The Texas Department of Insurance, Division of Workers' Compensation (DWC) maintains a database of institutional medical billing services (SV2). It contains charges, payments, and treatments billed on a CMS-1450 form (UB-92, UB-04) by hospitals and medical facilities that treat injured employees, excluding ambulatory surgical centers, with dates of service for the last five years. For datasets going back to 2010, see institutional medical billing services (SV2) header information – historical.

The header identifies insurance carriers, injured employees, employers, place of service, and diagnostic information. The bill header information groups individual line items reported in the detail section. The bill selection date and bill ID must be used to group individual line items into a single bill. Find more information in our institutional medical billing services (SV2) header data dictionary.

See institutional medical billing services (SV2) detail information for the corresponding detail records related to this dataset.

Go to our page on DWC medical state reporting public use data file (PUDF) to learn more about using this information.

The Texas Department of Insurance, Division of Workers’ Compensation (DWC) maintains a database of institutional medical billing services (SV2). It contains charges, payments, and treatments billed on a CMS-1450 form (UB-92, UB-04) by hospitals and medical facilities that treat injured employees, excluding ambulatory surgical centers, with dates of service for the last five years. For datasets going back to 2010, see institutional medical billing services (SV2) detail information – historical.

The detail contains information to identify insurance carriers, injured employees, employers, place of service, and diagnostic information. The bill details are individual line items that are grouped in the header section of a single bill. The bill selection date and bill ID must be used to group individual line items into a single bill. Find more information in our institutional medical billing services (SV2) detail data dictionary.

See institutional medical billing services (SV2) header information for the corresponding header records related to this dataset.

Go to our page on DWC medical state reporting public use data file (PUDF) to learn more about using this information.

The Texas Department of Insurance (TDI) collects and reports information about billing rates for emergency service providers within political subdivisions as reported by those political subdivisions. The National Provider Identifier Standard (NPI) is a unique ten-digit identification number for covered health care providers. This dataset relates emergency service providers by NPI with the political subdivisions where they operate by year and quarter. There is a row for each emergency service provider operating within a political subdivision. Subdivisions with more than one provider operating in them or providers operating in more than one subdivision will be listed in multiple rows. The data includes the year and quarter the information applies to as well as the date the political subdivision submitted their report.

The Texas Legislature amended Texas Insurance Code Chapter 38 via Senate Bill 2476 during the 88th session to add reporting “relating to consumer protections against certain medical and health care billing by emergency medical services providers. A political subdivision may submit to the department a rate set, controlled, or regulated by the political subdivision for emergency services.”

► For contact information, refer to dataset:  Emergency Services Billing Rates - Contact List.

► For procedure codes rates, refer to dataset:  Emergency Services Billing Rates - Code Rates.

► For ZIP codes within political subdivisions, refer to dataset:  Emergency Services Billing Rates - ZIPs.

Users are responsible for reviewing and updating data before the submission deadlines. Information entered or found in this dataset is subject to change. Visit TDI’s web site disclaimer for more information.

For more information related to this data, visit TDI’s FAQ page.

This dataset includes information related to network adequacy waiver requests filed by major medical health benefit plans. It includes data on physicians, providers, and facilities, other than facility-based physicians and providers. Related datasets are available for major medical (facility-based providers) and vision plans:

• Facility-based Physicians & Providers: Network Adequacy Waiver Request - Facility based Physicians & Providers.This dataset relates to waiver requests for networks used for major medical PPO and EPO plans and includes data on facility-based physicians and providers.

• Vision: Network Adequacy Waiver Request - Vision. This dataset relates to waiver requests for networks used for vision PPO and EPO plans.

Insurers offering health benefits through a preferred or exclusive provider benefit plan (also called PPO and EPO plans) are required to demonstrate that the health insurance network meets Texas network adequacy standards. When a network does not meet these requirements and has a deficiency in a county for a specific physician or provider specialty type, an insurer may apply for a waiver to continue operating within its service area. The commissioner of the Texas Department of Insurance (TDI) may grant the waiver following a public hearing and consideration of relevant testimony and information.

Anyone may attend the public hearing and offer testimony. Learn more about how to submit information related to a waiver request or participate in a hearing here: Network Adequacy Standards Waivers.

The Texas Department of Insurance, Division of Workers' Compensation (DWC) maintains a database of health care providers with current maximum medical improvement (MMI) and designated doctor certifications in Texas. This list includes doctors’ certification periods, phone numbers, and fax numbers.

For more information about designated doctors, go to https://www.tdi.texas.gov/wc/dd/index.html.

For a detailed list of exam locations for these health care providers, go to Workers’ Compensation Maximum Medical Improvement Doctors and Designated Doctors’ Address Information.

The Texas Department of Insurance (TDI) collects and reports information about billing rates for emergency service providers within political subdivisions as set by those political subdivisions. This dataset includes contact information for the reporting political subdivisions. There is a row for the contact information for each reporter and their political subdivision by year and quarter. The data also includes the date the political subdivision reported it.

The Texas Legislature amended Texas Insurance Code Chapter 38 via Senate Bill 2476 during the 88th session to add reporting “relating to consumer protections against certain medical and health care billing by emergency medical services providers. A political subdivision may submit to the department a rate set, controlled, or regulated by the political subdivision for emergency services.”

► For procedure codes rates, refer to dataset:  Emergency Services Billing Rates - Code Rates.

► For National Provider Identifier Standard (NPI) information reported in each political subdivision, refer to dataset: Emergency Services Billing Rates - NPI.

► For ZIP codes within political subdivisions, refer to dataset:  Emergency Services Billing Rates - ZIPs.

Users are responsible for reviewing and updating data before the submission deadlines. Information entered or found in this dataset is subject to change. Visit TDI’s web site disclaimer for more information.

For more information related to this data, visit TDI’s FAQ page.

The Texas Department of Insurance (TDI) collects and reports information about billing rates for emergency service providers within political subdivisions as reported by those political subdivisions. The Zone Improvement Plan (ZIP) code is a unique seven-digit identification number for postal delivery in the United States. This dataset relates political subdivisions and ZIP codes they contain by year and quarter. There is a row for each ZIP code within a political subdivision. Subdivisions containing more than one ZIP code or providers operating in more than one subdivision will be listed in multiple rows. The data includes the year and quarter the information applies to as well as the date the political subdivision submitted their report.

The Texas Legislature amended Texas Insurance Code Chapter 38 via Senate Bill 2476 during the 88th session to add reporting “relating to consumer protections against certain medical and health care billing by emergency medical services providers. A political subdivision may submit to the department a rate set, controlled, or regulated by the political subdivision for emergency services.”

► For contact information, refer to dataset:  Emergency Services Billing Rates - Contact List.

► For procedure codes rates, refer to dataset:  Emergency Services Billing Rates - Code Rates.

► For National Provider Identifier Standard (NPI) information reported in each political subdivision, refer to dataset: Emergency Services Billing Rates - NPI.

Users are responsible for reviewing and updating data before the submission deadlines. Information entered or found in this dataset is subject to change. Visit TDI’s web site disclaimer for more information.

For more information related to this data, visit TDI’s FAQ page.

This dataset includes information related to network adequacy waiver requests filed by major medical health benefit plans. It includes data on facility-based physicians and providers. Related datasets are available for major medical (non-facility-based providers) and vision plans:

• Major medical: Network Adequacy Waiver Request - Major Medical. This dataset relates to waiver requests for networks used for major medical PPO and EPO plans and includes data on physicians, providers, and facilities, other than facility-based physicians and providers.

• Vision: Network Adequacy Waiver Request - Vision. This dataset relates to waiver requests for networks used for vision PPO and EPO plans.

Insurers offering health benefits through a preferred or exclusive provider benefit plan (also called PPO and EPO plans) are required to demonstrate that the health insurance network meets Texas network adequacy standards. When a network does not meet these requirements and has a deficiency in a county for a specific physician or provider specialty type, an insurer may apply for a waiver to continue operating within its service area. The commissioner of the Texas Department of Insurance (TDI) may grant the waiver following a public hearing and consideration of relevant testimony and information.

Anyone may attend the public hearing and offer testimony. Learn more about how to submit information related to a waiver request or participate in a hearing here: Network Adequacy Standards Waivers.

This dataset includes information related to network adequacy waiver requests filed by vision plans. Related datasets are available for major medical PPO and EPO plans:

Major medical
•Network Adequacy Waiver Request - Facility based Physicians & Providers. This dataset relates to waiver requests for networks used for major medical PPO and EPO plans and includes data on facility-based physicians and providers.
• Network Adequacy Waiver Request - Major Medical. This dataset relates to waiver requests for networks used for major medical PPO and EPO plans and includes data on physicians, providers, and facilities, other than facility-based physicians and providers.

Insurers offering vision benefits through a preferred or exclusive provider benefit plan (also called PPO and EPO plans) are required to demonstrate that the health insurance network meets Texas network adequacy standards. When a network does not meet these requirements and has a deficiency in a county for a specific physician or provider specialty type, an insurer may apply for a waiver to continue operating within its service area. The commissioner of the Texas Department of Insurance (TDI) may grant the waiver following a public hearing and consideration of relevant testimony and information.

Anyone may attend the public hearing and offer testimony. Learn more about how to submit information related to a waiver request or participate in a hearing here: Network Adequacy Standards Waivers.

The Texas Department of Insurance, Division of Workers' Compensation (DWC) maintains a database of health care providers with current maximum medical improvement (MMI) and designated doctor certifications in Texas. This list includes doctors’ certification periods, phone numbers, fax numbers, and addresses.

For more information about designated doctors, go to https://www.tdi.texas.gov/wc/dd/index.html.

For a list of health care providers’ MMI and designated doctors’ certifications only, go to Workers’ Compensation Maximum Medical Improvement Doctors and Designated Doctors List.