Medical gas codes evolve slowly—but the details should influence how facilities maintain their systems and plan for future needs. Staying aware of these updates helps engineers and health facilities avoid compliance gaps or unexpected challenges.
By Jonathan Mann
NFPA 99: Health Care Facilities Code does not change dramatically from year to year. Most updates are clarifications or small additions to compliance codes, and many are not enforced for several years. Some facility teams assume the changes are always minor, so they risk becoming an afterthought—but even the smallest revision can affect a facility for years.
Awareness matters more than the size of the change. Engineers are not talking about code updates every day, so these things do not come up until they are working on a relevant project. Subtle changes have implications for operations, inspections, retrofits, and future planning.
Part of the challenge is that NFPA 99 is not adopted uniformly. Many states still follow editions that are more than a decade old, while others have moved ahead in uneven steps. Many states aren’t near 2024 updates, so some of this does not show up in daily conversations. That does not mean the updates can be ignored. It simply means facilities need a way to stay informed before the next project or inspection brings the changes into focus.
What New NFPA 99 Codes Are Signaling
Recent updates highlight why ongoing awareness is essential, even when changes appear minor.
One of the most-talked-about revisions in the 2024 edition is the requirement for an auxiliary connection on the patient side of the source valve. The purpose is to provide a location where a supplemental supply can be added in an emergency. The practical implications are not simple. Adding the tap is easy; figuring out how a facility will actually use it is where things get complicated. Some of this equipment is large and needs space and power that older facilities do not have.
Pressure drop requirements tell a similar story. New rules require calculations that document no more than a 10 percent pressure loss, and hospitals must keep those records on file. This is less about design and more about understanding that documentation and verification procedures are becoming more precise. The burden on facilities will increase, as other updates reinforce this steady rise in detail. The expectations around documentation are increasing. Hospitals will need to have their information organized and ready.
Revised pipe sizing guidance, minimum sizes for WAGD systems, new labeling requirements, cryogenic liquid withdrawal guidance, and added inspection expectations each appear modest in isolation. Together, they represent a tightening of the code’s clarity and intent. NFPA 99 is expanding into more clinical environments and refining expectations along the way. These changes do not require hospitals to overhaul their systems overnight. They do, however, require awareness, especially for teams that may be working with legacy equipment, older piping layouts, or outdated documentation.
Why Engineers and Facilities Should Stay Informed
While engineers spec out the medical gas systems that facilities will rely on for decades, they should understand how small revisions influence maintenance, inspections, and future capacity.
Many medical gas systems remain in service far longer than expected, and any update to NFPA 99 can introduce new obligations for testing, maintenance, labeling, and documentation. Most of these updates will not change the equipment itself; they change what the hospital must do to keep the system compliant. For busy departments, this can be easy to overlook until the next inspection or until an expansion project shines a light on a problem.
Consulting companies work to close that gap by staying engaged with code changes and sharing insights early. Consultants answer questions during planning reviews, and service partners provide ongoing guidance on how systems are aging (specific to each facility) and how teams should respond to new code demands.
Preparing for What Comes Next
For health facility managers and medical gas engineers, the goal is not to chase every revision. It is to understand the direction of the code and work with partners who can interpret the details before they become obstacles. A partner or one of its service providers can help teams build awareness and ensure systems are compliant both now and when they need to evolve.
These are not changes you feel every day, but when the code moves and a facility is not ready, that is when it becomes a real issue. Staying on top of the changes, no matter how small they seem, lays a stronger foundation for future success.
About the Author
Jonathan Mann is a Medical and Laboratory Gas Consultant at Pattons Medical, serving the Northeast U.S. region. Based in Brooklyn, New York, he specializes in providing tailored solutions for medical gas systems, including air compressors, vacuum systems, and pipeline equipment. Jonathan is known for his hands-on approach and deep understanding of NFPA 99 compliance and healthcare facility requirements. He is an active contributor to the medical gas community, sharing insights and engaging with peers.
The opinions expressed in this article are those of the author and not the American Society of Plumbing Engineers.
