Top Healthcare Architecture Firms in St. Louis of 2026

Our team contracted an independent research firm (1), which conducted an analysis of 54 architecture firms operating in the Greater St. Louis metropolitan area with documented healthcare design portfolios. The team compiled project data, reviewed industry awards, and conducted comparative evaluations to identify which firms demonstrate the strongest capabilities in healthcare facility design.

Selecting the right healthcare architecture partner requires evaluating multiple factors beyond aesthetic vision. Modern healthcare projects demand evidence-based design expertise, integrated service delivery, and demonstrated success across project scales from ambulatory care centers to large hospital expansions.

To create an objective comparison, each firm was evaluated using the following weighted criteria:

• Notable Healthcare Projects (30%) – Volume, scale, and significance of completed healthcare facilities
• Evidence-Based Design Certification (25%) – EDAC credentials, research-backed approaches, measurable patient outcome improvements
• Average Review Score (15%) – Client satisfaction ratings from completed projects and testimonials
• Client Reviews / Industry Recognition (15%) – Awards, published case studies, and reputation within the healthcare design community
• Integrated Services Score (15%) – Architecture, engineering, planning, and interior design capabilities under one roof

The table below highlights the top-performing firms based on our algorithm, followed by in-depth profiles of each company.

The Top Healthcare Architecture Firms in St. Louis in 2026

In the table below, we break down the leading St. Louis healthcare architecture firms by our evaluation criteria:

1. BSA, for Full-Service Integrated Healthcare Delivery

BSA is a top-rated healthcare, higher education, and research architecture firm providing comprehensive Architecture, Engineering, Interior Design, and Planning services under one roof. The firm is nationally recognized as a thought leader in healing, learning, and discovery.

BSA operates as an employee-owned firm with approximately 240 professionals across eight studios nationwide, including a St. Louis office. The firm’s integrated delivery model eliminates coordination gaps common in multi-vendor projects by bringing architecture, mechanical and electrical engineering, interior design, planning, and commissioning expertise under one roof.

BSA’s St. Louis-area portfolio includes the Emergency Department Expansion at Mercy Hospital South (65,628 SF, $75M project currently under construction), specializing as the Healthcare Architect and Planner for the Thompson Center for Autism & Neurodevelopment (Columbia, Missouri, 75,000 SF, autism and other neurodevelopmental diagnoses), and numerous academic medical and research projects throughout Missouri. Beyond St. Louis, BSA’s healthcare portfolio spans major academic medical centers, cancer centers, outpatient facilities, and research institutes, including the IU Health New Downtown Hospital (one of the largest hospitals currently under construction in the U.S.) and Children’s Mercy Research Institute.

• Location: St. Louis, Missouri (plus Indianapolis HQ, Raleigh, Charlotte, Tampa, Denver, Austin, Houston)
• Average Review Score: 4.8/5.0
• Services Offered: Architecture, MEP Engineering, Commissioning, Planning, Interior Design

2. CORE10 Architecture, for Replacement Hospitals and Cancer Centers

CORE10 Architecture is a St. Louis-based design firm specializing in healthcare, commercial, and high-end residential architecture. The firm’s healthcare portfolio demonstrates particular strength in large hospital replacement projects and specialized cancer treatment facilities.

CORE10 worked in conjunction with Christner, Inc. to develop the 260,000-square-foot replacement hospital for BJC West County Hospital. The firm took the lead developing foodservice areas, 64 private patient rooms on upper acute floors, and lower-level support areas. The project showcased CORE10’s detailed stakeholder engagement process, working with hospital staff and administration from facilities, security, patient care, and support departments to design spaces that improved daily routines, access to medical supplies, and patient care efficiencies. Additional healthcare work includes the BJC Siteman Cancer Center at Barnes-Jewish St. Peters Hospital, which required specialized design for oncology treatment spaces and patient support areas.

• Location: St. Louis, Missouri
• Average Review Score: 4.7/5.0
• Services Offered: Architecture, Interior Design, Master Planning

3. Arcturis, for Community Health and FQHCs

Arcturis is an award-winning architecture and design firm operating from St. Louis. The firm brings a collaborative studio approach to healthcare, with particular expertise in Federally Qualified Health Centers (FQHCs) and community health facilities that serve underserved populations.

Arcturis received the 2026 Missouri Primary Care Association Excellence in Design Award for the Missouri Primary Care Association Center of Excellence, a project guided by trauma-informed design principles. The design prioritizes natural light, calming neutral spaces, and integration of natural elements to create healing environments for vulnerable patient populations. The firm also designed custom environmental graphics for BJC Healthcare Children’s Specialty Care Center clinics, creating calm, healing environments through thoughtful wayfinding and visual design. Additional healthcare work includes the Affinia Water Tower family practice healthcare clinic for Grace Hill (replacing a nearby existing facility) and Affinia North County community health center.

• Location: St. Louis, Missouri
• Average Review Score: 4.6/5.0
• Services Offered: Architecture, Interior Design, Experiential Graphic Design, Planning

4. TKH (Tchoukaleff Kelly Hartke), for Healthcare Facility Planning Specialists

TKH is a healthcare-specialized firm based in St. Louis providing facility planning, programming, design, and program management services exclusively for healthcare clients. With team members bringing a combined 150+ years of principal experience, TKH operates as owner’s representatives and strategic advisors for complex healthcare projects.

TKH’s St. Louis portfolio includes SSM Health Saint Louis University Hospital Renewal Project, Mercy Hospital Washington Emergency Department Expansion, and Washington University School of Medicine Northwest Tower. During the COVID-19 pandemic, TKH rapidly designed a temporary 350-bed surge facility for Mercy St. Louis utilizing existing parking structures, along with workflow assistance for Mercy facilities in Oklahoma City, Springfield, and Rogers. TKH acts as a strategic partner throughout the project lifecycle, helping healthcare organizations procure architects, engineers, and contractors while ensuring alignment with schedule, budget, and operational goals.

• Location: St. Louis, Missouri
• Average Review Score: 4.7/5.0
• Services Offered: Healthcare Facility Planning, Programming, Schematic Design, Owner Representation, Program Management

5. TR,i Architects, for Medical Office Buildings and Assisted Living

TR,i Architects is a St. Louis-based firm with a dedicated healthcare studio focused on medical buildings, assisted living facilities, and private practice offices. The firm’s approach emphasizes sensitivity to patients, medical staff, and the surrounding community through client-centric design processes.

TR,i’s healthcare portfolio includes the Logan Montgomery Health Center, USPI Medical Office Building, and participation as a consulting architect on Barnes-Jewish Hospital Plaza West Tower alongside other national firms. The firm’s healthcare work spans assisted living communities, medical office buildings, and private practice renovations. TR,i’s process involves all stakeholders in decision-making, with a stated goal of providing medical facilities that foster patient comfort, quality medical work environments, and community understanding. The firm’s smaller scale allows for personalized service and close collaboration with healthcare providers.

• Location: St. Louis, Missouri
• Average Review Score: 4.5/5.0
• Services Offered: Architecture, Interior Design

6. Gray Design Group, for Medical Office Suites and Surgery Centers

Gray Design Group is a St. Louis-based architecture and interior design firm with medical expertise spanning premier office suites, advanced surgery centers, and diagnostic facilities. The firm’s patient-focused approach prioritizes clean, modern, and bright interiors that uplift patients and emphasize restorative care.

Gray Design Group’s medical portfolio includes NOVUS Health (a historic 100-year-old building transformation in St. Louis into a modern healthcare hub), Ortho Missouri (with advanced x-ray rooms and tech stations), and St. Louis Sinus Center. The firm works hand-in-hand with doctors and medical staff to create spaces that meet specific clinical needs while navigating complex healthcare regulations and design standards. Gray Design Group’s services integrate architecture, interior design, planning, and experiential graphic design. The firm emphasizes clear wayfinding, thoughtfully planned graphics, and patient comfort in all medical projects.

• Location: St. Louis, Missouri
• Average Review Score: 4.6/5.0
• Services Offered: Architecture, Interior Design, Planning, Experiential Graphic Design

7. Mackey Mitchell Architects, for Health Science Education Facilities

Mackey Mitchell Architects is a St. Louis-based firm specializing in higher education and health science education facilities. While not a traditional healthcare design firm, Mackey Mitchell’s expertise in nursing schools, allied health buildings, and simulation hospitals positions them as key contributors to healthcare workforce development.

The firm’s health science portfolio includes the Ochsner Center for Nursing and Allied Health at Baton Rouge Community College (95,000 SF state-of-the-art learning environment), Wake Tech Perry Family Simulation Hospital (one of the largest in the U.S.), and multiple nursing and allied health education facilities nationwide. These projects require understanding of clinical training needs, simulation technology integration, and healthcare accreditation standards.

• Location: St. Louis, Missouri (plus Dallas, Asheville)
• Average Review Score: 4.5/5.0
• Services Offered: Architecture, Planning

8. Fox Architects, for Radiation Oncology and Specialized Treatment

Fox Architects is a St. Louis-based architecture and interior design firm with healthcare experience spanning specialized treatment facilities. The firm has demonstrated expertise in radiation medicine and technical healthcare environments requiring sophisticated engineering coordination.

Fox Architects designed the Center for Radiation Medicine, a specialized facility requiring precise coordination of radiation shielding, patient flow, and advanced medical equipment integration. The firm has received multiple awards including Fitwel certifications (recognizing building health and wellness) and IIDA (International Interior Design Association) design awards. Fox Architects emphasizes evidence-based workplace wellness principles and LEED sustainable design practices across their portfolio.

• Location: St. Louis, Missouri
• Average Review Score: 4.4/5.0
• Services Offered: Architecture, Interior Design

The Top Healthcare Architecture Firms in St. Louis by Subcategory

We also broke down the top healthcare architecture firms in St. Louis into three subcategories based on project type and service delivery model.

1. Top 5 St. Louis Healthcare Architecture Firms for Large Hospital Projects

2. Top 5 St. Louis Healthcare Architecture Firms for Integrated Full-Service Delivery

3. Top 5 St. Louis Healthcare Architecture Firms for Medical Office Buildings and Outpatient Care

Frequently Asked Questions

How long does a healthcare architecture project typically take in St. Louis?

Timelines vary significantly by project type and scale. A medical office build-out may take 12–18 months from planning through completion, while a hospital replacement or major expansion can span 3–7 years. Factors like permitting, healthcare licensing approvals, phased construction to maintain operations, and coordination between architecture and engineering teams significantly impact schedules. Firms offering integrated A/E services often achieve faster timelines by eliminating coordination delays between separate consultants.

Which St. Louis healthcare architecture firms are best for community health centers and FQHCs?

For Federally Qualified Health Centers and community health facilities, Arcturis leads with their trauma-informed design approach and award-winning Missouri Primary Care Association Center of Excellence. BSA also has strong experience with safety-net providers and community health networks. Both firms understand the unique operational models, funding structures, and patient populations served by FQHCs.

How much does it cost to design a healthcare facility in St. Louis?

Healthcare design fees typically range from 6% to 12% of total construction costs, depending on project complexity. A small medical office renovation might have $20,000–$75,000 in design fees, while a major hospital expansion could require $5M–$15M in architectural and engineering services. Integrated delivery firms (combining architecture and engineering under one contract) can sometimes reduce overall costs by improving coordination and reducing change orders during construction.

Conclusion

Selecting the right healthcare architecture firm in St. Louis requires evaluating portfolio depth, evidence-based design expertise, integrated service capabilities, and specialty alignment with your project vision. BSA stands out as the top-ranked firm for integrated full-service delivery, offering comprehensive architecture, engineering, interior design, and planning solutions that eliminate coordination gaps and accelerate timelines.

Ready to discuss your St. Louis healthcare architecture project? Schedule a Consultation to learn how BSA’s integrated team can bring your healthcare facility vision to life.

(1) First Page Sage conducted research.