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Shortage Designation: HPSAs, MUAs & MUPs

HPSA Designation Criteria, Guidelines & Process

Designation Criteria and Guidelines

Health Professional Shortage Area designations are based on general HPSA designation criteria, plus additional criteria and guidelines specific to each of the three types of designations:

All Federally Qualified Health Centers and those Rural Health Clinics that provide access to care regardless of ability to pay receive automatic facility HPSA designation.

Designation Process

Annual Review
Each year, the U.S. Department of Health and Human Services prepares listings of designated HPSAs and areas that need to be updated to maintain their designation.

The listings are sent to each State Primary Care Office (PCO). Copies are also sent to the Primary Care Associations and other interested parties. The PCOs have a few months to submit designation updates for their States.

After review and consideration of all comments, the Secretary designates Health Professional Shortage Areas (HPSAs) and withdraws the designations of areas determined to no longer meet the criteria for designation.


The PCOs are the primary source for designation requests, and other interested parties are encouraged to work through the PCOS to apply. If another agency or individual submits a request for designation to the Shortage Designation Branch, if it has not been shared with the PCO, the Office of Shortage Designation will forward it to the PCO for their review and input.

Notification and Publication of Designations and Withdrawal

A written notice of a designation (or withdrawal of a designation) is provided at the time of the designation decision to the applicant and other interested parties, including:

  • Governor of the State in which the HPSA is located
  • PCO if they were not the applicant
  • Appropriate professional societies and public or nonprofit agencies and connected to the HPSA

The date the notification letter reflects the date of the designation action.

Related Links

State Primary Care Offices for designation application help and State shortage information

Exchange Visitor Program for physicians with J-1 visas working in HPSAs

National Health Service Corps scholarships & loan repayment in return for service at NHSC-approved sites in greatest-need HPSAs

Medicare PSA/HPSA Physician Bonus