DWC Proposes Changes to Designated Doctor Billing and Reimbursement Rules
DWC informally proposed amendments to 28 Texas Administrative Code (TAC) Chapter 133, General Medical Provisions and 28 TAC Chapter 134, Benefits–Guidelines for Medical Services,
Charges, and Payments to improve the designated doctor (DD) program. These can be found online at https://www.tdi.texas.gov/wc/rules/drafts.html.
Also posted with these amendments are billing examples for DD exams and a fee table showing the rates for DD exams, required medical exams, and maximum medical improvement and impairment rating exams for treating doctors and referral doctors.
To implement these improvements, DWC must adopt rules. DWC held stakeholder presentations in March and September 2022 to discuss specific possible changes to the billing methodology for DD exams and possible changes to DD exam reimbursement rates.
DWC will host a stakeholder presentation on the amendments to Chapters 133 and 134 on Thursday, December 1, 2022, at 1:30 p.m. CST to discuss updated amendments to rule language and feedback from system participants on the second informal proposal. This will be a Zoom meeting, and information for logging in can be found at https://tdi.texas.gov/alert/event/2022/12/dd0801.html.
DWC is requesting comments on the rule text. Email your comments to RuleComments@tdi.texas.gov. Include “Chapters 133 and 134 Informal Posting” in the subject line. Written comments must be received by 5 p.m. CST on Friday, December 16, 2022. You may also mail or deliver your comments to:
Legal Services, MC-LS
Texas Department of Insurance, Division of Workers’ Compensation
PO Box 12050
Austin, Texas 78711.
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