Key Facts: Texas Medical Billing Protections
Dispute Window
180 days from Explanation of Benefits (EOB) for insurance appeals
Applicable Statute
Consumer Protections
Texas SB 1264 provides strong surprise billing protections with mandatory mediation and arbitration
Surprise Billing Protection
Yes — state-level surprise billing law
Balance Billing Restrictions
Yes — state restrictions on balance billing
Key Consumer Protections in Texas
- Texas SB 1264 (2019) prohibits balance billing for emergency services by out-of-network providers.
- Protections extend to non-emergency services at in-network facilities by out-of-network providers.
- Disputes between insurers and providers are resolved through mandatory mediation or arbitration.
- The federal No Surprises Act provides additional protections.
- Patients have the right to request an itemized bill from any healthcare provider.
- Texas requires health plans to cover emergency services at in-network rates.
- Consumers can file complaints with the Texas Department of Insurance.
Read the full statute: Tex. Ins. Code § 1271.157; SB 1264
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Disclaimer: This information is for general informational purposes only and does not constitute legal or professional advice. Laws and regulations may change. Consult a licensed attorney or certified medical billing advocate for advice specific to your situation.
Content last reviewed: March 2026.