San Antonio, Texas, is the eighth largest city in the United States and has several distinct hospital systems. For-profit and not-for profit hospitals exist in the city along with a county hospital and multiple military institutions. This article compares and contrasts the structure of point-of-care testing (POCT) programs in the five largest systems. Specifically, inpatient glucose testing is examined. This comparison includes the nursing responsibilities and fiscal components of the programs, including billing.