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    Center For Health Statistics
    Department of State Health Services
    1100 West 49th Street
    Austin, Texas 78756-3199

    Phone: (512) 776-7261
    Fax: (866) 239-7344

    Email Center for Health Statistics



Medically Underserved Area (MUA) and Medically Underserved Population (MUP)

Designations in Texas




NOTE: The shortage designation programs are now being overseen by the Texas Primary Care Office. Please direct inquiries or requests for designations to them at (512) 458-7518, Fax: (512) 458-7658, or contact them by email.

Medically Underserved status is designated to areas or populations having a shortage of personal health services according to U.S. Department of Health and Human Services' rules. These designations are targeted toward:

Areas (MUAs). Eligibility for designation as an MUA is based on the demographics of the entire population in an area compared to national statistics for four health care demand/resource indicators:

  • Percentage of elderly population (over 65 years)
  • Poverty rate
  • Infant mortality rate
  • Ratio of primary care physicians per 1,000 population

These four indicators are converted to weighted values. The sum of the four weighted values equals the Index of Medical Underservice (IMU) score. Areas with IMU scores equal to or less than the national average IMU (62.0) are designated as underserved.

Populations (MUPs). IMU scores for MUPs are calculated in the same manner as for MUAs. However, the specific population for whom the MUP is calculated represents only a portion of the area's entire population. These specific populations encounter barriers to primary care access. The barriers may be economic (e.g., low income or Medicaid-eligible populations, low income population) or sociologic (cultural, linguistic) There are two types of MUPs:

  • IMU-based MUP - the underserved population group is designated using an IMU score


  • Exceptional MUP - either the total population, or a specific population in the area, has an IMU score of greater than 62. However, unusual local conditions serve as barriers to the access or the availability of personal health services. Exceptional MUPs require the approval of the Governor (e.g., prison populations).
  • Designation Updates. MUA and MUP designations do not have the federal requirement to be updated on a periodic basis. Therefore, most MUA and MUP sites were designated over 5 to 10 years ago.

    MUA/MUP Designations Are Used by:

    • Rural Health Clinic program for eligibility status
    • Community Health Center Programs
    • Licensing Boards for granting limited prescriptive authority

    Note: See the Shortage Designation Branch website for federal programs using MUA/MUP designations.

    Note: External links to other sites are intended to be informational and do not have the endorsement of the Texas Department of State Health Services. These sites may also not be accessible to people with disabilities.

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    Last updated April 08, 2010