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How to Meet NHSC Site Eligibility Requirements

To become a National Health Service Corps (NHSC)-approved site, your facility must meet the requirements in the NHSC Site Reference Guide (PDF - 643 KB) and NHSC Site Agreement (PDF - 291 KB).

This page provides an overview of NHSC eligibility requirements.

Site types

Review the site types to determine if your site is eligible to become an NHSC-approved site.

Site requirements

Review the NHSC Site Agreement (PDF - 291 KB) and the NHSC Site Reference Guide (PDF - 643 KB) in their entirety. These documents contain the program requirements your site must meet in order to maintain its status as an NHSC-approved site.

The following information is a summary of NHSC site requirements.


The site must:

  • Function as part of a system of care that either offers or assures access to ancillary, inpatient, and specialty referrals.
  • Provide services without regard to:
    • The individual’s inability to pay
    • Whether payment for those services would be made under Medicare, Medicaid, or Children’s Health Insurance Program (CHIP)
    • The individual’s race, color, sex, national origin, disability, religion, age, sexual orientation, or gender identity

Health Professional Shortage Areas (HPSAs)

The site must:

  • Be located in, and treat patients from, a federally designated Health Professional Shortage Area (HPSA).
    • NHSC-approved sites must be in and serve a designated HPSA for the specific category an NHSC clinician would serve to recruit an NHSC clinician. For example, an NHSC-approved site would need a primary care HPSA designation to recruit an internal medicine physician, a mental HPSA designation to recruit a psychiatrist, or a dental HPSA designation to recruit a dentist.
    • Facilities must be located in a designated mental or primary care HPSA if they provide SUD services. For the NHSC SUD Workforce Loan Repayment Program and the NHSC Rural Community Loan Repayment Program, an NHSC site approved for SUD services may use either the primary care or the mental health HPSA scores, even if it does not provide primary care (medical).
    • Centers for Medicaid and Medicare Services-Certified Rural Health Clinics are not required to be in geographic or population Health Professional Shortage Areas to apply for site approval. If their application is approved, we designate their facility HPSAs.
  • Provide culturally competent and linguistically appropriate comprehensive primary care services (medical, dental, and/or behavioral), which correspond to the designated HPSA type.

Payment for services

NHSC sites (with some exceptions) must: 

  • Provide services for free (or, for a nominal charge, consistent with the site's policy) to individuals and families with annual incomes at or below 100% of the most current federal poverty guidelines.
  • Provide services at a discount based on family size and income for individuals and families with incomes above 100% and at or below 200% of the most current federal poverty guidelines.
  • Ensure eligibility for the program is based solely on income and family size. No other factors, such as assets, insurance application and/or coverage, citizenship, or population type, may be used to assess eligibility.
  • Make every reasonable effort to secure payment according to the schedule of fees or schedule of discounts and/or any other third party.
  • Accept assignment for Medicare beneficiaries and have an appropriate agreement with the applicable state agency for Medicaid and CHIP beneficiaries.
  • Prominently display a statement in common areas and on the site's official website and social media platforms (if one exists) that explicitly states that (a) no one will be denied access to services due to inability to pay, and (b) there is a discounted/sliding fee schedule available based on family size and income. This statement should be translated into the appropriate language/dialect when applicable.
  • CAHs must implement the NHSC Sliding Fee Discount Program only for primary care services in the emergency room and outpatient/ambulatory clinic.

Note: If the Sliding Fee Discount Program does not apply to your site, you must provide documentation explaining that no one is charged or billed for services and individuals are not denied service because of their inability to pay.

Clinician recruitment and retention

The site must:

  • Use a clinician credentialing process that, at a minimum, includes reference review, licensure verification, and a query of the National Practitioner Data Bank (NPDB).
  • Adhere to sound fiscal management policies and adopt clinician recruitment and retention policies to help the patient population, the site, and the community obtain maximum benefits.
  • Maintain a clinician recruitment and retention plan, including specific strategies to promote clinician resiliency and reduce burnout.

Primary behavioral and mental health and SUD sites

Sites that provide behavioral and mental health services must demonstrate services provided directly to patients on-site and services provided off-site through referral arrangements. 

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