Sec. 55.004. AMOUNT OF LIEN. (a) In this section, "emergency hospital care" means health care services provided in a hospital to evaluate, stabilize, and treat a serious medical problem of recent onset or severity, including severe pain that would lead a prudent layperson possessing an average knowledge of medicine and health to believe that the condition, illness, or injury is of such a nature that failure to obtain immediate medical care would in all reasonable probability:
(1) seriously jeopardize the patient's health;
(2) seriously impair one or more bodily functions;
(3) seriously harm an organ or other part of the body;
(4) cause serious disfigurement; or
(5) in the case of a pregnant woman, seriously jeopardize the health of the fetus.
(b) A hospital lien described by Section 55.002(a) is for the lesser of:
(1) the amount of the hospital's charges for services provided to the injured individual during the first 100 days of the injured individual's hospitalization;
(2) 50 percent of all amounts recovered by the injured individual through a cause of action, judgment, or settlement described by Section 55.003(a); or
(3) if the trier of fact specifies the amount awarded for hospital charges for services provided to the injured individual, the amount awarded by the trier of fact for the services provided to the injured individual by the hospital less the pro rata share of reasonable attorney's fees and expenses the injured individual incurred in pursuing the claim.
(c) A hospital lien described by Section 55.002(a) may also include the amount of a physician's reasonable and necessary charges for emergency hospital care services provided to the injured individual during the first seven days of the injured individual's hospitalization. At the request of the physician, the hospital may act on the physician's behalf in securing and discharging the lien.
(d) A hospital lien described by Section 55.002(a) does not cover:
(1) charges for other services that exceed a reasonable and regular rate for the services;
(2) charges by the physician related to any services provided under Subsection (c) for which the physician has accepted insurance benefits or payment under a private medical indemnity plan or program, regardless of whether the benefits or payment equals the full amount of the physician's charges for those services;
(3) charges by the physician for services provided under Subsection (c) if the injured individual has coverage under a private medical indemnity plan or program from which the physician is entitled to recover payment for the physician's services under an assignment of benefits or similar rights;
(4) charges by the physician related to any services provided under Subsection (c) if the physician is a member of the legislature; or
(5) charges for which recovery is barred under Section 146.003, Civil Practice and Remedies Code.
(e) A hospital lien described by Section 55.002(a) is not affected by a hospital's use of a method of classifying patients according to their ability to pay that is solely intended to obtain a lien for services provided to an indigent injured individual.
(f) An emergency medical services lien described by Section 55.002(c) is for the amount charged by the emergency medical services provider, not to exceed $1,000, for emergency medical services provided to the injured individual during the 72 hours following the accident that caused the individual's injuries.
(g) An emergency medical services lien described by Section 55.002(c) does not cover:
(1) charges for services that exceed a reasonable and regular rate for the services;
(2) charges by the emergency medical services provider related to any services for which the emergency medical services provider has accepted insurance benefits or payment under a private medical indemnity plan or program, regardless of whether the benefits or payments equal the full amount of the charges for those services; or
(3) charges by the emergency medical services provider for services provided if the injured individual has coverage under a private medical indemnity plan or program from which the provider is entitled to recover payment for the provider's services under an assignment of benefits or similar right.
(h) If the physician is employed in that capacity by an institution of higher education, as defined by Section 61.003, Education Code, and the lien does not include the amount of the physician's reasonable and necessary charges described by Subsection (c), the physician has a lien on the cause of action in the same manner as a hospital under this chapter. The lien is subject to provisions of this chapter applicable to a hospital lien, and the physician or the physician's employing institution may secure and enforce the lien in the manner provided by this chapter.
Acts 1983, 68th Leg., p. 3563, ch. 576, Sec. 1, eff. Jan. 1, 1984. Amended by Acts 2001, 77th Leg., ch. 930, Sec. 1, eff. Sept. 1, 2001; Acts 2003, 78th Leg., ch. 337, Sec. 1, eff. Sept. 1, 2003; Acts 2003, 78th Leg., ch. 1266, Sec. 1.16, eff. June 20, 2003.
Amended by:
Acts 2005, 79th Leg., Ch. 728 (H.B. 2018), Sec. 23.001(79), eff. September 1, 2005.
Acts 2019, 86th Leg., R.S., Ch. 862 (H.B. 2929), Sec. 2, eff. June 10, 2019.
Acts 2021, 87th Leg., R.S., Ch. 812 (H.B. 2064), Sec. 1, eff. June 16, 2021.
Notes of Decisions
Satsky v. United States, 993 F. Supp. 1027 (S.D. Tex. 1998).
“Further evidence that no debt exists over the amount that has already been paid is found in Tex.Prop.CodeAnn. § 55.004(a), which provides that the statutory hospital *1030 lien “does not cover charges for operating costs that exceed the cost limits established under Section 405.”
Keith Wright v. Johnna C. Hooker, No. 12-17-00095-CV (Tex. App.—Tyler Dec. 13, 2017).
· cites it 6× “lar rate for the services; (2) by the EMS provider related to any services for which the EMS provider has accepted insurance benefits or payment under a private medical indemnity plan or program, regardless of whether the benefits or payments equal the full amount of the charges…”
In re N. Cypress Med. Ctr. Operating Co., 559 S.W.3d 128 (Tex. 2018).
“They point out that a lien can include only reasonable and necessary charges for a physician's emergency hospital care, Tex. Prop. Code § 55.004(c), and does not cover charges for emergency medical services or other services that exceed a reasonable and regular rate, id.”
North Cypress Med. Operating Co. GP v. Angeline Norvil, 580 S.W.3d 280 (Tex. App.—Houston [1st Dist.] 2019).
· cites it 2× “Specifically, Norvil argued that Texas Property Code Section 55.004(d)(1) limits the amount of a hospital lien to the “reasonable and regular rate for the services,” and she asked the court to declare that North Cypress’s charges exceeded a reasonable and regular rate for the…”
Mcallen Hospitals, L. P. v. Arturo Gomez, No. 13-12-00421-CV (Tex. App.—Corpus Christi Feb. 28, 2013).
· cites it 3× “004(b); and (4) The injections received by appellee cannot be defined as “emergency hospital care” under the Texas Property Code because they were not provided to “treat a serious medical problem of recent onset or severity,” as required by Texas Property Code section 55.004(a).…”
Keantae Berry v. ETX Successor Tyler, No. 12-18-00095-CV, 2019 WL 968528 (Tex. App.—Tyler Feb. 28, 2019).
“As a result, she contends the charges are not reasonable and, therefore, not recoverable under Texas Property Code Section 55.004(d)(1) which limits the amount of a hospital lien to the “reasonable and regular rate for the services.”
Geico Choice Ins. Co. v. Jeffrey Stern, No. 01-18-00013-CV (Tex. App.—Houston [1st Dist.] Aug. 15, 2019).
“2d at 309 ; see also TEX. PROP. CODE ANN. § 55.004(b)(1). And significantly, a “release of a cause of action or judgment to which a lien under this chapter may attach is not valid unless” the hospital lien is paid in full or otherwise satisfied according to the terms of the…”
Tex. Prop. Code § 55.004(a): 3 cases
Satsky v. United States, 993 F. Supp. 1027 (S.D. Tex. 1998).
“Further evidence that no debt exists over the amount that has already been paid is found in Tex.Prop.CodeAnn. § 55.004(a), which provides that the statutory hospital *1030 lien “does not cover charges for operating costs that exceed the cost limits established under Section 405.”
Mcallen Hospitals, L. P. v. Arturo Gomez, No. 13-12-00421-CV (Tex. App.—Corpus Christi Feb. 28, 2013).
“004(b); and (4) The injections received by appellee cannot be defined as “emergency hospital care” under the Texas Property Code because they were not provided to “treat a serious medical problem of recent onset or severity,” as required by Texas Property Code section 55.004(a).…”
Tex. Prop. Code § 55.004(b): 2 cases
Mcallen Hospitals, L. P. v. Arturo Gomez, No. 13-12-00421-CV (Tex. App.—Corpus Christi Feb. 28, 2013).
“004(b); and (4) The injections received by appellee cannot be defined as “emergency hospital care” under the Texas Property Code because they were not provided to “treat a serious medical problem of recent onset or severity,” as required by Texas Property Code section 55.004(a).…”
Tex. Prop. Code § 55.004(b)(1): 1 case
Geico Choice Ins. Co. v. Jeffrey Stern, No. 01-18-00013-CV (Tex. App.—Houston [1st Dist.] Aug. 15, 2019).
“2d at 309 ; see also TEX. PROP. CODE ANN. § 55.004(b)(1). And significantly, a “release of a cause of action or judgment to which a lien under this chapter may attach is not valid unless” the hospital lien is paid in full or otherwise satisfied according to the terms of the…”
Tex. Prop. Code § 55.004(c): 3 cases
In re N. Cypress Med. Ctr. Operating Co., 559 S.W.3d 128 (Tex. 2018).
“They point out that a lien can include only reasonable and necessary charges for a physician's emergency hospital care, Tex. Prop. Code § 55.004(c), and does not cover charges for emergency medical services or other services that exceed a reasonable and regular rate, id.”
Tex. Prop. Code § 55.004(d): 1 case
Tex. Prop. Code § 55.004(d)(1): 7 cases
North Cypress Med. Operating Co. GP v. Angeline Norvil, 580 S.W.3d 280 (Tex. App.—Houston [1st Dist.] 2019).
“Specifically, Norvil argued that Texas Property Code Section 55.004(d)(1) limits the amount of a hospital lien to the “reasonable and regular rate for the services,” and she asked the court to declare that North Cypress’s charges exceeded a reasonable and regular rate for the…”
Keantae Berry v. ETX Successor Tyler, No. 12-18-00095-CV, 2019 WL 968528 (Tex. App.—Tyler Feb. 28, 2019).
“As a result, she contends the charges are not reasonable and, therefore, not recoverable under Texas Property Code Section 55.004(d)(1) which limits the amount of a hospital lien to the “reasonable and regular rate for the services.”
Tex. Prop. Code § 55.004(g)(1): 1 case
Keith Wright v. Johnna C. Hooker, No. 12-17-00095-CV (Tex. App.—Tyler Dec. 13, 2017).
“lar rate for the services; (2) by the EMS provider related to any services for which the EMS provider has accepted insurance benefits or payment under a private medical indemnity plan or program, regardless of whether the benefits or payments equal the full amount of the charges…”
Tex. Prop. Code § 55.004(g)(3): 1 case
Keith Wright v. Johnna C. Hooker, No. 12-17-00095-CV (Tex. App.—Tyler Dec. 13, 2017).
“lar rate for the services; (2) by the EMS provider related to any services for which the EMS provider has accepted insurance benefits or payment under a private medical indemnity plan or program, regardless of whether the benefits or payments equal the full amount of the charges…”
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