Subsection C of § 32.1-102.1:2 of the Code of Virginia states: 

No general hospital shall make any capital expenditure of $5 million or more and no medical care facility other than a general hospital shall make any capital expenditure between $5 million and the amount established by the [State Board of Health] as the minimum capital expenditure by a medical care facility other than a general hospital for which a certificate is required pursuant to subdivision B 8 of § 32.1-102.1:3 without first registering such capital expenditure with the [State Health Commissioner] pursuant to regulations of the Board. The amounts specified in this subsection shall be revised annually to reflect inflation using appropriate measures incorporating construction costs and medical inflation. 

Subsection B of § 32.1-102.1:3 of the Code of Virginia states, in relevant part: 

The following actions undertaken by or on behalf of a medical care facility described in subsection A shall constitute a project for which a certificate of public need is required pursuant to subsection A of § 32.1-102.1:2: 

* * * 

8. Any capital expenditure of $15 million or more, not defined as reviewable in subdivisions 1 through 7 [of this subsection], by or on behalf of a medical care facility described in subsection A other than a general hospital. The amounts specified in this subdivision shall be revised annually to reflect inflation using appropriate measures incorporating construction costs and medical inflation… 

Subsection B of 12VAC5-220-110 states that the capital expenditure threshold is annually adjusted: 

…using the percentage increase listed in the Consumer Price Index for All Urban Consumers (CPI-U) for the most recent year as follows: 

A x (1+B)

where: 

A = the capital expenditure threshold amount for the previous year

and 

B = the percent increase for the expense category “Medical Care” listed in the most recent year available of the CPI-U of the U.S. Bureau of Labor Statistics. 

Additionally, subsection D of 12VAC5-220-110 requires the Virginia Department of Health to annually “(i) publish the threshold amount in the General Notices section of the Virginia Register of Regulations and (ii) post the threshold amount on its website.”  

The previous year’s threshold requiring a certificate of public need was $21,219,588 and the threshold requiring registration was $7,061,144. Using the calculation of A x (1+B) listed in subsection B of 12VAC5-220-110 and the 2022 CPI-U percentage of 4.0% for medical care, the current year’s thresholds are as follows:  

Threshold for capital expenditures requiring a certificate of public need: $22,068,371

Threshold for capital expenditures requiring registration: $7,343,590