Do I Need a Certificate of Need?

We get asked from time to time whether a mobile trailer for an interim rental has a CON. We have also been asked what in the world is a CON? Well, it isn’t super simple but CON is a certificate of need and is legislated at the state level. Some states require a CON and some do not. A CON is the government's way of regulating the overbuilding of healthcare facilities and resulting healthcare price inflation.


Arguments for and against CON laws



  • CON laws distribute healthcare across all geography
  • CON laws provide an evaluation to healthcare
  • Patients do not evaluate healthcare options mostly and this protects their costs


  • Reduces the free market and potentially reduces supply increasing demand/pricing
  • Cumbersome and timely evaluation slows market response
  • Inconsistent across states and regions
  • CON laws brings lobbyist and politics into healthcare considerations
  • Reduces the consumer urgency to ‘own’ individual healthcare

To review if your state has CON laws and what they are, we have found the National Conference of State Legislatures website to be helpful.  Feel free to contact us directly to investigate this tricky issue further.

There is debate within the medical community regarding whether Certificate of Need (CON) programs are good public policy. Regardless of your position on the issue, the fact is, if you are looking to invest in a significant capital project, such as a building expansion, or ordering new high-tech devices, such as CT scanners or MRI machines, you must first see if your state requires a CON.

The goals of CON programs are to restrain healthcare facility costs and allow coordinated planning of new services and construction. According to the National Conference of State Legislatures, a majority of states retain some type of CON program, law, or agency as of December 2011, despite the fact that the federal mandate for such laws was repealed in 1987.

With so many CON programs still in place, it is important to know if your state requires a CON in order to purchase your next piece of medical imaging equipment. It's also important to note that not all CON programs are created equal. Some are very open and require little more than a check box on a form, while others give virtual veto power to your proposed competitors. In either case, it's good to know what you are dealing with before beginning your project.

Here is the NCSL's most up-to-date list. If your state is on it, click through to find your regulatory website :


States With CON Requirements


Alabama Missouri
Alaska Montana
Arkansas Nebraska
Connecticut Nevada
Delaware   New Hampshire  
  District of Columbia   New Jersey
Florida New York
Georgia North Carolina
Hawaii Ohio
Illinois Oklahoma
Indiana Oregon
Iowa Rhode Island
Kentucky South Carolina
Louisiana Tennessee
Maine Vermont
Maryland Virginia
Massachusetts Washington
Michigan West Virginia


As you continue to work through the decision-making, legal compliance, and site planning of your imaging equipment project, feel free to contact us. Our product experts and project managers are here to help throughout each stage of the process.

Download the free resource below to start learning your state's unique requirements:

List of State Radiological and Health Department Links

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Paul Crawford

Paul Crawford is the Vice President of Equipment Solutions at Block Imaging. Paul connects with healthcare facilities across the world to offer CT solutions and manages the wholesale sales team. When Paul is not helping customers with their CT needs, he enjoys spending time with his family, watching MSU sports, and CrossFit.