Shortage Area Designations

Throughout the United States, there are geographic areas, special populations, and facilities with shortages of primary care, dental, and mental health providers, and services.  

The Health Resources and Services Administration (HRSA) and State Primary Care Offices, such as the Texas Primary Care Office (TPCO), work together to determine when such a shortage qualifies for designation as a Health Professional Shortage Area (HPSA), or a Medically Underserved Area/Population (MUA/P).  

The shortage designation process helps target and distribute limited resources to the areas that need the most assistance with increasing the supply, capacity, and distribution of health professionals. A HPSA designation may help a community attract new primary care, mental health, and dental health workers, as certain incentive programs are available in designated shortage areas.  It may also increase Medicare reimbursement to professionals already providing care in a community.  Currently, there are more than 30 federal and state programs which use shortage designation to determine eligibility.   

Priority for these programs is often based on the HPSA Score, which ranges from 0 - 25 for Primary Care and Mental Health, and 0 - 26 for Dental Health.   

Get information on the criteria used for scoring HPSAs  

The TPCO can assist providers and clinic administrators in determining: 

  • What, if any designations are in their area. 
  • Whether their area may potentially qualify for designation. 
  • What designation types are needed for participation/eligibility for certain federal or state programs 

Explore the interactive map for information about current shortage designations in Texas. 

Additional shortage designation map resources:


Based on the statutes, regulations, and program requirements, HRSA automatically designate certain facilities as HPSAs. These Auto-HPSAs do not need to apply for designation but may need to submit data to determine eligibility for HRSA to calculate a score. 

  • Federally Qualified Health Centers (FQHCs) - These are scored at HRSA once an organization receives a Health Center Grant. 
  • CMS Certified Rural Health Clinics (RHCs) - RHCs must apply for and be approved as a National Health Service Corps site. 
  • Indian Health Service (IHS) or Tribal Clinics 
  • Federal Correctional Facilities - The Federal Bureau of Prisons (BOP) and U.S. Immigration and Customs Enforcement's (ICE) central offices work directly with HRSA for its Correctional Facility Designations.

FQHCs, RHCs & IHS or Tribal Clinics may request their auto-HPSAs be rescored through the HRSA Bureau of Health Workforce Portal

NOTE:  State correctional facilities should determine eligibility for a Correctional Facility HPSA. 

Healthcare Provider Assessment 

In addition to population data, an important piece to shortage designation is healthcare provider information. 

HRSA requires that the Primary Care Offices regularly evaluate (at least every 24 months) all primary care, mental health, and dental health providers to assess whether there is adequate primary medical, dental, or mental health care available statewide. To do so, the TPCO contacts healthcare facilities and providers, primarily by phone or fax to conduct the evaluation on an ongoing basis. The TPCO relies on timely and accurate responses in order to make clear determinations about whether or not an area would qualify for a shortage designation. 

If you are a primary care provider, psychiatrist, dentist, or an administrator who works with these types of providers, access the Online Assessment form or  Healthcare Provider Assessment pdf  to submit updated provider/practice information.  

The Healthcare Provider Assessment takes approximately 5-10 minutes to complete and can be submitted by email or fax.   

Get Information on the Shortage Designation Modernization Project and National Shortage Designation Updates.