All persons, living or dead, except elected officials and current political candidates, are eligible to receive the medal.

[1] While there are no residency requirements for the Medal of Merit, all recipients to-date were either born in Washington or lived there at the time of their decoration.

In addition to the recipient's name, the reverse reads "For exceptionally meritorious conduct in performing outstanding services to the people and state of Washington."

By custom, the medal is awarded by the Governor to a slate of recipients during a joint session of the Washington State Senate and Washington State House of Representatives convened for that purpose.

The authorizing legislation does not specify a frequency for issuing the medal, therefore, it has generally been awarded with irregularity.