What makes it different: clinical workflow drives the layout; heavy specialty MEP; strict codes; expensive equipment that must be coordinated.
- Key requirements: operatory/exam-room plumbing density; medical gas (med-gas) for some practices; lead-lined / shielded rooms for X-ray, CT, cone-beam imaging; sterile-environment HVAC with proper zoning and sometimes negative pressure; ADA throughout; infection-control during construction (ICRA) in active facilities; hand-wash/scrub areas.
- Codes/agencies: local building + health codes; TDLR accessibility (TX); for licensed facilities, state health requirements; ASC/surgery centers face far more stringent code.
- FF&E & equipment: dental chairs, imaging units, sterilizers, casework — large, often vendor-coordinated (Henry Schein, Patterson, etc.); usually budgeted separately from construction.
- Cost driver order: imaging/shielding > plumbing density (operatories) > sterile HVAC > finishes.
- Smart questions to ask the prospect: practice type, number of operatories/exam rooms, imaging modality (drives shielding), ground-up vs. TI, existing shell condition, equipment vendor, target open date.
- Directional: mid-complexity medical TI often $175–$450/SF; a 5,000 SF practice in Plano commonly $1.0M–$1.4M all-in.
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