Certified Urgent Care Criteria

Facilities will receive a Certification of Category 1 or Category 2 depending on their staffing model:

  • Category 1 = licensed physician (MD/DO) on site during all posted hours of operation
  • Category 2 = licensed provider (MD/DO or NP/PA) on site during all posted hours of operation (mixed models)

All facilities, regardless of staffing model, must meet or exceed all of the minimum criteria below.

  1. Facility must accept and advertise that walk-in patients of all ages are accepted for a broad spectrum of illness, injury and disease during all hours the facility is open to see patients.
    • Pediatric specialty centers are exempt from above age requirement IF pediatric-only specialization is included in the name of the facility.
  2. The following must be available during all posted hours of operation for the facility:
    • X-ray on site
    • Phlebotomy services on site
    • Licensed provider on site with the appropriate state licenses and resources to:
      • obtain and read an EKG and x-ray on site o administer PO, IM & IV medication/fluids on site
      • perform minor procedures (ex. sutures, cyst removal, incision & drainage, splinting) on site
    • The following equipment, and staff trained in its use:
      • automated external defibrillator (AED) (or more advanced device)
      • oxygen, Ambu-bag/oral airway
      • drug cart stocked appropriately for patient population (as determined by the facility) o working phone to dial 911
    • At least two exam rooms, separate waiting area and restricted access patient restrooms
  3. Minimum hours of operation (must meet all three criteria)
    • 7 days/week (not including national holidays)
    • 4+ hours each day
    • 3000 hours per year

Alternatively, special circumstances will be considered for a facility if all of the following are met (see application):

  • Facility is part of a multi-center system
  • Facility is open 5+ days/week (not including national holidays)
  • Another facility that is part of the same system meets standard minimum hours of operation criteria [Criteria 3] AND is less than or equal to five miles away

The Certification Committee at its sole discretion may make an occasional exception for “certain religious holidays” only on a “case by case basis,” as long as it does not affect the overall purpose of the facility to be open year round, 7 days a week and accepting walk in patients of all ages without appointment. Also we would allow a, temporary emergency closure of the facility, because of force majeure (or acts of god, flood, hurricane, power outage, etc) is an exception.

  1. Facility must have a licensed physician designated as Medical Director for the facility who is responsible for overall clinical quality.
  2. Facility must provide medical care and perform business activities in an ethical manner.

Eligibility

Certain facilities and practice types are unlikely to meet all of the above minimum criteria and therefore would be excluded from eligibility for certification as an urgent care center.  These facilities should use extreme caution when applying, as fees are not refundable. Some examples include:

  • Retail or similar clinic with limited scope of service located within a pharmacy, supermarket or similar retail facility
  • Physician offices with only selected hours for walk-ins
  • Chiropractic offices & Pain clinics

Note:  In states with legal restrictions on using the term “urgent care,” facilities will be issued Certified Immediate Care designations.

Pre-Opening Certification

Facilities that would like to obtain a Certification designation prior to the center’s opening day have the option to do so. Supplemental criteria listed below are required to qualify.

  1. All items must be submitted within a 60 day period, the submission’s postage date will mark the start date. (note: items are NOT required to be submitted all at once)
  2. The facility’s opening day MUST fall within the 60 day period in order to receive approval for the CUC designation.
  3. The duration between the facility opening day and the end of the 60 day period, the facility will be temporarily approved and presented with a Press Release, Note to Payers, and a temporary Certificate.
  4. Once all pending documents are received and approved the facility will be awarded an official CUC designation and receive their complete recognition package.

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