Commissioned Corps Management Information Site

What are Health Profession Special Pays (HPSP)?

Special pays include incentive pay, bonuses (accession, critical wartime skills accession, or retention), and board certification incentive pay for officers in approved health professions -- Medical, Dental, Nurse, Scientist, Veterinary, Pharmacy, Dietitian, Therapy, and Health Services. In return for this special pay, the officer commits to serve in the USPHS Commissioned Corps for a specified number of years. The National Defense Authorization Act and 37 U.S.C. § 335, “Special bonus and incentive pay authorities for officers in health professions,” authorize these special pays and outline the limits on each type of pay.

Which USPHS Commissioned Corps policies govern HPSP?

Commissioned Corps Directive (CCD) 151.05, issued by the Secretary of HHS, provides broad policy on HPSP including what is required by legislation, authorities, and responsibilities.

Commissioned Corps Instruction (CCI) 633.01, issued by the Assistant Secretary for Health (ASH), prescribes the manner of or specific plan of action for carrying out the CCD. It includes the conditions and circumstances under which health professionals of the U.S. Public Health Service (USPHS) Commissioned Corps can receive HPSP.

Commissioned Corps Personnel Operations Memorandum (POM) 821.70, issued by the Surgeon General (SG), provides the procedures that an officer and the agency to which the officer is assigned must follow in submitting an HPSP agreement. It also establishes the criteria used by CCHQ to set the effective date of an HPSP agreement and clarifies the specific medical subspecialties for which HPSP is available as well as the subspecialties that fall within the subspecialty categories.

Why did the USPHS Commissioned Corps change the policy?

The policies incentivize officers who are most needed to care for patients and the public health. It rewards the officers most needed for USPHS’ unique mission to serve the nation through deployments and public health community activities. Importantly, these policies ensure retention of key professionals that are essential to carrying out the core public health mission of our service including officers in the Ready Reserve Corps. The changes also address concerns raised by officers regarding training obligations and categories that were not included in previous versions of the policy. The table below provides an overview of changes.

Previous Policy	New Revised Policy
No mention of Ready Reserve	Extends Special Pays to Ready Reserve
No mention of Ready Reserve	Allows Ready Reserve to serve their obligation in the Active Corps.
Officers serving a training obligation were previously eligible for Retention Bonus (RB) but current policy made them ineligible (includes USUHS graduates and oral maxillofacial dental officers).	Grandfathers in these officers so they may continue to receive RB as they could previously.
Rules on Accession Bonus (AB) and Critical Wartime Skills Accession Bonus (CWS-AB) for civil service conversions were unclear.	Clarifies the rules so individuals know when they are eligible for AB and CSW-AB.
Social Workers ineligible for AB and RB	Authorizes both AB and RB for Social Workers
Specialists in Obstetrics/Gynecology, Otolaryngology, and Pediatrics can receive the CWS-AB.	Specialists in Obstetrics/Gynecology, Otolaryngology, and Pediatrics no longer can receive the CWS-AB.

How do I know if I qualify for HPSP?

The requirements are different for different types of special pay and officers should check the policies listed below for specific details. In general:

Health Professions Accession Bonus (AB)	Officers must:
	• Graduate from accredited school in a health profession
	• Hold a current, valid, and unrestricted license or certification
	• Submit a written agreement that CCHQ receives no later than 180 days after the appointment
	• Be appointed to a clinical position that is in the specialty for which the pay is received
	• Be in a position that provides direct hands-on patient care or oversees the provision of direct hands-on patient care
Health Professions Critical Wartime Skills Accession Bonus (CWS-AB)	Officers must have all of the above plus:
	• Be in a health profession specialty designated as a critically short wartime specialty by the Secretary of Defense.
	• Be in a health profession for which the USPHS Commissioned Corps is experiencing a critical shortage.
Retention Bonus (RB)	Officers must:
	• Be below the rank of O-7
	• Graduate from accredited school in a health profession
	• Hold a current, valid, and unrestricted license or certification
	• Agree to remain on extended active duty (Regular Corps) or continue to serve in an active status (SELRES) for a specific period through the execution of a written agreement.
Health Professions Incentive Pay (IP)	Officers must:
	• Be entitled to basic pay
	• Serve in a health profession specialty or have a skill designated by the ASH
	• Sign an initial agreement and flag grade officers must submit annual agreements.
	• The IP will continue until revoked (unless the officer obtains an RB).
Board Certification Incentive Pay (BCIP)	Officers must:
	• Be entitled to basic pay/compensation
	• Have board certification in a health profession specialty or skill designated by the ASH
	• Hold a current, valid, and unrestricted license or certification
	• Sign an initial agreement
	• The BCIP will continue unless the officer loses eligibility or the BCIP is revoked

If I qualify, what do I do to receive HPSP?

Officers must initiate HPSP agreements with their respective agency Liaisons. Agency Liaisons will submit completed agreements and supporting documents to CCHQ. The USPHS Commissioned Corps encourages officers to follow up and confirm with their agency Liaison that CCHQ has accepted the agreement.

Do I still need to do practice hours with this new policy?

Yes. The clinical requirements of 80 practice hours for IP and new RBs apply to every option in which officers are paid HPSP, whether Transitional (T-HPSP), legacy pay, or regular HPSP.

Have the practice hours requirement changed for Retention Bonuses?

Yes. Officers initiating a new RB agreement must document their completion of at least 80 practice hours for as many years in the past as the term of the RB going forward. However, if fewer than two/three/four years have passed since 1 June 2020, the officer is only obligated to produce evidence showing practice hours since 1 June 2020 or since the officer was commissioned in the USPHS Commissioned Corps, whichever is later. The SG can waive this requirement under the criteria in Section 6-2.g.(1) through (4).

What is the time limit for new officers to submit applications for Accession Bonus or Critical Wartime Skills Accession Bonus?

Officers must submit a written agreement that is received in CCHQ no later than 180 days after their appointment to the USPHS Commissioned Corps.

I have T-HPSP, will this be impacted? What do I need to do?

Transitional HPSP (T-HPSP) allows Medical and Dental officers to transition into the new consolidated HPSP from the old legacy special pays. T-HPSP allowed officers who were unable or unwilling to enter into a full four-year HPSP Retention Bonus agreement in 2019 to retain their Legacy Pay Multiyear Retention Bonus (MRB) active duty obligation (ADO) that they had previously aligned with their retirement plans. This transitional pay will expire on December 31, 2021. Officers who are still in the Corps and who wish to continue receiving special pay after this date must sign a new agreement under the current rules.

Who is eligible for Health Professions Special Pays?

In general officers are eligible if they agree to stay in the Corps for the length of the contract or accept an Active Duty Obligation (or Commissioned Service Obligation if in the Reserve Corps), hold a valid license or certification, and serve in a specified field or category. See the table on "How do I know if I qualify for HPSP?" for specifics.

Health Professions Accession Bonus (AB)	Nurse Nurse Practitioner Pharmacist Physician Assistant Social Worker Veterinarian
Health Professions Critical Wartime Skills Accession Bonus (CWS-AB)	A field designated as a critically short wartime specialty Medical: Anesthesia Diagnostic Radiology Emergency Medicine Family Practice General Surgery Internal Medicine Neurosurgery Ophthalmology Preventive Medicine Psychiatry Pulmonary Medicine Urology Vascular Surgery Dental General Dentist Comprehensive Dentistry Endodontics Oral and Maxillofacial Surgery Prosthodontics Other Certified Registered Nurse Anesthetist (CRNA) Clinical Psychologist (PhD or PsyD)
Retention Bonus (RB)	See Appendices B-D for specific specialties in the following fields:
Health Professions Incentive Pay (IP)	Medical Dental Nurse HSO Clinical Psychologist Pharmacist Veterinarian Note RB and IP rates are different for members of the SELRES, see Appendices F-G
Board Certification Incentive Pay (BCIP)	See Appendix E for specific boards in the following fields: Medical Dental Nurse Veterinarian Pharmacist Dietitian Therapist Psychologist Health Services

What are the requirements for special pay?

Officers eligible for special pay must:

Be a graduate of an accredited school in an approved health profession, and submit and maintain in the Commissioned Corps Headquarters (CCHQ) a current, valid, and unrestricted license or certification;
Maintain compliance with CCD 111.03, “Conditions of Service;”
Receive a satisfactory performance rating on the most recent annual Commissioned Officers’ Effectiveness Reports (COER);
Not be under investigation for allegations of unacceptable performance or misconduct, and must not have any current (e.g., AWOL within last 12 months, or Letter of Reprimand) or pending administrative and/or disciplinary actions;
Be eligible to remain on active duty for the period specified in the respective HPSP agreement or, for a member of the SELRES, eligible to remain in an active status;
Not have a HPSP Review Board action;
Perform a minimum of 80 practice hours, as defined by the SG in a Personnel Operations Memorandum (POM) during the previous 12 months; and
Not be on non-duty status.

Is there a limit on the amount of AB and CWS-AB?

Yes, there are statutory limitations for each HPSP as follows:

The limit for AB is $30,000 for each 12-month period of obligated service, which means that for a 48-month period, a service can pay no more than $120,000.
The limit for CWS-AB is $100,000 for each 12-month period of obligated service, which means that for a 48-month period, a service can pay no more than $400,000.
The limit for RB is $75,000 for each 12-month period of obligated service.
The pay for IP:
- Medical and Dental officers may not exceed $100,000 in any 12-month period.
- All other professions may not exceed $15,000 in any 12-month period.

Does receipt of an HPSP affect any other pays?

HPSP is in addition to any other pay and allowance for which an officer is eligible unless otherwise noted in CCI 633.01. Officers who receive an AB, or CWS-AB, or RB are not eligible for any other bonuses authorized by 37 U.S.C. §§ 332 and 335 for the same period of obligated service. Officers who receive either IP or BCIP are not eligible for other incentive pays authorized by 37 U.S.C. § 353 for the same period of obligated service. Officers who receive BCIP are not eligible for pay authorized by 37 U.S.C. § 353(b) for the same period of obligated service.
An officer may receive AB or CWS-AB and IP and/or BCIP for the same period of obligated service (i.e., any resulting ADOs are served concurrently).
An officer may receive RB, IP, and/or BCIP for the same period of obligated service.
An officer may not receive RB while serving a period of obligated service as a result of receiving either AB or CWS-AB.

Can the ADO be shortened or made retroactive?

No. An officer who is fulfilling a Legacy Pay or HPSP ADO may request a new agreement only if the new agreement would extend beyond the officer’s current ADO. The new ADO may not retroactively cover any portion or period that was served under the previous agreement. When an agreement is terminated in order to enter into a new agreement, payment of the existing agreement(s) will be terminated and the officer must repay the unearned portion of the agreement, which will be collected from the new agreement payment.

Can my HPSP be terminated?

Yes, under the following circumstances:

An officer can renegotiate an agreement; however, the new obligation must be at least as long as the previous HPSP’s original length.
When an officer is promoted to a flag grade CCHQ will terminate any RB and officers with an IP must submit a new agreement. BCIP is not affected by a promotion to flag grade.
During the obligation period, CCHQ may terminate an HPSP agreement after a hearing before a Board of Inquiry (BOI) or Involuntary Termination Board (ITB) if the board recommends termination.
After the obligation period, CCHQ may terminate an IP or BCIP upon a recommendation of an HPSP Review Board. The Director, CCHQ, may convene an HPSP Review Board in the following circumstances:
- A promotion board recommends against an officer’s promotion;
- An officer fails to maintain a condition of service (e.g., license, readiness, background investigation, medical retention standards, or weight standards).
- An officer Is found guilty of one or more criminal offenses by a civil authority, tribal authority, or military tribunal or administrative board (including non-judicial punishment under Article 15 of the Uniform Code of Military Justice (UCMJ))
- An officer is disciplined for misconduct (e.g., letter of reprimand, absent without leave (AWOL)). If the officer is AWOL, the USPHS Commissioned Corps will not pay the HPSP while the officer is AWOL and will extend the ADO for a period of time at least equal to the period of AWOL.

Note: When the Corps terminates payment of a special pay, the officer cannot enter into a new HPSP agreement for at least the following 12 months or a later date specified by the HPSP Review Board. Payments are terminated as of the date specified in CCI 633.01 or a later date specified by the HPSP Review Board.

Can officers commissioning from a civil service position receive an AB?

Yes, but only if they:

Did not previously meet the education requirements to qualify for an appointment to the USPHS Commissioned Corps when the individual joined the civil service and then applied to the USPHS Commissioned Corps within one year after completing additional education that qualifies the individual for an appointment to the USPHS Commissioned Corps;
Did not hold the civil service appointment on the date when the individual applied to the USPHS Commissioned Corps;
Accepted a position in which the individual will be called to duty at a location that differs from the individual’s current employment location; or
Accepted a position in which the new employing PHS agency will be different from the current agency.

Corps physicians trained at the Uniformed Services University of the Health Sciences (USUHS) School of Medicine (in return for USPHS service obligations) understand that their overall compensation will be less than that of civilian counterparts. But many of these officers believe that waiting 10 years to receive Retention Bonus seems excessive.

CCHQ heard the issues raised by many graduates of USUHS and modified policy so now these new rules only apply to officers who entered the Uniformed Services University of the Health Sciences (USUHS) School of Medicine on or after 30 December 2019.

Officers who entered USUHS School of Medicine prior to 30 December 2019 can enter into an RB agreement after they serve eight years on active duty after graduation from USUHS medical school. Such officers can enter up to 3 RB agreements and serve the resulting active duty obligation (ADO) concurrent with the USUHS ADO as well as the training ADO resulting from their initial residency.
Officers who entered USU School of Medicine after 30 December 2019 must complete seven of their 10-year USUHS ADO (with residency/internships not counting toward that ADO) before receiving an RB. The officer must serve the ADOs consecutively with the ADO from USUHS served first (See Section 6-4.d. regarding consecutive ADOs).
Similarly, officers who had incurred a GPE training ADO prior to 30 December 2019 can enter into up to 2 RB agreements and serve the resulting ADO concurrent with the GPE ADO.

What are the new rules for new graduates? Can graduates of USUHS now receive special pay while paying off their service obligations? What about those paying off their ADO from Graduate Professional Education (GPE)?

The USPHS Commissioned Corps changed these rules to align our practices with those of the other services; however,

Officers who entered USUHS School of Medicine on or after 30 December 2019 must complete seven years of their ten-year USUHS ADO before becoming eligible to enter an RB agreement. The initial residency (including internships) does not count towards the USUHS ADO. Furthermore, the provisions of CCI 633.01 regarding consecutive ADOs apply to such officers.
Officers paying off ADO from GPE (clinical training) incurred on Active Duty or in an active status in the SELRES can receive an RB but must complete the ADO from GPE before serving the RB ADO (consecutive obligation). They cannot then obtain a second RB until after completing the delayed ADO from the first RB. The officer can return to the 1-year rate IP while fulfilling a consecutive ADO/CSO, however, this does not occur automatically. An officer with a remaining education and training ADO/CSO should be explicitly aware that, in many cases, the RB payments and the ADO/CSO may not be synchronized.

What changes has the USPHS Commissioned Corps made in who can receive HPSP?

Under the new version of this policy, specialists in Obstetrics/Gynecology, Otolaryngology, and Pediatrics no longer can receive the CWS-AB. Also, eligible licensed independent clinical Social Workers can obtain an AB and (upon completing an AB obligation) RB.

Can Social Workers receive an Accession Bonus (AB) before January 11, 2021?

No. Only those called to duty on Jan 11, 2021 or later can receive an AB.

Can officers receive both Board-Certified IP (BCIP) pay & a Retention Bonus (RB)?

Officers, including board certified social workers who work independently, may receive RB and BCIP for the same period of obligated service. See CCI 633.01. But they do not need a BCIP or to have board certification to obtain an RB.

What are the penalties if an officer leaves the USPHS Commissioned Corps with a remaining service commitment from special pays?

If the Corps terminates an officer pursuant to Section 6-7.a., Section 6-7.b., Section 6-7.c.(3), Section 6-7.c.(4), or Section 6-7.d. the officer must repay the unearned portion, becomes indebted to the federal government in accordance with 37 U.S.C. § 373, and may be subject to the collection of the indebtedness under the procedures in 45 C.F.R. Part 30. An officer separating from active duty is subject to the collection and repayment procedures in CCI 654.02, “Collection of Commissioned Officer’s Indebtedness upon Separation.” (CCI 633.01 Section 6-7.e(2.))

Can social workers qualify for retention pay in 2021 if they did not complete clinical hours in 2020?

Yes. New updates to the special pay policy Section 6-2.h. state that “Officers eligible for an RB for the first time due to a policy update are not required to submit evidence of practice hours for dates before the RB availability.” This includes social workers prior to 2021. However, in the future, these officers must provide proof of completing practice hours on the annual anniversary date of obtaining the RB.

Section 6-2.h. states that “In order to initiate a new two/three/four year RB agreement, an officer must submit documentation that demonstrates proof that the officer has performed a minimum of 80 practice hours… during the previous two/three/four years in the officer’s discipline or specialty for which the RB agreement is authorized.” Since Social Workers were not eligible for AB/RB in previous years, must they show proof of previous practice hours?

No, new updates to the special pay policy Section 6-2.h. state that “Officers eligible for an RB for the first time due to a policy update are not required to submit evidence of practice hours for dates before the RB availability.” This applies to social workers prior to 2021.

What documentation is required?

Required supporting documentation for HPSP includes the officer’s license, board certification, residency certificate, or other documents required by CCHQ.

Under what circumstances can the Director CCHQ adjust the date of an HPSP agreement?

In accordance with CCI 633.01, the Director may backdate certain RB agreements to 1 October 2020, provided the officer initiates an agreement or makes a request to adjust an existing agreement before 11 May 2021, for officers who:

Entered the Uniformed Services University of the Health Sciences (USUHS) School of Medicine prior to 30 December 2019.
Were serving a GPE training ADO on 30 December 2019 or incurred a GPE training ADO prior to 30 December 2019 but had not begun serving the ADO.

Additionally, in accordance with POM 821.70, the Director may backdate an HPSP agreement by no more than 3 months to remedy a delay in processing the agreement within the OPDIV/STAFFDIV/non-HHS organization that is reasonably outside of the officer’s control (e.g., a delay in processing the agreement in the agency, an officer is experiencing significant medical issues).

In order for the Director, CCHQ, to adjust an agreement’s effective date the liaison must make this request and the circumstances requiring the adjustment must be outside the officer’s control. The Director, CCHQ, may not adjust an agreement if the request is made after 11 May 2021.

What do I do if I am an officer whose effective date is impacted by an unresponsive liaison?

An officer should contact the read contact the CCHQ Liaison Coordinator at CCHQ. The officer should also include records (e.g., e-mails to supervisor and liaison) of all correspondence that they have had related to the submission of their agreement.

When can we submit HPSP Agreement Applications?

No date is specified in the policy. The CCI ASH signed the policy on Jan 11th, 2021 and the SG signed the POM on Jan 18th. So, any later date should work.

How, where, and how often do we submit the form?

The officer electronically submits the HPSP agreement to his/her immediate supervisor. Upon receipt of the HPSP agreement with the supervisor’s signature, the officer electronically submits the agreement to his/her Agency Liaison in accordance with guidance provided by the Agency Liaison (See Section 2 of POM 821.70.) See instructions for completing HPSP agreements (https://dcp.psc.gov/ccmis/PDF_docs/2019%20HPSP%20Agreement%20Instructions.pdf)

On the RB form (PHS 6189-1), what date should we put for commencement of the agreement? Is it that day's date, the first of the next month? 90 days out?

The effective date of the agreement is the date the officer becomes eligible for HPSP, provided the completed agreement is signed within 30 days of becoming eligible and the agreement is received by CCHQ within 60 days of becoming eligible; the date the completed agreement is signed, if received by CCHQ within 60 days of the date of becoming initially eligible for HPSP but signed more than 30 days after becoming initially eligible; the date the completed agreement is received by CCHQ, if received more than 60 days after the date of becoming initially eligible; or any later date. (See Section 3 of POM 821.70)

With whom should officers work to understand individual circumstances?

Your Agency Commissioned Corps Liaison is your sources for guidance.

What are my responsibilities as an officer receiving special pays?

Officers receiving special pay must follow the following rules:

It is the officer’s responsibility to be familiar with the published policies that apply to all USPHS Commissioned Corps officers and maintain an ongoing awareness of updates and changes to USPHS Commissioned Corps policies, including any periodic changes to the HPSP policy, pay rates, and/or eligibility requirements;
An officer must maintain current and updated contact information (e.g., e-mail, phone, address) in CCHQ in order to facilitate the USPHS Commissioned Corps’ communication of information to the office;
It is the officer’s responsibility to initiate and/or renew an agreement when appropriate and to ensure data is correct to support their eligibility for HPSP. An officer should retain copies of her/his agreement and other documentation; and
An officer is required to notify CCHQ/Financial Service Branch within 7 days if the officer fails to remain eligible for an HPSP. All payments made while not eligible will be recouped once identified in accordance with Section 6-7.e. An officer must also immediately notify CCHQ/Financial Services Branch of any overpayment, underpayment, discrepancy, or error in their pay.

What are the requirements for Reserve officers seeking HPSP?

Officers in the Ready Reserve Corps who are in an active duty status or who are in the Selected Ready Reserves (SELRES) can apply for HPSP if they meet the eligibility requirements.

How can reserve officers serve their commissioned service obligations (CSO) from special pays?

Members of the Ready Reserve Corps may serve their CSOs from receiving special pay in the Selected Ready Reserve (SELRES) or by transferring to the Regular Corps to fulfill their CSO in an active duty status. Alternatively, the officer can renegotiate a new agreement (except for AB) with a new effective date at the rates in effect at the time the new agreement is signed after transferring to the Regular Corps, as long as the new ADO (in the case of RB agreements) is as long or longer than the previous CSO. However, when officers receiving IP transfer from the Ready Reserve to the Regular Corps, they would need to sign a new IP agreement.

Health Professions Special Pays (HPSP)

Q & A on Updates to Health Profession Special Pays Policies

CCD 151.05, “Health Professions Special Pays”

CCI 633.01, “Special Pays”

POM 821.70, “HPSP Submission, Effective Dates, and Rates”:

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