Texas Administrative Code
Title 28 - INSURANCE
Part 1 - TEXAS DEPARTMENT OF INSURANCE
Chapter 21 - TRADE PRACTICES
Subchapter P - MENTAL HEALTH PARITY
Division 2 - PLAN INFORMATION AND DATA COLLECTION
Section 21.2427 - Plan Reimbursement Rates Compared with Medicare Rates
Universal Citation: 28 TX Admin Code § 21.2427
Current through Reg. 50, No. 13; March 28, 2025
(a) Reporting worksheet. An issuer must report the data required by this section within the "MH/SUD Parity Rule Division 2 Data Collection Reporting Form" template in the worksheet titled "Reimbursement Rates."
(b) Categories of providers and billing codes. An issuer must report average plan reimbursement rates separately for in-network and out-of-network providers for services provided by the following categories of providers for the billing codes specified by TDI in the worksheet:
(1)
orthopedic surgeons;
(2)
cardiologists;
(3)
internists;
(4)
endocrinologists;
(5)
gastroenterologists;
(6)
neurologists;
(7)
pediatricians;
(8)
dermatologists;
(9)
psychiatrists;
(10)
psychologists;
(11) licensed
clinical social workers;
(12)
podiatrists;
(13)
chiropractors;
(14) occupational
therapists; and
(15) physical
therapists.
Disclaimer: These regulations may not be the most recent version. Texas may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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