Texas · ER
Dispute an emergency room services surprise bill in Texas
The No Surprises Act prohibits balance billing for emergency services at any facility, regardless of network status. In Texas, additional state-level protections apply.
What the law says
Texas Insurance Code Chapter 1467, enacted by SB 1264, prohibits out-of-network providers from balance billing patients with state-regulated insurance for emergency care, facility-based services at in-network facilities, and certain laboratory and diagnostic imaging services. Disputes are resolved through Texas's mediation and arbitration process. This protection applies in addition to the federal No Surprises Act (42 U.S.C. § 300gg-111 et seq.).
- Tex. Ins. Code Ch. 1467 (SB 1264)
- 42 U.S.C. § 300gg-111 et seq. (No Surprises Act)
Your options
- Dispute the bill in writing before paying anything. The provider must respond and cannot send the bill to collections during the dispute.
- Notify your health insurer that an apparent NSA-protected service has been balance-billed. Ask them to adjudicate at the in-network cost-sharing amount.
- File a complaint with the federal No Surprises Help Desk at CMS if either party refuses to comply.
- If unresolved, you can invoke the patient-provider Independent Dispute Resolution (IDR) process for an external decision.
Other bill types in Texas
- Anesthesiology at an in-network facility
- Lab or pathology at an in-network facility
- Radiology at an in-network facility
- Hospitalist services at an in-network facility
ER bills in other states
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