Below are the required billing forms for medical, pharmacy, and dental under Texas workers’ compensation.

Important: Providers must submit bills and billing forms electronically (e-billing) for all network and non-network workers’ compensation claims unless exempt.

Billing Forms

This table lists the required billing forms for Texas workers’ comp.

Exemptions to Mandatory e-Billing

Texas requires all providers to submit bills electronically (e-billing). However, providers can claim an exemption from e-billing if one of the following applies:

• The provider employs fewer than 10 full-time employees
• The provider treated 32 or fewer injured workers in the previous calendar year, or
• The provider can demonstrate that setting up e-billing would cause an unreasonable financial burden and can submit financial statements and other documentation as proof of implementation costs.

If a provider claims one of these exemptions, the DWC may ask for proof. If requested, the provider must submit all supporting documentation within 15 days of the DWC’s request.

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