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How Do Texas Telemedicine, Telehealth, Teledentistry Billing Work?

03 Jun, 2025 Frank Ferreri

                               
Compliance Corner

It seems like just yesterday that the proliferation of telemedicine services in health care was new and novel. Now, it's an established part of workers' compensation process across the country, including Texas. If you were in the Lone Star State, where would you find what the rules are for billing and telehealth?

Simply Research subscribers have access to that information, but we give an overview here.

How Must Providers Bill?

A health care provider must bill for telemedicine, telehealth, and teledentistry services according to applicable:

(1) Medicare payment policies, as defined in 134.203 of the Texas Workers' Compensation Act (relating to Medical Fee Guideline for Professional Services).

(2) Medicaid payment policies, in accordance with the dental fee guideline in 134.303 of Texas Workers' Compensation Act (relating to 2005 Dental Fee Guideline).

(3) Provisions of Chapter 133 of the Texas Workers' Compensation Act.

Does Location Matter?

A health care provider may bill and be reimbursed for telemedicine, telehealth, or teledentistry services regardless of where the injured employee is located at the time the telemedicine, telehealth, or teledentistry services are provided.

Conflict with other Rules

The provisions of these rules for billing take precedence over any conflicting provisions adopted or used by:

(1) The Centers for Medicare and Medicaid Services in administering the Medicare program; and

(2) The Texas Health and Human Services Commission in administering the Texas Medicaid Program.

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    About The Author

    • Frank Ferreri

      Frank Ferreri, M.A., J.D. covers workers' compensation legal issues. He has published books, articles, and other material on multiple areas of employment, insurance, and disability law. Frank received his master's degree from the University of South Florida and juris doctor from the University of Florida Levin College of Law. Frank encourages everyone to consider helping out the Kind Souls Foundation and Kids' Chance of America.

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