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TITLE 28INSURANCE
PART 1TEXAS DEPARTMENT OF INSURANCE
CHAPTER 21TRADE PRACTICES
SUBCHAPTER KKHEALTH CARE REIMBURSEMENT RATE INFORMATION
RULE §21.4505Requirement to Collect Data

(a) Each applicable health benefit plan issuer and plan specified in §21.4502(a) and (b) of this title must annually collect the data specified under §21.4507 of this title and prepare and file data as provided.

(b) Data elements and health care services specified under §21.4507(b) and (c) of this title must be collected with respect to medical billing codes specified by TDI. The current set of medical billing codes will be available to issuers in a Microsoft Excel template on TDI's website at www.tdi.texas.gov/health/reimbursement.html. If there are changes in standard medical practice or medical billing codes that necessitate changing the identified billing codes for the services specified in §21.4507(c) of this title, the billing codes on TDI's website will be updated and affected carriers notified, but in no event will these updates occur more often than annually or less than six months before the May 1 reporting deadline.


Source Note: The provisions of this §21.4505 adopted to be effective January 9, 2011, 35 TexReg 11868; amended to be effective June 6, 2016, 41 TexReg 4027

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