Certificate of Need Application Payment

Paying for a CN Application via e-check or credit card:

Directions: Click on the type of CN Application you wish to pay for from the selections below.  Please include your facility’s license number for all application transactions. Once you have submitted payment, you must complete and submit the required form and (if applicable) supporting documentation before our review process can begin.

Important: Online payment alone is not sufficient for our review process to begin. The original, signed forms and any required attachments and/or documentation must be mailed to this office with the proof of online payment attached. Your submission will not be valid until the required forms and documentation have been received by this office.

When you are finished paying:
Print the payment confirmation page or the confirmation e-mail you received as proof of payment. Attach this printout to your application form. No submission will be processed without proof of payment.

Please note that the CN Application Fees listed below are non-refundable.

CN-1 LTC Facilities
CN-4 For Designation as a Perinatal Facility
CN-3 Hospital Related Project
CN-19 Expedited Review

 

Last Reviewed: 5/15/2017