Texas Register
TITLE 28 INSURANCE
PART 2TEXAS WORKERS' COMPENSATION COMMISSION
CHAPTER 134BENEFITS--GUIDELINES FOR MEDICAL SERVICES, CHARGES, AND PAYMENTS
SUBCHAPTER AMEDICAL POLICIES
RULE §134.1Use of the Fee Guidelines
ISSUE 05/10/2002
ACTION Final/Adopted
Preamble Texas Admin Code Rule
(a)The ground rules and the medical service standards and limitations as established by the fee guidelines shall be used to properly calculate the payments due to the health care providers.

(b)Health care providers shall bill the insurance carrier for all compensable injuries in accordance with the fee guidelines established by the commission. The health care provider shall bill the insurance carrier for the health care treatments and services performed, and medically necessary to relieve the effects of the compensable injury and promote recovery.

(c)Reimbursement for services not identified in an established fee guideline shall be reimbursed at fair and reasonable rates as described in the Texas Workers' Compensation Act, §413.011 until such period that specific fee guidelines are established by the commission.

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on April 26, 2002

TRD-200202621

Susan Cory

General Counsel

Texas Workers' Compensation Commission

Effective date: May 16, 2002

Proposal publication date: December 28, 2001

For further information, please call: (512) 804-4287

 

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