No regulator we found in the Gulf, German-speaking Europe, the UK, the USA, Russia and the CIS, Africa or the EU makes JCI, TEMOS or ISO certification a legal condition for sending a patient abroad; what the rules do name is the licence of the country of treatment and, in Dubai, an ISQua-approved accreditation for the hospital itself. JCI (hospital standards, 8th edition, in force since 1 January 2025, three-year cycle, quote-based fees) accredits a whole facility; TEMOS is a medical-tourism programme (typically 4–12 months, 2–5 on-site days, valid for three years) that is not an accreditation in the EU legal sense; ISO 9001 and ISO 7101 certify a management system, not clinical care. Choose by the markets you sell to, the kind of facility you run and the budget: this page sorts the public evidence for you and shows what is published and what is quote-based.
Updated: 2026-10-17 · Reading time: 32 min · Guide
Agencies ask “are you JCI?” in the first call; ministries and insurers ask for a certificate number; a clinic owner wonders whether ISO 9001 is enough. These questions mix three different things: accreditations of care, certifications of a management system and licences to operate. This guide separates them, puts the published facts about each scheme side by side and shows which source markets name which scheme in a written rule.
It is written for hospital and clinic management deciding what to invest in, and for agencies that need to know what a partner’s certificate does and does not prove. Use the board at the top to sort the evidence for your own markets and facility type; the sections below give the sources.
A licence is the state’s permission to operate; without it nothing else matters, and it is the document most rules actually name. An accreditation of a hospital, such as JCI, is a voluntary external assessment of care and safety against published standards, repeated on a cycle. A certification such as ISO 9001 says that an organisation’s management system meets a standard; it is issued by a certification body, which is itself accredited by a national accreditation body.
The word “accreditation” is also used in a narrower legal sense. Under Regulation (EC) No 765/2008, accreditation is the attestation by a national accreditation body that a conformity assessment body, for example an ISO certification body, is competent. Temos says on its website that its activity in the EU “does not constitute an accreditation” in that sense and rests on private, non-governmental standards. Hospital accreditation by JCI, DNV or Accreditation Canada is private and voluntary in the same way.
ISQua, the International Society for Quality in Health Care, adds a second layer. Its accrediting body, the ISQua External Evaluation Association (ISQua EEA, also written IEEA), accredits three things: external evaluation organisations, sets of health and social care standards, and surveyor-training programmes. It does not accredit individual hospitals, so “an ISQua-accredited hospital” really means a hospital assessed against an ISQua-accredited set of standards. Examples from 2025–2026: DNV’s International Accreditation Standards for Hospitals (Revision 26-0) were endorsed by ISQua EEA on 23 June 2026 and approved through June 2030; TÜSKA’s SAS Hospital Set v4.0/2025 is accredited from December 2025 to December 2029.
Joint Commission International published the 8th edition of its hospital and academic medical centre standards on 1 July 2024; surveys follow it from 1 January 2025, and the new environmental sustainability standards must be fully met from 1 January 2026. The edition has five sections — accreditation participation requirements, patient-centred care, healthcare organisation management, global health impact and academic medical centre standards — adds a Healthcare Technology chapter (electronic records, telehealth, cybersecurity) and a Patient Safety chapter with a sentinel event policy that favours non-punitive reporting, and cuts the number of standards by roughly 10–15%. JCI says it works with organisations in more than 70 countries.
Accredited hospitals are re-surveyed every three years, with touchpoint sessions in between. Surveyors use tracer methodology: a patient tracer follows one patient’s path through the facility, a system tracer follows a process such as medication management across the organisation. JCI also publishes separate standards for ambulatory care, which matter for day-surgery and outpatient clinics, and a programme-level route, Clinical Care Program Certification (4th edition, from 1 January 2024), for one service line. For the programme route JCI’s fact sheet gives 12–24 months of preparation and requires at least six months of consistent compliance before applying; we did not find the length of the certification award on JCI’s public pages.
Cost. We found no public JCI fee schedule for hospital accreditation, so any figure quoted for “the price of JCI” without a source should be treated as an estimate. Request a quote with your bed count, services and number of sites; budget separately for gap-closing, training, consultants and staff time, which usually exceed the survey fee. The Joint Commission’s US fee pages describe a different programme and do not apply to JCI.
Temos International GmbH is headquartered in Germany and describes itself as an evidence-based accreditation organisation. Its public site lists 13 assessment options in six programme areas: medical care, dental care, eye care, reproductive care, rehabilitation care and medical travel coordinators. Its “Excellence in Medical Tourism” programme was introduced to optimise the non-medical services an international patient meets, alongside the clinical-quality standards. Temos states that ISQua EEA has recognised several of its programmes, among them its dental and ambulatory standards and its surveyor-training programme, and that it is a recognised external evaluation organisation.
The process has eight steps — registration, agreement, orientation and self-assessment, technical review and pre-assessment, on-site assessment by Temos assessors (2–5 days), a decision by the Temos Medical Board, progress reports and annual follow-ups. Temos says the journey typically takes 4–12 months and that initial accreditation is valid for three years; re-accreditation needs a renewed evaluation. We found no published fee schedule and no public edition number for the standards, which Temos shares with applicants.
Does TEMOS accredit hospitals in Türkiye? Yes, Turkish providers hold Temos accreditation, and Türkiye’s Ministry of Trade lists Temos certificates (medical, dental, rehabilitation, eye, reproductive care, community pharmacy and medical travel coordinators) among the market-entry documents it supports under its service-export decision. But Temos is voluntary there. The legal requirements are the International Health Tourism Authorization Certificate and, from 31 December 2026, TÜSKA accreditation for hospitals, medical centres, laboratories and dialysis centres or a Ministry certificate for other facilities; see the Turkish authorization certificate guide.
ISO writes standards but does not certify anyone; independent certification bodies do, and they are accredited by national accreditation bodies. A certificate follows a three-year cycle: initial certification, annual surveillance audits and a recertification audit before expiry. ISO 9001:2026, published in September 2026, replaces the 2015 edition; DNV and LRQA report a three-year transition for organisations certified to ISO 9001:2015; LRQA gives 30 September 2029 as the end date, so confirm the dates with your certification body. It keeps the core principles — customer focus, process approach, risk-based thinking, continual improvement — and the harmonised structure of leadership, planning, support, operation, performance evaluation and improvement.
ISO 9001 fits any organisation and says nothing specific about clinical care. For healthcare there are two adaptations. EN 15224:2016, a CEN standard, applies EN ISO 9001:2015 to healthcare services and covers clinical processes. ISO 7101:2023, “Healthcare organization management — Management systems for quality in healthcare organizations — Requirements”, was published in October 2023, applies to any healthcare provider regardless of type or size, and can be certified: SGS issued its first certificate to Chi Mei Medical Center in Taiwan in July 2025, covering leadership, governance, clinical operations, risk management and patient safety, and BSI ran a pilot with two Indian hospitals. A certificate proves that a system works as described, not that care is clinically better.
The heat strip at the top of the page is built from the rows below. “In rules” means a law, regulation or state programme of that market names the scheme; “in guidance” means official or professional guidance names it; “voluntary” means we found nothing written down. A voluntary cell is not a negative judgement: it means the buyer’s own panel criteria decide.
Dubai is the one place where the rule is written down: its own hospitals must be accredited by an ISQua-approved accreditor within 24 months of licence activation, and DHA’s 2020 circular named JCI, Accreditation Canada and ACHSI as examples. Saudi Arabia requires CBAHI accreditation of facilities inside the Kingdom, and Abu Dhabi runs its own ISQua-accredited hospital standards. We found no published criteria for foreign hospitals in Gulf treatment-abroad programmes: Kuwait, for example, was reported in 2016 to route each case through specialised medical committees. The schemes a Gulf regulator names for its own hospitals are the ones Gulf institutions already work with.
Statutory health insurers may pay for treatment outside the EEA only if a recognised treatment exists nowhere in Germany or the EEA, and then at their discretion (§ 18 SGB V); inside the EU, planned treatment follows the rules of the treatment country. No German-speaking regulator or insurer we found names JCI, TEMOS or ISO for foreign providers; because statutory cover abroad is the exception, the assessment usually falls to patients and agencies. Temos is based in Germany, which agencies there may recognise, but that is familiarity, not a rule.
The UK Health Security Agency’s TravelHealthPro advises people planning overseas treatment to use internationally accredited clinics or hospitals, names Joint Commission International and ISQua as examples of accrediting bodies and adds that accreditation does not guarantee a satisfactory outcome (page updated 17 June 2024). That is guidance, not a rule.
There is no federal accreditation rule for care abroad, and Medicare generally does not pay for care outside the USA. The American Medical Association’s medical tourism guidelines of June 2008 say patients should be referred only to institutions accredited by recognised international bodies, naming JCI and ISQua. Employer and insurer programmes set their own criteria, so ask the payer.
A Russian-language report quotes the Ministry of Health advising patients, including those going abroad under a state programme, to look for international accreditation such as JCI or ISO certificates as independent confirmation of quality; we could not locate the ministry’s own document, so treat it as reported guidance. We found no rule naming a scheme for payers.
We found no ministry or insurer rule that names a hospital accreditation for patients treated abroad. Where governments or insurers fund treatment abroad we found no published hospital-accreditation criteria, and private buyers set their own panels. Ask each agency or payer for its criteria before you invest.
Directive 2011/24/EU says cross-border care follows the legislation, quality and safety standards of the state of treatment (Article 4(1)) and obliges providers to inform patients about their authorisation or registration status and liability cover (Article 4(2)(b)). Article 8 lets states require prior authorisation for care involving at least one overnight hospital stay or highly specialised, cost-intensive infrastructure. The legal gate is therefore the destination’s licence; JCI, TEMOS or ISO add evidence on top.
Three budget lines are missing from every published schedule and usually decide the real cost: closing the gaps the self-assessment shows (equipment, protocols, building works), training and consultants, and the staff hours the survey absorbs. Ask for the price list of the issuer or certification body, then add an internal estimate for these three. Travel and lodging of surveyors are often billed on top; NABH states this explicitly.
Heuristics drawn from the published scope, not predictions of enquiries: a hospital selling to Gulf institutions has written evidence for a facility-wide accreditation named by the local regulator; a small clinic selling through agencies to self-pay patients in DACH, the UK or Africa faces no written rule, so a management-system certificate or a medical-tourism programme is a proportionate place to start; whether it satisfies a given agency is for that agency to say. If an agency or payer names a scheme in its panel criteria, that requirement outweighs any heuristic.
Providers: show your licence, accreditation and certificate numbers on your Health onMESSE profile and answer agencies’ due-diligence questions in writing before the meeting. Exhibitors pay for participation; see the exhibitor page for what is included.
Payback in months = one-off cost ÷ (extra international cases per year × contribution per case − annual fees and upkeep) × 12. Count only cases that would not have booked without the certificate; an agency or payer that made the scheme a condition can tell you. The numbers below are chosen to show the arithmetic, in any currency; they are not a price quote and not a benchmark.
Change the four inputs to see your own payback in months. If extra cases times contribution does not exceed the annual fees, the scheme does not pay back on those assumptions.
Agencies join Health onMESSE free: browse providers by the licences and accreditations they list, post a Reverse Pitch describing the patients you want to place and book meetings with the clinics and hospitals that respond.
It does not rate hospitals, rank accreditation bodies by quality, or advise on medical treatment or legal compliance. The 1–3 levels record what a market’s published rules and guidance say; they are not a measure of how much a scheme is respected in practice. Rules and fee schedules change: where a figure comes from a trade report, a press release or a mirror of an issuer’s page, the sources list says so, and the issuer’s own page prevails.
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