Texas Claims Dispute & Statutory Guide

The Texas workers' compensation system is administered by the Texas Department of Insurance, Division of Workers' Compensation (TDI-DWC). Medical billing fee disputes are handled through the Medical Fee Dispute Resolution (MFDR) process under 28 Texas Administrative Code § 133.307.

Last Updated: 2026-03-01 • Framework: Workers' Compensation Dispute & Fee Schedule Guides (South Region)

Statutory Framework & Jurisdiction

Texas is an elective workers' compensation state (employers may opt out as 'non-subscribers'). For covered employers, certified workers' comp healthcare networks (HCNs) operate under Chapter 1305 of the Texas Insurance Code.

Official Medical Fee Schedule & Reimbursement Standards

name

Texas Medical Fee Guidelines (28 TAC Chapter 134)

structure

Medicare-based methodology with state-specific conversion factors for professional medical services, inpatient hospital services, and ambulatory surgical centers.

electronic Billing

Mandatory electronic medical billing under 28 TAC §§ 133.500 - 133.501

Preauthorization & Decision Point Review

protocol

Governed by 28 TAC § 134.600. Certain non-emergency outpatient surgeries, physical medicine beyond guideline limits, and repeat diagnostics require prospective preauthorization.

deadlines

Carrier must respond within 3 working days of receipt of complete preauthorization request.

dispute Mechanism

Independent Review Organization (IRO) process for medical necessity determinations under Texas Insurance Code Chapter 4202.

Medical Billing & Appeals Procedure

timely Filing

95 days from date of service (Texas Labor Code § 408.0272)

reconsideration

Mandatory prerequisite. Provider must request reconsideration within 10 months of the date of service or 60 days from initial EOB.

medical Fee Dispute Resolution

TDI-DWC MFDR filed on DWC Form-027 within one year of the date of service under 28 TAC § 133.307.

soah Hearings

Appeals of MFDR decisions proceed to the State Office of Administrative Hearings (SOAH) for formal contested case adjudication.

Critical Statutory & Dispute Deadlines

Dispute Phase / Trigger EventStatutory Timeline / Deadline
Initial Medical Bill Submission95 calendar days from date of service
Carrier Explanation of Benefits (EOB)45 days from receipt of clean medical bill
Request for Medical Bill Reconsideration10 months from date of service
Carrier Reconsideration Response30 days from receipt of request
MFDR Application (DWC Form-027)Strictly within 1 year from the date of service

Required Evidentiary Filing Checklist

  • DWC Form-027 (Medical Fee Dispute Resolution Request)
  • Complete CMS-1500 / UB-04 billing form with applicable CPT codes and modifiers
  • Medical records, daily progress notes, and diagnostic test findings for contested dates of service
  • Copy of original medical bill, initial EOB, written request for reconsideration, and second EOB
  • Detailed position statement calculating allowable amounts under Texas Medical Fee Guidelines

Official Primary Sources & Legislative Authorities

Texas Labor Code Title 5 (Workers' Compensation)
Agency / Body: Texas Legislature (2024)
View Official Text
Texas Administrative Code Title 28, Part 2 (Division of Workers' Compensation)
Agency / Body: Texas Secretary of State (2025)
View Official Text

Official Forms & Downloads for Texas

PDF460 B
Workers' CompensationTexas

TX DWC Form 027 Medical Fee Dispute Resolution

Dispute Forms reference for Texas Workers' Compensation. Available for download.

Authority: Texas Regulatory Agency

Governing Regulatory Authorities

Texas Department of Insurance - Division of Workers' Compensation (TDI-DWC)
Statewide Workers' Compensation Administration & MFDR
Official Portal →
State Office of Administrative Hearings (SOAH)
Administrative law hearings for contested MFDR decisions
Official Portal →
Operational Support

Need Case Preparation Support in Texas?

Millennova Legal assists healthcare providers, revenue cycle teams, and law firms with comprehensive dispute documentation, arbitration filing bundles, and fee schedule calculations.

Request Dispute Consultation
Non-attorney arbitration support & claims documentation services.