The PHS Outstanding Service Medal is awarded to an officer who has demonstrated continuous outstanding leadership that has had a major effect on the health of the Nation, or has performed a heroic act resulting in the preservation of life or health.

[2] The PHS Outstanding Service Medal may also be awarded "With Valor", signified by a bronze "V" for recognizing acts of courage and bravery.

The designation “With Valor” is not to be used to recognize hazardous assignments or exposure to dangerous and life threatening environments.

The officer must exhibit a positive and particular act, or actions, of bravery and courage, and/or heroism, resulting in the saving or preserving of the life or health of others.

The degrees of risk to personal safety, the level of bravery, and the demonstration of courage, are determining factors that must be clearly displayed.