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Fee Guidelines History

Notes about the table:

Fee Guidelines History (1991 - Current)
Guideline / Description Rule Citation Applicable for Dates of Service Proposal published in Texas Register Adoption published in Texas Register

Ambulatory Surgical Center Fee Guideline

This fee guideline applies to facility medical services provided in a licensed ambulatory surgical center.

§134.402

On and after September 1, 2008

6/13/08

8/22/08 (current rule)

Ambulatory Surgical Center Fee Guideline

§134.402

From December 30, 2007 through August 31, 2008

10/26/07

12/21/07

Ambulatory Surgical Center Fee Guideline

§134.402

From March 10, 2005 through November 30, 2007

12/3/04

3/4/05

Ambulatory Surgical Center Fee Guideline

§134.402

From May 9, 2004 through March 9, 2005

10/31/03

4/30/04

Dental Fee Guideline

This fee guideline applies to professional dental services

§134.303

On and after June 15, 2005

3/4/05

6/3/05 (current rule)

Dental Fee Guideline

§134.202 [Dental Fee Guideline located at (c)(4)]

From August 1, 2003 through June 14, 2005

12/28/01

5/10/02

Dental Fee Guideline

§134.302

From April 1, 1996 through July 31, 2003

7/26/96

10/22/96

Hospital Facility Fee Guidelines - Inpatient

This fee guideline applies to facility medical services provided in an inpatient acute care hospital.

§134.404

On and after March 1, 2008

10/12/07

1/11/08 (current rule)

Hospital Facility Fee Guidelines - Inpatient

§134.400 repeal

Repealed effective August 1, 1997

2/11/97

7/4/97

Hospital Facility Fee Guidelines - Inpatient

§134.400

From September 1, 1992 through July 31, 1997

3/27/92

7/10/92

Acute Care Inpatient Hospital Fee Guideline

§134.401 repeal

Repealed effective July 13, 2008

2/22/08

7/4/08

§134.401

From August 4, 1997 through February 29, 2008

2/11/97 7/4/97

Hospital Facility Fee Guidelines - Outpatient

This fee guideline applies to facility medical services provided to an outpatient in an acute care hospital.

§134.403

On and after March 1, 2008

10/12/07

1/11/08 (current rule)

Medical Fee Guideline for Professional Services

This fee guideline applies to professional medical services such as services provided by a doctor.

§134.203

On and after March 1, 2008

10/5/07

1/11/08 (current rule)

Medical Fee Guideline for Professional Services

§134.202 (also contained Dental Fee Guideline at (c)(4) through 6/14/05)

From August 1, 2003 through February 29, 2008

12/28/01

12/27/02 (supplemental adoption order)
5/10/02

Medical Fee Guideline for Professional Services

§134.201 (commonly called the 1996 Medical Fee Guideline; also contained Pharmacy Fee Guideline)

From April 1, 1996 through July 31, 2003

10/20/95

3/12/96

Medical Fee Guideline for Professional Services

§134.201 repeal (commonly called the 1991 Medical Fee Guideline)

Repealed effective April 1, 1996

10/20/95

3/12/96

Medical Fee Guideline for Professional Services

§134.201 (commonly called the 1991 Medical Fee Guideline)

From December 11, 1991 through March 31, 1996

09/10/91

11/29/91

Medical Fee Guideline for Workers' Compensation Specific Services

This fee guideline applies to professional medical services that are specific to the Texas workers' compensation system.

§134.204

(previously included in §134.202)

On and after March 1, 2008

10/5/07

1/11/08 (current rule)

Medical Reimbursement / Use of the Fee Guidelines

This rule provides initial instructions for concepts used in calculating reimbursement for medical treatments and services.

§134.1

On and after March 1, 2008

10/5/07

1/11/08 (current rule)

Medical Reimbursement / Use of the Fee Guidelines

§134.1

From May 2,2006 through February 29, 2008

2/10/06

4/28/06

Medical Reimbursement / Use of the Fee Guidelines

§134.1 repeal

Repealed effective May 1, 2006

2/10/06

4/28/06
Medical Reimbursement / Use of the Fee Guidelines

§134.1

From May 16, 2002 through May 1, 2006

12/28/01

5/10/02

Pharmaceutical Benefits Definitions §134.500 On and after January 17, 2011 for all DOIs 7/16/10 12/17/10
(current rule)

Pharmaceutical Benefits Definitions

§134.500

On and after January 3, 2002

8/31/01

12/28/01

Initial Pharmaceutical Coverage

This rule provides instruction for pharmacy benefits for the first seven days following an injury.

§134.501

On and after November 7, 2002

8/9/02

11/1/02 (current rule)

Pharmaceutical Services

This rule provides instructions for prescribing doctors and pharmacists.

§134.502

On and after January 1, 2003

9/13/02

12/27/02 (current rule)

Pharmaceutical Benefits

§134.502

From January 3, 2002 through December 31, 2002

8/31/01

12/28/01

Pharmacy Fee Guideline

This rule provides the methodology for calculating reimbursement for pharmaceutical benefits excluding inpatient drugs and parenteral drugs.

§134.503 On and after October 23, 2011 7-1-11 10-14-11
(current rule)

Pharmacy Fee Guideline

This rule provides the methodology for calculating reimbursement for pharmaceutical benefits excluding inpatient drugs and parenteral drugs.

§134.503 On and after January 1, 2011 Emergency Rule 12/31/10

Reimbursement Methodology

§134.503

On and after March 14, 2004

10/31/03

3/5/04

Reimbursement Methodology

§134.503

From January 3, 2002 through March 13, 2004

8/31/01

12/28/01

Pharmacy Fee Guideline

§134.201 (previously part of Medical Fee Guideline)

From April 1, 1996 through March 1, 2002

10/20/95

3/12/96

Pharmacy Fee Guideline §134.201 (previously part of Medical Fee Guideline) From December 11, 1991 through March 31, 1996 09/10/91 11/29/91

Pharmaceutical Expenses Incurred by the Injured Employee

This rule provides the procedure for injured employees to be reimbursed for certain out-of-pocket expenses related to prescription medication.

§134.504

On and after March 14, 2004

10/31/03

3/5/04 (current rule)

Pharmaceutical Expenses Incurred by the Injured Employee

§134.504

From January 3, 2002 through March 13, 2004

8/31/01

12/28/01

Outpatient Open Formulary for Claims with Dates of Injury Prior to September 1, 2011

Continues the Open formulary for use with "legacy' claims.

§134.506 On and after January 1, 2011 for claims with a DOI prior to September 1, 2011 7/16/10 12/17/10 (current rule)

Outpatient Drug Formulary

This rule adopted the open formulary defined in §134.500.

§134.506

On and after January 3, 2002

8/31/01

12/28/01

Transition to the Use of the Closed Formulary for Claims with Dates of Injury Prior to September 1, 2011 §134.510 On and after September 1, 2011 for claims with a DOI prior to September 1, 2011 7/16/10 12/17/10
(current rule)
Outpatient Closed Formulary for Dates of Injury on or After September 1, 2011 §134.520 Applies to claims with DOIs on or after September 1, 2011 beginning September 1, 2011; and then applies to all claims on and after September 1, 2013 7/16/10 12/17/10
(current rule)
Requirements for Use of the Closed Formulary for Claims Not Subject to Certified Networks §134.530 Applies to non-network claims with DOIs on or after September 1, 2011 beginning September 1, 2011 7/16/10 12/17/10
(current rule)
Requirements for Use of the Closed Formulary for Claims Subject to Certified Networks §134.540 Applies to network claims with DOIs on or after September 1, 2011 beginning September 1, 2011 7/16/10 12/17/10
(current rule)
Medical Interlocutory Order §134.550 On and after September 1, 2011 7/16/10 12/17/10
(current rule)

Incentive Payments for Workers' Compensation Underserved Areas

This rule provides the ZIP codes in Texas that have been designated as medically underserved for workers' compensation purposes. This rule is used only with §§ 134.203 and 134.204

§134.2

On and after March 1, 2008

10/5/07

1/11/08 (current rule)



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Last updated: 02/22/2016

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