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Medical Waste Regulations by State: A Comparative Guide

Last reviewed: August 17, 2026

Medical waste regulations in the United States are primarily set at the state level. While federal agencies like OSHA and the EPA establish baseline standards, each state designates its own regulatory agency, defines what counts as regulated medical waste, sets generator thresholds, and determines storage and treatment requirements.

For healthcare organizations operating across multiple states, these differences matter. A practice that is fully compliant in Texas may be out of compliance in Georgia simply because generator categories, storage limits, or labeling rules differ. This guide compares the medical waste regulatory frameworks in the five states where remedi provides services: Texas, Arizona, Georgia, Colorado, and New Mexico.

Federal Baseline: What Applies Everywhere

Before looking at state-specific rules, it helps to understand the federal requirements that apply regardless of location:

• OSHA Bloodborne Pathogens Standard (29 CFR 1910.1030): Requires employers to protect workers from bloodborne pathogen exposure. Mandates sharps containers, exposure control plans, annual training, and post-exposure protocols.
• DOT Shipping Requirements: Regulated medical waste shipped off-site must be classified as UN 3291 (Regulated Medical Waste) and packaged according to DOT Hazardous Materials Regulations (49 CFR 173.134).
• EPA RCRA (hazardous pharmaceutical waste): Pharmaceuticals that are RCRA hazardous must follow EPA hazardous waste management standards, including the 2019 Subpart P rule for healthcare facilities.

Everything beyond these federal requirements is governed by state law. The differences are significant.

Texas: TCEQ 25 TAC Chapter 326

Texas regulates medical waste through the Texas Commission on Environmental Quality (TCEQ) under Title 25 of the Texas Administrative Code, Chapter 326.

• Regulatory agency: TCEQ (Texas Commission on Environmental Quality)
• Generator threshold: Facilities generating 50 pounds or more of untreated medical waste per month must register with TCEQ as a generator.
• Storage limits: Untreated medical waste may be stored for up to 30 days at the point of generation. If refrigerated at or below 40°F, the storage period may be extended.
• Treatment methods: Autoclaving, incineration, and other TCEQ-approved treatment technologies.
• Transporter requirements: Transporters must be registered with TCEQ. Shipments require tracking documents (manifests).
• Record retention: Generators must retain records for a minimum of three years.

For more on Texas-specific sharps requirements, see Where to Dispose of Sharps Containers in Texas.

Arizona: ADEQ AAC Title 18, Chapter 13, Article 14

Arizona regulates biohazardous waste through the Arizona Department of Environmental Quality (ADEQ).

• Regulatory agency: ADEQ (Arizona Department of Environmental Quality)
• Generator threshold: Facilities generating 40 pounds or more per month are classified as large generators and must register with ADEQ.
• Storage limits: Untreated biohazardous waste may be stored for up to 30 days from the date of generation.
• Treatment methods: Autoclaving, incineration, and other ADEQ-approved methods.
• Transporter requirements: Authorized transporters only. Manifest documentation required for every shipment.
• Record retention: Minimum three years.

For Arizona-specific guidance, see Biohazardous Waste Disposal in Arizona: 5 Steps to Compliance and How to Dispose of Sharps Containers in Arizona.

Georgia: GA EPD Rule 391-3-4-.15

Georgia regulates biomedical waste through the Georgia Environmental Protection Division (GA EPD) under Rule 391-3-4-.15. Georgia uses the term "biomedical waste" rather than "medical waste" or "biohazardous waste."

• Regulatory agency: Georgia EPD (Environmental Protection Division, under the Georgia Department of Natural Resources)
• Generator threshold: Facilities generating less than 100 pounds of biomedical waste per month are considered small generators and are exempt from most provisions of the rule. Facilities at or above 100 pounds per month must comply with full registration, reporting, and record-keeping requirements.
• Biomedical waste categories: Pathological waste, biological waste (blood and blood products), cultures and stocks, contaminated animal materials, sharps, chemotherapy waste, and discarded medical equipment with potential for contamination.
• Container requirements: Containers must be sturdy, leak-proof, and puncture-resistant. Each container must display the biohazard symbol and be labeled "Biohazardous Waste."
• Storage limits: Consult GA EPD for current storage time and temperature requirements, as these are subject to updates.
• Treatment methods: Incineration, autoclaving, or other state-approved treatment techniques.
• Transport: Only transporters authorized and registered with the state may transport biomedical waste. Vehicles must be labeled, and manifest protocols must be followed.
• Records: Generators must maintain records for a minimum of three years and submit quarterly reports to GA EPD.
• Registration: Facilities must register with the Georgia Department of Natural Resources.

For detailed Georgia guidance, see Medical Waste Disposal in Georgia and Sharps Disposal in Georgia.

Colorado: CDPHE 6 CCR 1007-2, Part 16

Colorado regulates medical waste (referred to as "biohazardous waste" in state rules) through the Colorado Department of Public Health and Environment (CDPHE).

• Regulatory agency: CDPHE (Colorado Department of Public Health and Environment)
• Generator threshold: Colorado does not use a weight-based small/large generator distinction in the same way as Texas or Arizona. All generators of biohazardous waste must follow CDPHE handling and disposal rules.
• Storage limits: Consult CDPHE for current storage time limits. Best practice is to arrange pickup before waste has been stored for 30 days.
• Treatment methods: Autoclaving, incineration, and other CDPHE-approved methods. Colorado allows certain alternative treatment technologies with prior approval.
• Transporter requirements: Transporters must comply with CDPHE and DOT regulations. Manifests or tracking documents are required.
• Record retention: Generators should retain records in accordance with CDPHE guidance. Consult the department for current retention periods.

New Mexico: NMAC 20.9.20

New Mexico regulates infectious waste through the New Mexico Environment Department (NMED) under the New Mexico Administrative Code.

• Regulatory agency: NMED (New Mexico Environment Department)
• Generator threshold: New Mexico distinguishes between small quantity generators and large quantity generators. Consult NMED for current threshold definitions.
• Storage limits: Consult NMED for current storage time and temperature requirements.
• Treatment methods: Autoclaving, incineration, and other NMED-approved treatment methods.
• Transporter requirements: Transporters must be permitted by NMED. Manifests are required for all shipments.
• Record retention: Consult NMED for current retention period requirements.

Quick Comparison Table

Requirement	Texas (TCEQ)	Arizona (ADEQ)	Georgia (EPD)	Colorado (CDPHE)	New Mexico (NMED)
Large generator threshold	50 lbs/month	40 lbs/month	100 lbs/month	No weight-based tier	Consult NMED
Max storage (unrefrigerated)	30 days	30 days	Consult GA EPD	Consult CDPHE	Consult NMED
Authorized transporter required	Yes	Yes	Yes	Yes	Yes
Manifests required	Yes	Yes	Yes	Yes	Yes
Record retention	3 years	3 years	3 years	Consult CDPHE	Consult NMED
Accepted treatment	Autoclave, incineration	Autoclave, incineration	Autoclave, incineration, approved alternatives	Autoclave, incineration, approved alternatives	Autoclave, incineration

Why State Differences Matter for Multi-Location Organizations

If your organization operates facilities in more than one state, you cannot simply apply one state's rules everywhere. A facility compliant in Texas (50 lb threshold) might be a non-registered generator in Georgia (100 lb threshold) without knowing it falls below the Georgia line. Conversely, a practice generating 45 pounds per month would be unregistered in Texas but classified as a large generator in Arizona.

The practical solution is to work with a waste management partner that understands the regulatory framework in every state where you operate. This eliminates the need for your staff to track changing state requirements across multiple jurisdictions.