As defined by Texas Health and Safety Code Section 243.002, an ambulatory surgical center is a facility that operates primarily to provide surgical services to patients who do not require overnight hospital care. ASCs are commonly referred to as "day surgery centers."
Texas Health and Safety Code Chapter 243 establishes the state licensing requirements for ASCs. Under state law, HHSC is responsible for the licensing and regulation of ASCs in Texas, and the Regulatory Services Division within HHSC carries out these duties.
HHSC adopts rules for ASCs including establishing standards for:
- Licensing procedures and fees
- License denial, probation, suspension, and revocation
- Qualifications of facility professional staff and other facility personnel
- Equipment essential to patient health and welfare
- Sanitary and hygienic conditions of the facility
- A quality assurance program for patient care
- Inspection, investigation, and enforcement procedures
- Design and construction requirements to ensure patient health and safety
Laws and Rules
Texas Laws
Rules and Regulations
- Texas Administrative Code Title 25 Part 1, Chapter 135, Ambulatory Surgical Centers
- Medicare/Medicaid State Operations Manual, Publication 100-07
- Federal Regulations - Code of Federal Regulations Title 42 Part 416, Ambulatory Surgical Centers
Find or Verify a License
- Verify a facility license by searching the Online Licensing System
- View the accessible version of the Directory of Ambulatory Surgical Centers (Excel)
Licensing
An applicant seeking an ASC license must submit a completed application, license fee, and other applicable documents to HHSC. The Health Facility Licensing Unit will not process an application until after HHSC Accounts Receivable receives and posts the license fee.
Refer to the application or instructions linked in this section for specific requirements.
HHSC must review and approve all required application materials received before issuing a license to an applicant.
Initial Licensure Application
Change of Ownership Application
Relocation Application
Renewal Licensure Application
Annual Report
An ASC must fill out and submit an annual report as required by 25 TAC Section 135.26(g). Submit the completed form via email to ASC Licensing.
Architectural Review Information and Forms
- Refer to the Architectural Information page
Complaint and Incident Submission Information
- Incidents Submission Portal for Health Care Regulation Providers
- File a Complaint for a Health Facility
Inspection Components
HHSC conducts health compliance on-site inspections to determine compliance with the provisions of the Health and Safety Code and associated rules listed in the Laws and Rules section of this page. During the inspection, HHSC staff will generally perform the following activities:
- Conduct an entrance and an exit conference with applicable facility personnel
- Explain the inspection process and answer questions
- Review clinical records
- Review facility and personnel records
- Review facility policies and procedures
- Review quality assurance activities
- Interview staff
- Assess the facility’s compliance with applicable statutes and rules
- Discuss final inspection findings with applicable facility personnel
Enforcement Actions
Ambulatory Surgical Centers Enforcement Actions (PDF)
Human Trafficking Resources
- Human Trafficking Prevention Task Force Training Curriculum (PDF)
- Required for ASCs where more than 50 abortions in any 12-month period are performed
- Required Human Trafficking Signage for ASCs Where Abortions are Performed:
- HHSC Texas Human Trafficking Resource Center
Abortion Reporting
As defined by Texas Health and Safety Code Section 245.002, an abortion facility is a place where abortions are performed.
Texas Health and Safety Code Chapters 245 and 171 require abortion facilities and physicians that provide abortion services to report to HHSC certain information about abortion procedures the provider performs. HHSC must follow strict confidentiality provisions in the law regarding any information about an abortion facility. The law does allow HHSC to release statistical information reported to HHSC by abortion providers. The HHSC Office of Data, Analytics, and Performance (DAP) compiles this statistical information and publishes it on HHSC’s Induced Termination of Pregnancy Statistics webpage.
Abortion Reporting Forms
The following forms are required to be submitted by the physician to DAP:
- Induced Abortion Report Form
- Medical Emergency Abortion Incident Reporting Form
- Third Trimester Induced Abortion Certification Form
- Abortion Complication Reporting Form
The following form is required to be submitted by the facility to DAP:
Email Health Care Policies and Rules with questions regarding the statutory and regulatory abortion reporting requirements.
For assistance completing the online forms, for technical support, or to provide feedback on the user experience, email ITOP Reporting.
Provider Certification
The Secretary of the United States Department of Health and Human Services directs state health agencies or other appropriate agencies to determine whether health care entities meet federal standards. This helping function is termed “provider certification.” Health Care Regulation staff are responsible for providing certification oversight on behalf of CMS for ASCs.
For more information on the certification process, refer to our Centers for Medicare & Medicaid Services Information page, or contact your regional office (PDF).
Clinical Laboratory Improvement Amendments Information
Refer to our CLIA information page. For more information on CLIA, please contact your regional office (PDF).
Contact Information
Health Care Regulation
For Health Care Regulation contact information, visit our Contact Us page.
Health Care Facility Enforcement
Phone: 512-438-5439
Fax: 512-438-3697
Email: Health.Facilities.Enforcement@hhsc.state.tx.us
Mailing Address:
Texas Health and Human Services Commission
Regulatory Services Division
Health Care Facility Enforcement, MC 1866
P.O. Box 149347
Austin, TX 78714-9347
Open Records Requests
Texas Health and Human Services is committed to providing full access to public information. For information on how to submit an open records request, read the Open Records Policy and Procedures.