CRCST Exam PrepQuick answer: As of 2026, New Jersey, New York, and Connecticut have enacted laws requiring certification for central service or sterile processing technicians. There is no federal mandate. Several other states have considered similar bills. In every other state, certification is driven by employer requirements, not statute, but most hospitals prefer or require CRCST or CBSPD certification anyway.
One important distinction: HSPA certification is a national, voluntary credential, not a state license. State laws do not create a state license; they require technicians to hold certification from a national program such as HSPA's CRCST (or CBSPD).
1Why this tracker exists
Sterile processing is one of the few critical hospital roles with almost no state-level licensing. A 2021 Center for Public Integrity investigation found that only New Jersey had a certification mandate on the books, even as contaminated instruments kept making headlines. Since then, New York and Connecticut have joined New Jersey, and advocacy groups continue pushing bills in state legislatures.
If you are deciding whether to get certified, the legal picture matters, but the employment picture matters more: even in states without a mandate, the overwhelming majority of hospital sterile processing departments list CRCST or CBSPD certification as required or strongly preferred in job postings. Certification is the safe bet everywhere.
2Filter by status
3State by state
New Jersey: the first mandate
New Jersey became the first state to require certification of central service professionals. The rules sit in the state administrative code at N.J.A.C. 8:43G-8.2 (staff qualifications) and 8:43G-8.3 (education and training). Central service staff must be certified through a national sterile processing program recognized by the Department of Health. The director or supervisor of central services must have supervisory experience plus certification, with no grace period for managers.
When the law took effect, existing technicians received five years to become certified, new hires received three years, and ambulatory care staff received two years. The law was the culmination of a multi-year effort led by the state health department and professional advocates.
Sources: N.J.A.C. 8:43G-8.2, 8:43G-8.3; Infection Control Today reporting on the 2004 enactment.
New York: certification required
New York's legislature passed bills requiring certification of central service technicians, making it the second state with a mandate. The legislation followed sustained advocacy by the New York State Association of Central Service Professionals and national groups, who argued that increasingly complex surgical instruments demand verified technical knowledge.
Sources: Infection Control Today reporting on Senate and Assembly passage.
Connecticut: third state
Connecticut became the third state to require certification of central service technicians. Professional associations have continued using Connecticut's passage as momentum for bills in other states.
Sources: Infection Control Today, "CS Certification Gains Momentum."
Pennsylvania
Certification legislation has been introduced in Pennsylvania, and professional groups spent 2016 and beyond educating House Health Committee legislators about the technician role. As of the last review, no mandate has been enacted, but advocacy continues.
Massachusetts
Massachusetts certification legislation advanced out of the Joint Public Health Committee. The bill's progress through the Joint Health Care Financing Committee has been the key hurdle. No mandate enacted as of the last review.
Tennessee
Tennessee introduced study bills directing the Board for Licensing Health Care Facilities to report on whether central service technicians should be regulated. Some industry sources list Tennessee among states where certification is effectively required for employment, though the statutory picture remains a study phase rather than a full mandate.
Delaware, Florida, Minnesota
These states have been reported at various times as considering similar legislation or as places where certification is commonly required for employment. Treat these as "watch" states: no enacted mandate confirmed as of the last review, but legislative interest has been documented.
All remaining states
No state-level certification mandate is on the books. That does not mean certification is optional in practice: hospital systems, surgical centers, and staffing agencies in these states routinely require CRCST or CBSPD certification as a condition of hire. The market has moved faster than legislatures.
4What mandates typically require
State certification laws share a common shape. Understanding the pattern helps you prepare regardless of where you live:
- Recognized certification: Laws point to a national program such as HSPA's CRCST or CBSPD, rather than naming a single vendor.
- Grandfathering: Current workers get a multi-year window. New Jersey gave existing techs five years.
- New hire timelines: Shorter, typically two to three years from date of hire.
- Leadership first: Supervisors and managers are often required to certify immediately, with no grace period.
- Continuing education: Maintaining certification means ongoing CE, which the laws incorporate by reference to the certifying body.
5What this means for your career
Three practical takeaways. First, if you work in New Jersey, New York, or Connecticut, certification is not optional: it is the law, and your employer must comply. Second, if you work anywhere else, certification is still the strongest move you can make, because employers have effectively created a private mandate. Third, if your state is considering a bill, getting certified now means you sail through any grandfathering window instead of scrambling under a deadline.
6Methodology and updates
We track state activity through legislature websites, state registers, and professional association advocacy updates. A state moves to "law enacted" only when we can cite the statute or regulation. "Pending" covers introduced bills, committee advancement, and formal study resolutions. We review quarterly; the last review was October 2026. If your state passes a law we have missed, tell us and we will verify and update.