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We are a therapuetic program and have many clients who want to use their Health Savings Account (HSA). However, when we swipe their cards or manually put the numbers in, the cards are declined. How do we fix this problem? Do the customers need to contact their HSA?
Thanks so much.

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Hi @sallyjanemixon, great question!
Licensed health care providers can process HSA cards just like any other cards. If you selected the Medical Practitioner, Medical Services, or Dentistry business category when you signed up, you shouldn't have any issue accepting these cards. If you believe your business category needs to be updated, just get in touch with our Support Team. Once they collect some details, they'll be able to adjust your business type
You can check out this article has more info about accepting HSA/FSA cards.
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You're welcome! Sorry for the confusion! 😀
Seller Community Manager
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Helen,
Thank you for your response! No confusion from you!! Actually help confirm what I was asking!
Again Thank you for your time!
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Hi There,
I am a psychotherapist who recently had my MCC code changed to medical. However, my customers FSA card is still getting declined.
Im confused. Any additional info would be helpful!
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This reply was created from merging an existing thread: “Updated MCC but customers FSA card still declined”
@Hmc346 Our Support team can double check your MCC if needed! However, keep in mind that an FSA card may be declined for other reasons, for example insufficient funds or incorrect card information. If your MCC is correct and your customer's card is declined you should ask your customers to contact their card-issuer directly.
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I need to be able to take HSA credit cards. I changed my business type to medical. Is that sufficient?
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My square reader declines several FSA/HSA cards. I have no idea why. I even ordered a replacement square, but I have the same issue. I have always been categorized as “medical”, and have been able to accept some FSA/HSA debit cards. It seems to pick and choose. It’s been a real pain.

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Hey @BonnieLMFT,
Welcome to the seller community and sorry to hear about the confusion this is causing. It sounds like a member of our Customer Success team will need to double check your account settings. If you haven't already, please get in touch with them directly and let them know that FSA/HSA cards have been declining—they'll be able to make sure this gets sorted out ASAP.
Hope this helps clear things up! 🙂
Square Community Program Manager | Square, Inc.
Find step-by-step help in our Support Center
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I'm having an issue with Health Savings Account Visa Cards being declined due to my merchant category code...I need assistance in checking/updating my code.
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The title of this thread has been edited from the original: Why can I no longer use Health Savings Accounts / Flexible Spending Accounts?
I am a acupuncturist using square and for some reason the (add card) for HSA or FSA will not longer allow me to inpt or use HSA or FSA cards. I have been storing and using them for some time. I can't figure out what changes, any one else having this problem?
Thank you, Terri
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@terrimatson It sounds like you have the correct Merchant Category Code already (though our Customer Success team can check for you if you call).
Saying that, even if you have the right MCC to accept HSA and FSA cards as a medical practitionar the card-issuer may still decline the payment for another reason. Card-issuers don't share the reason a payment is declined with Square so I recommend asking one of your clients to call the card issuer to see why their payment was declined. It could be that the card has expired for example.
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Does the Square app accept Health Savings Account cards (HSA Cards) and Debit cards as form of payment? I've tried charging a few HSA cards for my counseling practice, but they are always declined by the Square app. Thanks!
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Hey @jpk2919! Welcome to the Community.
I merged your post to an existing thread on how to accept HSA cards with us.
Check out @George's post/best answer above for more details on how to make sure you're set up correctly to accept them.
If not- you can contact our CS team to make sure you're set up under a medical category or help edit yours if not.
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Yes. Contact customer service to make sure that your account is set up as a health care merchant. If cards are declined after you are set up properly the issue is probably with the card or cardholder's account.
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Boom! Thanks for adding this here, @Possibilities! This is spot on.
If anyone is curious how to contact our Customer Success Team, you can do so here. 📫
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I, too, have trouble with swiping HSA/FSA cards and them being accepted. I have found that I need to manually enter HSA/FSA cards. That has eliminated, for me, any other variables. So when the card is not accepted then it truly is because their card is out of savings.
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I have to manuually enter the HSA card, too. But Square charges more when we manually enter card info. Is there any other way to avoid those high fees?
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Hi there, @dewi!
Manual card entry payments incur the largest processing fee of all Square Payments. Other payment options with lower fees include regular swiped or dipped transactions, as well as Invoices.
You can learn more about processing rates here.
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How do I sign up to accept HEA andfsa FSA Cards?
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@Jpetry - Looks like someone already covered your question on this thread. Check out the best answer on the first page !
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I am trying to HSA card with my card reader on iPhone or iPad. I keep getting a "card declined" error when card is swiped or inserted. I have the correct designation from SquareUp as a Medical Practitioner which I just completed 4 days ago. The customer checked with her card services center and they say they are receiving attempt to charge her card, but it is not being accepted b/c I do not have a Medical Practitioner designation.
Question: Where to go to resolve this? SquareUP or HSA card services or ???
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Hey @DJR - We're not able to check your account's Merchant Category Code from here I'm afraid.
Since it is the card issuer, not Square, that determines card acceptance, any questions you may have about benefit card acceptance should be directed to the card issuer.
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