Texas Medical Billing Rights & Protections
Everything you need to know about fighting unfair medical bills in Texas. Learn your rights, understand state laws, and take action.
Surprise Bill Protection
State + Federal
Balance Billing
Prohibited
Charity Care Law
No State Law
Avg ER Cost
$2,400
Educational Content: This page provides general information about medical billing rights in Texas. Laws change frequently. This is not legal advice. Consult a qualified attorney or patient advocate for your specific situation.
Texas Medical Billing Laws
Texas enacted SB 1264 (2019), one of the strongest surprise billing laws in the nation, which prohibits balance billing for emergency services and for out-of-network providers at in-network facilities. The law establishes a mediation process for billing disputes. Despite these protections, Texas has not expanded Medicaid, leaving approximately 1.4 million adults without affordable coverage — the largest uninsured population in the country. The Texas Department of Insurance (TDI) handles complaints about insurance companies and has an active consumer assistance program. Texas's massive and diverse healthcare market means prices can vary dramatically by region.
Texas has a 4-year statute of limitations on medical debt under Texas Civil Practice and Remedies Code Section 16.004. Texas has NOT expanded Medicaid, leaving approximately 1.4 million adults in the coverage gap — the largest uninsured population in the nation. However, SB 1264 (2019) provides strong surprise billing protections. Texas follows federal credit reporting rules for medical debt. Texas also has the Texas Finance Code Chapter 392 (Texas Debt Collection Act) which provides additional protections.
Your Key Protections in Texas
SB 1264 prohibits balance billing for emergency services and surprise out-of-network billing at in-network facilities
Mandatory mediation process for billing disputes between insurers and providers
Texas Debt Collection Act provides additional protections beyond federal FDCPA
4-year statute of limitations on medical debt (CPRC Section 16.004)
Right to request itemized bills from all providers
Federal medical debt credit reporting protections
Texas Department of Insurance consumer assistance program
Texas has NOT expanded Medicaid — largest uninsured population in the nation
How to Dispute a Medical Bill in Texas
Request an itemized bill with all CPT and ICD-10 codes from the provider
Check if the bill violates SB 1264's balance billing protections — emergency services and out-of-network providers at in-network facilities are protected
Compare charges against Medicare rates — Texas costs vary dramatically by region (Houston vs. rural areas)
Apply for the hospital's financial assistance program
Request mediation through the Texas Department of Insurance if the bill involves surprise out-of-network charges
Send a written dispute via certified mail to the billing department
File a complaint with the Texas Department of Insurance at (800) 252-3439
Contact the Texas Attorney General's Consumer Protection Division at (800) 621-0508
Important Deadlines in Texas
4-year statute of limitations on medical debt (CPRC Section 16.004)
30 days to dispute a debt with a collector under the FDCPA
180 days for internal insurance appeals
1 year before medical debt appears on credit reports
Texas has NOT expanded Medicaid — check marketplace plans and county hospital district programs for coverage
Average Medical Costs in Texas
Avg ER Visit
$2,400
Avg Urgent Care
$195
Median Income
$67,321
200% FPL (Single)
$31,280