Skip to Top Main Navigation Skip to Left Navigation Skip to Content Area Skip to Footer
Texas Department of Insurance
Topics:   A B C D E F G H I J K L M N O P Q R S T U V W X Y Z All

Balance billing: health care provider resources

Sign up for updatesStay connected!

Use the Independent Dispute Resolution portal to submit mediation and arbitration requests and check on claims.

Plans not regulated by TDI

Starting January 1, 2022, the federal No Surprises Act will protect Texas consumers with health plans not regulated by the state from surprise bills for:

  • Air ambulance services.
  • Emergency care.
  • Care provided at in-network facilities when the patient didn’t have a choice of doctors.

To learn more about federal laws and rules, see the Centers for Medicare & Medicaid Services’ webpages: Overview of rules & fact sheets and Provider requirements and resources.

Plans regulated by TDI

Texas and federal laws protect Texas consumers with state-regulated health plans from surprise bills.

  • Federal law bans balance bills for air ambulance services received on or after January 1, 2022.
  • State law bans balance bills for the following received on or after January 1, 2020:
    • Emergency care.
    • Care provided at in-network facilities when the patient didn’t have a choice of doctors.

State law authorizes arbitration (for doctors) and mediation (for facilities) to resolve payment disputes in those cases.

The law carves out a narrow exception when a consumer chooses an out-of-network doctor or provider at an in-network facility. See Balance billing waiver information below.

How can you tell if a plan is regulated by TDI?

Resources and webinars

Related guidance

Balance billing waiver

For more information, contact: MediaRelations@tdi.texas.gov

Last updated: 1/5/2022