Hospital Privileges

Key facts

Granted by

The hospital governing body, on medical staff recommendation

Medicare rule

Conditions of Participation, 42 CFR 482.22 (medical staff)

Telemedicine option

Hospitals may rely on a distant-site hospital's privileging decisions

Performance review

Joint Commission standards include OPPE and FPPE

What are hospital privileges?

Before a clinician can treat patients in a hospital, the hospital must decide what that person may do there. After credentialing confirms training and licensure, the medical staff reviews the request and recommends specific privileges, and the governing body grants them. Privileges apply to one facility and are renewed periodically.

Privileges are delineated, meaning they list services. A general surgeon might hold privileges for hernia repair and gallbladder removal but not for robotic procedures until trained and evaluated.

Types of hospital privileges

Common categories include:

Hospitals monitor clinicians through Ongoing Professional Practice Evaluation (OPPE), and use Focused Professional Practice Evaluation (FPPE) for new privileges or when concerns arise.

• Admitting privileges: authority to admit patients to the hospital under the clinician's care.
• Clinical or procedural privileges: authority to perform named procedures or manage defined conditions.
• Courtesy or consulting privileges: limited privileges for clinicians who treat patients at the hospital only occasionally.
• Temporary privileges: short-term privileges for an urgent patient care need or while an application is completed.
• Telemedicine privileges: privileges for remote clinicians, which Medicare rules allow to be based on another hospital's credentialing and privileging.

Why hospital privileges matter

Privileges show where a clinician can actually admit patients and perform procedures. Device companies use them to identify surgeons who can use a product at a given hospital, health systems track independent physicians who bring cases to competing facilities, and recruiters check them when hiring.

Restricting or revoking privileges after professional review can require a report to the National Practitioner Data Bank, so privilege history becomes part of credentialing elsewhere.

Limitations of hospital privileges data

No federal public database lists hospital privileges. Public datasets instead show affiliations, such as the hospital affiliations reported in CMS Doctors and Clinicians data. An affiliation suggests where a clinician practices but does not confirm which privileges they hold.