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Licensing Requirements - Ambulatory Surgical Centers

License Application

The following documents, fees, and actions shall be completed and approved before a license will be issued:

Initial Application

  • A license application form (PDF, 199KB) submitted no earlier than 90 calendar days prior to the projected opening date of the center.
  • A license fee of $5,200.00 shall be submitted. License fees are not refundable.
  • Approval for occupancy shall be obtained from the Department of State Health Services, Architectural Review Group.
  • The applicant or the applicant’s representative shall attend a pre-survey conference at the zone office designated by the department. Please contact the designated zone office to schedule the pre-survey conference.

Relocation Application

  • A license application form (PDF, 199KB) submitted no earlier than 90 calendar days prior to the projected opening date of the center.
  • A license fee of $5,200.00 shall be submitted. License fees are not refundable.
  • A copy of the letter of accreditation by an accrediting organization verifying accreditation and the effective date of accreditation, if applicable.
  • Approval for occupancy shall be obtained from the Department of State Health Services, Architectural Review Group.

Change of Ownership (CHOW) Application

  • A license application form to be submitted at least 30 calendar days before the date of the change of ownership.
  • A license fee of $5,200.00 shall be submitted. License fees are not refundable.
  • A copy of the letter of accreditation by an accrediting organization verifying accreditation and the effective date of accreditation, if applicable.
  • The applicant or the applicant’s representative shall attend a pre-survey conference at the zone office designated by the department. The designated zone office may waive the pre-survey conference requirement for a change of ownership. Please contact the designated zone office to schedule the pre-survey conference or to request a waiver.
  • The applicant shall include evidence (bill of sale, lease agreement, or legal court document) of the change of ownership. This document can be submitted separately from the license application.

Survey Components

During the initial licensing period, department zone office staff will conduct an on-site survey to ascertain compliance with the provisions of the Health and Safety Code and associated rules. An entrance conference will be held with key facility personnel. Zone office staff will explain the survey process and answer questions. During the survey, zone office staff will:

  • Review clinical records
  • Review facility policies and procedure
  • Review quality assurance activities
  • Review personnel records
  • Interview staff
  • Conduct an exit conference with key facility personnel
  • Discuss survey findings

Provider Certification

Medicare certification information may be obtained from the Centers for Medicare & Medicaid Services (CMS) page.

The Social Security Act directs the Secretary of the Department of Health and Human Services to use the help of state health agencies or other appropriate agencies to determine if health care entities meet federal standards. This task is one of the Department of State Health Services’ responsibilities. For information on gaining provider certification, please contact zone office staff.


CLIA Information

CLIA information is located on the department’s website at www.dshs.state.tx.us/facilities/clia.aspx. For more information, please contact the zone office for your location.


Contact Information

The Facility Licensing Group is dedicated to assist you through this process and is available to answer your questions. If you have any questions, please contact the Facility Licensing Group.


Last updated April 16, 2018