Code Change Summary: Clarifications were made to specify that metallic outlet boxes, device boxes, junction boxes, fittings, and other wiring enclosures are required for patient care space branch circuits.

SME commentary: In the 2026 NEC^®, revised language in Section 517.13(A) clarifies that the redundant ground wiring methods required for branch circuits serving patient care spaces in this section is not just limited to the metal raceway or cable, but also includes ensuring that outlet boxes, device boxes, junction boxes, fittings, and other wiring enclosures are metallic. The new text now reads, “All branch circuits serving patient care spaces shall be provided with an effective ground-fault current path by installation in a metal raceway system or a cable having a metallic armor or sheath assembly including metallic outlet boxes, device boxes, junction boxes, fittings, and other wiring enclosures.”

The addition of this wording closes a gap in the 2023 NEC^® that could have been interpreted to allow the use of nonmetallic outlet or junction boxes in these circuits. Prior to this revision, the language only required the metal raceway or metallic cable armor to serve as the effective grounding path, without specifically mentioning the enclosures that complete the system. As a result, installers could have used nonmetallic boxes while maintaining metallic wiring methods, inadvertently interrupting the low-impedance grounding path required for branch circuits serving patient care spaces.

The revision reaffirms the NEC’s intent that the entire wiring assembly, including metallic boxes and fittings, contribute to the effective ground-fault current path. Patient care spaces are areas where continuity of grounding integrity is vital to patient and equipment safety. A metallic raceway or cable armor provides one part of this redundant path, while the metallic enclosures ensure the continuity of the second part that connects receptacles, switches, and devices to the system grounding path. Using nonmetallic boxes in these locations could compromise the two-part protective scheme, potentially preventing fault current from returning promptly to the source under fault conditions.

The 2026 update also reinforces the correlation between 517.13(A) and Sections 250.118 and 250.109(A), which recognize metallic raceways and cable armor as acceptable equipment grounding conductors. By explicitly adding boxes and fittings to this list, the NEC^® ensures consistent compliance and eliminates ambiguity during inspection. This change helps inspectors and designers verify that all components in patient care branch circuits are metallic and properly bonded, maintaining an uninterrupted fault-current path for quick overcurrent device operation during a fault.

Below is a preview of the NEC^®. See the actual NEC^® text at NFPA.ORG for the complete code section. Once there, click on their link to free access to the 2026 NEC^® edition of NFPA 70.

2023 Code Language:

517.13(A) Wiring Methods. All branch circuits serving patient care spaces shall be provided with an effective ground-fault current path by installation in a metal raceway system or a cable having a metallic armor or sheath assembly. The metal raceway system, metallic cable armor, or sheath assembly shall itself qualify as an equipment grounding conductor in accordance with 250.118.

2026 Code Language:

517.13(A) Wiring Methods. All branch circuits serving patient care spaces shall be provided with an effective ground-fault current path by installation in a metal raceway system or a cable having a metallic armor or sheath assembly including metallic outlet boxes, device boxes, junction boxes, fittings and other wiring enclosures. The metal raceway system, metallic cable armor, or sheath assembly shall itself qualify as an equipment grounding conductor in accordance with 250.118 and 250.109(A).