org/health/certificate-of-need-state-laws",
      "source_quote": "Certificate of Need Law | No",
      "verified_fields": [
        "has_con_program",
        "moratorium"
      ]
    }
  ]
}