Accepting HSA/FSA Cards by Partner and Platform

Merchants accepting Health Savings Account (HSA) and Flexible Spending Account (FSA) cards must meet specific requirements depending on their payment processor , software platform , and business type. This article outlines those requirements and common decline codes .

HSA/FSA Processing by Acquirer
Elavon
Driven By	Merchant Category Code (MCC)
Automatic Eligibility	Medical MCCs typically qualify automatically
Special Cases	Pharmacies (5912) and grocery stores may require SIGIS registration
EPI
Acquirer Selection	Choose Fiserv/First Data (EPI will not be listed)
Registration Outcome	Visa and MasterCard assign MVV and MCID Codes are sent to First Data for account setup
Processing Time	Up to 30 days for Visa/MasterCard to return codes
90% Rule	MC ICA: 9820 Visa BIN: 412259
Tipping Considerations	Merchants cannot process HSA and tips on the same account without downgrade risks. Options: Use a healthcare SIC and accept downgrade Set up two MIDs: one for HSA and one for tips
Nuvei
Initial Check	Nuvei checks if the merchant is already registered with SIGIS
If Registered	Nuvei assigns the correct MCC for medical card acceptance
If Not Registered	The merchant must register with SIGIS before proceeding

🔧 Hardware Note

Terminals must be PIN debit injected to accept HSA/FSA cards used as debit.

HSA/FSA Platform Compatibility
Platform	HSA/FSA Compatibility
Dejavoo	Supported. Terminal must be debit-injected.
PAX	Supported. Terminal must be debit-injected.
Valor	Supported. Terminal must be debit-injected.
Authorize.Net	Supported if the HSA card is part of a credit network (e.g., Visa, Mastercard).
NMI	Supported if the HSA card is not debit-only. No special setup needed in most cases.
USCRVT	Supported.
SwipeSimple	❌ Not compatible with debit – cannot accept HSA/FSA cards requiring a PIN.