Tex. Codes » Labor Code · TITLE 5. WORKERS' COMPENSATION · SUBTITLE A. TEXAS WORKERS' COMPENSATION ACT · CHAPTER 413. MEDICAL REVIEW
Texas Codes

Tex. Lab. Code § 413.012 (2026)

Medical Policy And Guideline Updates Required

✓ current as of May 2026
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Sec. 413.012. MEDICAL POLICY AND GUIDELINE UPDATES REQUIRED. The medical policies and fee guidelines shall be reviewed and revised at least every two years to reflect fair and reasonable fees and to reflect medical treatment or ranges of treatment that are reasonable or necessary at the time the review and revision is conducted.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Notes of Decisions
Cited in 8 cases, 2002–2015 · leading case: Texas Mut. Ins. Co. v. Vista Cmty. Med. Ctr., LLP, 275 S.W.3d 538 (Tex. App. 2009).
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Texas Mut. Ins. Co. v. Vista Cmty. Med. Ctr., LLP, 275 S.W.3d 538 (Tex. App. 2009). · cites it 2× “See Tex. Lab.Code Ann. § 413.012 (West 2006).”
Patient Advocates v. Texas Workers Comp. Comm'n, 80 S.W.3d 66 (Tex. App. 2002). · cites it 2× “Tex. Lab.Code Ann. § 413.012. This provision suggests that the Guideline may impose mandatory caps on fees.”
Texas Med. Ass'n v. Texas Workers Comp. Comm'n, 137 S.W.3d 342 (Tex. App. 2004). · cites it 2× “See Tex. Lab.Code Ann. § 413.012 (Commission is to review and revise guidelines at least every two years).”
Texas Med. Ass'n Texas AFL-CLO Patient Advocates of Texas Allen J. Meril, M.D. & L. E. Richey v. Texas Workers Comp. Comm'n Richard F. Reynolds, Exec. Dir. & Texas Ass'n of Bus. (Tex. App. 2004). · cites it 2× “See Tex. Lab. Code Ann. § 413.012 (Commission is to review and revise guidelines at least every two years).”
Texas Mut. Ins. Co., Liberty Mut. Ins. Co., Zenith Ins. Co. & Zurich Am. Ins. Co. v. Vista Cmty. Med. Ctr., LLP, D/B/A Vista Med. Ctr. Hosp. Christus Health Gulf Coast & the Texas Dep't of Ins., Div. of Workers' Comp. (Tex. App. 2008). · cites it 2× “See Tex. Lab. Code Ann. § 413.012 (West 2006).”
Texas Mut. Ins. Co., Liberty Mut. Ins. Co., Zenith Ins. Co. & Zurich Am. Ins. Co. v. Vista Cmty. Med. Ctr., LLP, D/B/A Vista Med. Ctr. Hosp. Christus Health Gulf Coast & the Texas Dep't of Ins., Div. of Workers' Comp. (Tex. App. 2008). · cites it 2× “See Tex. Lab. Code Ann. § 413.012 (West 2006).”
Texas Med. Bd. & Scott Freshour, in His Off. Capacity as Gen. Couns. of the Texas Med. Bd. v. Teladoc, Inc. (Tex. App. 2015). · cites it 2× “See Tex. Lab.Code Ann. § 413.012 (West 2006).”
Patient Advocates of Texas & Allen J. Meril, M.D. v. Texas Workers Comp. Comm'n Leonard Riley, Exec. Dir. & State of Texas (Tex. App. 2002). “Tex. Lab. Code Ann. § 413.012 . This provision suggests that the Guideline may impose mandatory caps on fees.”
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