---
title: "Accept FSA and HSA Cards"
slug: "accept-fsa-and-hsa-cards"
updated: 2026-03-05T22:00:14Z
published: 2026-03-05T22:00:14Z
stale: true
---

> ## Documentation Index
> Fetch the complete documentation index at: https://resource.payrix.com/llms.txt
> Use this file to discover all available pages before exploring further.

# Accept FSA and HSA Cards

The Payrix Pro platform follows a meticulous process to assist with properly authorizing flexible spending account (FSA) and health savings account (HSA) card payments, using an innovative Inventory Information Approval System (IIAS) solution.

Merchants in medical-related industries can process HSA and FSA cards by meeting IRS requirements through either IIAS Certification or 90% Rule registration. The following table describes each program:

| Process | Description | Compliance |
| --- | --- | --- |
| **IIAS Certification** | Implements a system that can verify and approve eligible healthcare items at the point of sale (POS). This ensures that items purchased with an FSA or HSA account card comply with IRS guidelines for qualified medical expenses. | Certain merchant category codes (MCCs) require an IIAS-compliant POS system. |
| **90% Rule registration** | An alternative method allowing merchants to automatically approve transactions as eligible if at least 90% of the items sold are FSA and HSA eligible. This rule simplifies the process for some merchants but may not provide as much detailed verification as IIAS. | Only stores whose gross sales are at least 90% from prescriptions and over-the-counter eligible healthcare products can be registered as qualifying for the 90% Rule. |

After getting certified with IIAS or registered with the 90% Rule, your merchant locations can accept most FSA and HSA account card payments for various medical-related products and services.

## HSA and FSA Card Payment Processing

To accept card payments from HSA and FSA accounts, you must:

1. Be an eligible Merchant Commercial Code (MCC).
2. Receive IIAS Certification from the Special Interest Group for IIAS Standards (SIGIS) with Worldpay as your acquirer.

> [!NOTE]
> **Note**
> 
> Medical MCCS, specific MCCs don’t require SIGIS certification, governed by the FSA/HSA plan administrator.
3. Integrate with the Express Gateway to pass IIAS certification data. See [Express Features & Functionality Documentation](https://docs.worldpay.com/apis/express/features) for more information on Express healthcare processing guidelines.

> [!WARNING]
> **Important!**
> 
> In compliance with IRS regulations, if a merchant does not register for the 90% Rule Exemption or has not implemented an IIAS certification, card issuers will decline transactions submitted by customers with FSA or HRA cards.

---

## IIAS Certification

The following sections explain MCC eligibility and how to obtain IIAS certification from the Special Interest Group for IIAS Standards (SIGIS).

### IIAS Certification: Merchant Category Code (MCC) Eligibility

Merchants with IIAS certification can accept FSA or HSA cards for eligible items under specific medical-related MCCs, which enables auto-substantiation of purchases. Key MCCs include doctors, dentists, hospitals, pharmacies, and various healthcare practitioners.

#### Medical-Related MCCs

Key medical-related MCCs for IIAS-certified merchants include:

- **8011:** Doctors—not elsewhere classified
- **8021:** Dentists, Orthodontists
- **8031:** Osteopathic Physicians
- **8041:** Chiropractors
- **8042:** Optometrists, Ophthalmologists
- **8043:** Opticians, Optical Goods, and Eyeglasses
- **8050:** Nursing and Personal Care Facilities
- **8062:** Hospitals
- **8071:** Dental and Medical Laboratories
- **8099:** Health Practitioners, Medical Services—not elsewhere classified
- **5975:** Hearing Aids
- **4119:** Ambulance Services

#### Retail and General MCCs

Key retail or general MCCs that require IIAS compliance include:

- **5912/5122:** Pharmacies/Drug Stores
- **5411:** Grocery Stores, Supermarkets
- **5310:** Discount Stores
- **5300:** Wholesale Clubs
- **5499:** Convenience Stores
- **5960, 5964, 5965, 5969:** Direct Marketing - Pharmacy/Catalog/Specialty

Merchants without these specific medical MCCs, such as supermarkets and discount stores, must use an IIAS to verify that items purchased with FSA or HSA cards are eligible.

#### Childcare-Specific MCCs

Childcare-specific cards can be used only at the following MCC:

- **8351:** Child Care Services

> [!NOTE]
> **Note**
> 
> ***8299:****Schools and Educational Services (Not Elsewhere Classified)* is not eligible for FSA or HSA healthcare card acceptance.

### Obtain IIAS Certification

Based on your entity level, follow the steps in one of the sections below to become a SIGIS member and receive IIAS certification.

#### Merchant IIAS Certification

1. Merchants must complete the [SIGIS IIAS Merchant Certification Self-Assessment](https://sig-is.org/download?contentid=21387). If the merchant’s partner is registered with SIGIS, they must [register as a certified TPS Merchant](https://sig-is.org/Download?ContentID=21389).
2. Worldpay sends this completed self-assessment to the SIGIS Certification and Compliance Committee.
3. SIGIS reviews the self-assessment for the merchant, ensuring completeness and accuracy. If deficiencies are identified, Worldpay collaborates with the merchant to revise and resubmit the self-assessment to meet SIGIS requirements.
4. After getting approved for SIGIS membership, the merchant begins the technical testing with Worldpay.
5. After technical testing is successful and the self-assessment is approved, the merchant is certified and will be listed on the SIGIS record of certified merchants.

> [!NOTE]
> **Note**
> 
> Merchants that are members of SIGIS under a partner, also known as a *third-party servicer (TPS)*, certified by SIGIS and Worldpay can obtain IIAS Certification without technical testing.

After successful IIAS certification, the merchant is listed in the SIGIS IIAS Merchant List and fully IIAS-compliant to accept FSA and HSA payments.

#### Partner or Third-Party Servicer IIAS Certification

1. Partners must complete a [SIGIS Third-Party Servicer Certification Self-Assessment](https://sig-is.org/Download?ContentID=21390).
2. Worldpay sends this completed self-assessment to the SIGIS Certification and Compliance Committee.
3. SIGIS reviews the self-assessment for the merchant, ensuring completeness and accuracy.

If deficiencies are identified, Worldpay collaborates with the merchant to revise and resubmit the self-assessment to meet SIGIS requirements.
4. After getting approved for SIGIS membership, the partner begins the technical testing with Worldpay.
5. After technical testing is successful and the self-assessment is approved, the partner is certified and will be listed on the SIGIS record of certified TPSs.

> [!NOTE]
> **Note**
> 
> To begin IIAS Certification for merchants in your portfolio, complete an online [SIGIS TPS Client Merchant Form](https://sig-is.org/Download?ContentID=21389).

After successful IIAS certification, the partner (in other words, the TPS) is listed in the SIGIS IIAS Merchant List and fully IIAS-compliant to accept FSA and HSA payments.

---

## 90% Rule Registration

Completing the 90% Rule Registration does not make a merchant IIAS-compliant. If a merchant registers to be designated as 90% Rule exempt, the merchant is stating that its stores are exempt from the IRS requirement to have IIAS standards in place.

> [!WARNING]
> **Important!**
> 
> The IRS requires annual registration and re-attestation of the sales of each registered store location to maintain 90% rule registration from prescriptions or eligible medical items.

### 90% Rule Registration: Merchant Category Code (MCC) Eligibility

FSA and HSA cards may be accepted by merchants with 90% Rule Registration under the following medical-related MCCs:

- **5912**– Drug Stores/Pharmacies
- **5122**– Druggist/Drug Proprietaries

### Merchant 90% Rule Registration

1. Contact your Partner Experience Manager to obtain the following for each store location:
  - **Mastercard Interbank Card Association (ICA) Number:** A four to six-digit number used to identify each financial institution and third-party processor operating within the Mastercard network.
  - **Visa Bank Identification Number (BIN):** A unique six or eight-digit number assigned by Visa to the processors, acquirers, issuers, and other financial institutions operating within the Visa network.
  - **Mastercard Card Acceptor ID:** A numeric string identifying the store location or transaction point by Mastercard.
  - **Visa Card Acceptor ID:** A numeric string identifying the store location or transaction point by Visa.
  - **Merchant Category Code (MCC):** The MCC from the ISO 18245 list.
  - **Merchant ID:** The merchant’s ID on the Worldpay platform.

1. Log in to the [SIGIS Members Area](http://www.sig-is.org/).
2. Click the **Access 90% Forms** link and complete the online registration form.

> [!NOTE]
> **Note**
> 
> Members can enter multiple DBAs under one Primary Organization (SIGIS Membership).

1. The merchant receives a registration confirmation through email.

After successful 90% Rule Registration, the merchant’s locations are listed on the SIGIS website as a **90% Rule Compliant Merchant**.

A PayFac-as-a-service platform. Software companies can act as payment facilitators without taking on the associated risks, compliance burdens, and investment.

The location of a transaction’s origin. Also known as *point of service*.

An entity that can process transactions and has been onboarded through a Payrix Pro partner.

A gateway used by Payrix Pro for triPOS integrations. All transactions flow through this gateway, which serves as the processing engine behind all Worldpay APIs. Designed as a routing gateway for both Worldpay acquired and non-acquired merchants, Express enables developers certifying to Express APIs to integrate payment solutions with the processor of a merchant’s choice. Worldpay's server-side, web service payment applications use secure point-to-point encryption and tokenization methods.

1. Any merchant or partner account operating on the Payrix Pro platform.
2. In API terms, the top-level resource for any merchant or partner account.