Sign up to get health care provider news by email.A health care provider is a health care facility or a health care practitioner.
A health care facility is a hospital, emergency clinic, outpatient clinic, or other facility, that is appropriately licensed to provide inpatient and outpatient medical services to patients experiencing acute illness or trauma.
A health care practitioner is an individual who is licensed to provide health care, or an unlicensed individual who provides health care under the direction or supervision of a doctor.
With some exceptions, health care practitioners are not required to complete training or apply to DWC to provide health care to Texas injured employees. The exceptions are:
- Doctors who conduct maximum medical improvement and impairment rating examinations (certifying examinations) must complete the DWC required training and testing.
- Designated doctors are required to complete training and testing and apply to be included on the DWC list of designated doctors.
- Health care practitioners who assist doctors with the range of motion, strength, and sensory testing portion of a certifying examination must complete the required impairment rating training.
- Health care practitioners and health care facilities providing services to injured employees who are required to receive health care through a workers’ compensation health care network (network claims) must complete the network credentialing process. To join a workers’ compensation health care network, see Information for Providers and Find a certified WCNet on the TDI website.
All health care practitioners who participate in the Texas workers' compensation system must:
- have an active license to practice in their jurisdiction;
- not have any disciplinary orders restricting them from participating in the Texas workers’ compensation system; and
- disclose the identity of any other health care provider they have financial interest in to DWC. To learn more, see the fast facts about financial disclosure. You can report financial interest online through TXCOMP.
TXCOMP is an automated system that allows public access to non-confidential workers' compensation information. Through TXCOMP the public can verify an employer has workers’ compensation insurance coverage, find an insurance carrier’s claims administration information, find a health care provider by type and location, and report certain information including financial interest.
You can disclose financial interest through TXCOMP by creating a health care provider profile. To create a profile, go to TXCOMP and select 'Online Access Request' from the main menu.
Watch the Health Care Provider Roles and Responsibilities on-demand training to learn more about health care provider requirements.
To learn more about providing health care services to Texas workers' compensation patients, please check out this webpage, including the on-demand training.
Texas government employers are required to provide workers’ compensation coverage to their employees. However, in Texas, private employers can choose to carry workers' compensation insurance coverage, but it is not required in most cases.
The Texas Workers' Compensation Act (Texas Labor Code, Title 5) and rules only apply to Texas employers that provide workers’ compensation coverage to their employees.
Covered employers:
- Individual employer workers' compensation commercial policy (Subscriber)
- Company holds a Certificate of Authority as a Certified Self Insurer in Texas (Certified self-insureds)
- Self-insured government employer
Watch the Identifying a Workers’ Compensation Patient on-demand training to learn how to verify if an employer has workers' compensation coverage.
DWC has an online tool to help verify if an employer has workers' compensation insurance coverage.
For help with coverage, contact. Coverage.verification@tdi.texas.gov
Texas workers' compensation fee guidelines establish reimbursement of medical services and treatments for non-network care.
- Medical fee guidelines for professional services and workers' compensation specific services (includes durable medical equipment, home health services, maximum medical improvement/impairment exams and other services)
- Hospital fee guidelines
- Ambulatory surgical center fee guideline
- Pharmacy fee guideline
- Dental fee guideline
Watch the Reimbursement for Professional and Workers’ Compensation Specific Services and Texas Workers’ Compensation Reimbursement Policies and Methodologies on-demand training to learn about Texas workers' compensation reimbursement policies.
Topic descriptions | YouTube playlist
- Finding Resources on the TDI Website
- Introduction to Texas Workers’ Compensation System
- Health Care Provider Roles and Responsibilities
- Identifying a Workers’ Compensation Patient
- Health Care Provider Billing Procedures
- Reimbursement for Professional and Workers’ Compensation Specific Services
- Texas Workers’ Compensation Reimbursement Policies and Methodologies
- Return to Work and the DWC Form-073, Work Status Report
- Billing and Reimbursement for Designated Doctor Examinations and Required Medical Examinations
- Billing and Reimbursement for Maximum Medical Improvement and Impairment Rating Examinations by Certifying Doctor
- Medical Fee Dispute Resolution (MFDR)
- Navigating TXCOMP
- The Preauthorization Process: Medical Necessity and Utilization Review
Scheduled live webinars
Topic descriptions | Health care provider calendar
To register for a webinar, select the webinar you want to attend from the health care provider calendar.
A basic goal of the Texas workers’ compensation system is to facilitate the safe and timely return of injured employees to productive roles in the workplace.
Treating doctors and other health care providers have an important role in achieving this goal by providing high-quality medical care, that promotes restoration of the injured employee's physical condition facilitating the employee's return to work.
- Return to work homepage
- §129.5 Work Status Reports
- DWC-073, Work Status Report
- DWC-073S, Reporte de Estado de Trabajo
To learn more, watch the Return to Work and the DWC Form-073, Work Status Report on-demand training.
Every injured employee must have a treating doctor who is primarily responsible for the efficient management and coordination of the health care for an injured employee's compensable injury.
A doctor is defined in the Texas Workers’ Compensation Act as a doctor of medicine, osteopathic medicine, optometry, dentistry, podiatry, or chiropractic who is licensed and authorized to practice.
The injured employee's initial choice of a treating doctor does not require approval. However, to change the treating doctor, the injured employee must submit an Employee Request to Change Treating Doctor (DWC-053) to the DWC for approval (non-network claim) or notify the workers’ compensation network of the change (network claim).
Non-network claims
§126.9 Choice of treating doctor and liability for payment
DWC-053, Employee Request to Change Treating Doctor
DWC-053S, Solicitud del Empleado para Cambiar de Médico de Tratamiento
Network claims
§10.85 Selection of Treating Doctor; Change of Treating Doctor
A designated doctor is selected by DWC to resolve questions about an injured employee's medical condition or resolve a dispute about a work-related injury or illness.
To learn more about designated doctors, visit the Designated doctor homepage
