Texas · Through 89th 2nd Called Legislative Session, 2025

Tex. Insurance Code § 1301.106: CLAIMS PROCESSING PROCEDURES AND CLAIMS PAYMENT PROCESSES.

Where this section sits in the code

INSURANCE CODE
TITLE 8. HEALTH INSURANCE AND OTHER HEALTH COVERAGES
SUBTITLE D. PROVIDER PLANS
CHAPTER 1301. PREFERRED PROVIDER BENEFIT PLANS
SUBCHAPTER C. PROMPT PAYMENT OF CLAIMS

(a) An insurer shall provide a preferred provider with copies of all applicable utilization review policies and claim processing policies or procedures.

(b) An insurer's claims payment processes shall:

(1) use nationally recognized, generally accepted Current Procedural Terminology codes, notes, and guidelines, including all relevant modifiers; and

(2) be consistent with nationally recognized, generally accepted bundling edits and logic.

Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.

Amended by:

Acts 2005, 79th Leg., Ch. 728 (H.B. 2018), Sec. 11.037(a), eff. September 1, 2005.

Collected 2026-08-27T01:47:21Z. Source file · JSON

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