This chapter focuses on assessment of community interpreter performance in U.S. healthcare setting where nearly 50 million U.S. residents speak a language different from their primary healthcare provider. It briefly discusses the way assessment of mediated interaction in patient-healthcare professional interaction falls short in its exclusive emphasis on words and phrases and “verbatim” renditions, at the exclusion of other linguistic and interactional features. Grounded in concepts derived from interactional sociolinguistics and conversation analysis, it points to the need to develop a more comprehensive approach to assessing interpreter performance, emphasizing discourse management and the use and transfer of contextualization cues. A step-by-step approach for developing an analytic scoring rubric for assessing interactional competence is presented.