1 Texas Administrative Code § 61.501 – Payment of Medical Bills

(a) All bills for emergency medical treatment, medical, psychiatric care or counseling, and all bills of health care service providers must be itemized and submitted on a form approved by the OAG. If a collateral source is available, the explanation of benefits (EOB) showing the utilization of collateral sources must be attached.

(b) Health care service providers shall be reimbursed according to the Texas Department of Insurance, Division of Workers’ Compensation allowable medical fee guidelines, where applicable.

(c) Services not covered under the medical fee guidelines that the OAG deems reasonably and necessarily incurred as a result of the criminally injurious conduct may be compensated at a fair and reasonable amount.