Texas workers’ comp case management billing —
and the 95-day rule.
Texas gives you 95 days to file. Not a year, not 120 days — 95, and Texas Mutual and the carriers will not stretch it. Private vocational rehabilitation is carrier-optional under §408.150, which is why nurse case management is the work that runs every week here.
The facts, before the pitch.
How billing works in Texas
- Who you bill
- The carrier or TPA.
- What you send
- CMS-1500 or invoice.
- The channel
- E-billing both directions since 2008.
- Fee basis
- No published rate we have verified. Ask the Texas Department of Insurance — Division of Workers' Compensation (DWC) before anyone quotes you one — including us.
- The clock
- 95-day timely filing.
The system. Carrier-optional private vocational rehabilitation alongside Texas Workforce Commission referrals.
Where the rules are written. Texas Labor Code §408.150; 28 TAC 133.500 and 133.20.
Electronic billing. Providers must e-bill; payers must accept. Direct electronic submission is on our roadmap and is not something we ship today: Med Claims Pro builds the bill, the report packet and the receivable, and files your proof of what left — you send it through the channel the Texas Department of Insurance — Division of Workers' Compensation (DWC) gives you.
Nurse case managers in Texas are supported today. Invoice-based case-management billing needs no state-specific setup — it works here now. Private vocational rehabilitation in Texas is a different story, told plainly further down, and there is a Texas voc-rehab list you can join.
Your week, in Texas’s documents.
The tightest timely-filing clock in the country, on a caseload spread across counties the size of small states.
- 7:40 a.m.Two telephonic updates and a note to the adjuster.Entered as they finish. A bill you can send this week is a bill that beats the clock by 88 days.
- 11:20 a.m.Appointment attended in the next county. Wait time, then 74 miles back.Miles and wait time as their own lines, priced as you type.
- 2:30 p.m.Monthly report for the TPA.Out of the weekly logs it already wrote — no reconstruction session.
- 4:50 p.m.This week’s billing out. Nothing waiting for a Sunday.Every bill becomes a receivable with a filing date attached, and the clock is visible rather than assumed.
Every one of those rows is typed once, as it happens. The daily log writes itself as you go, the weekly narrative log builds in your own Word template, a CMS-1500 fills with the right units and the right payer block where a payer wants one — and where your state bills on its own form or an invoice, the dated, timed, priced lines that go on it come off the grid, and the receivable is tracked from the moment the bill leaves. The whole chain →
Ninety-five days is not a deadline. It is a habit you either have or do not.
Under 28 TAC 133.20 you have 95 days from the date of service. A bill that sits in a pile for six weeks and then waits on a report you have not written yet is a bill with three weeks of margin left, and no margin at all if anything comes back for correction.
The cure is not a reminder. It is that the bill already exists: the work was entered as it happened, the report is built from the same entries, and sending is a Friday task rather than a project.
Texas has required electronic billing in both directions since 2008. We do not do that yet — the software builds the bill, the documentation and the receivable and files your proof; direct submission is on our roadmap.
Who pays you in Texas.
Texas Mutual is the largest single carrier here, with the national carriers and TPAs behind it. Everything runs on a 95-day clock, which makes payer aging less about politeness and more about survival.
Texas payers
- Texas Mutual
- Private carriers
- TPAs
National carriers you will meet
- Travelers
- The Hartford
- AmTrust
- Zurich
- Chubb
- Berkshire Hathaway
- Liberty Mutual
- AF Group / Accident Fund
- Old Republic
- Great American
TPAs that send the referrals
- Sedgwick
- Gallagher Bassett
- ESIS
- Helmsman
- Broadspire
- CorVel
- TRISTAR
- CCMSI
- Athens Administrators
One check, many claimants. Whichever of these names is on the envelope, the check covers a dozen files at once. You record it once, tick the bills it pays, and anything short is flagged with the exact gap and the original form attached, ready to rebill. How that screen works.
Billing addresses and submission preferences go stale faster than any page can keep up, so we publish them only where we keep them current — today that is Ohio’s nine MCOs. Your Texas payers and their submission preferences get set up during onboarding, from your own files.
Case files, adjusters, mileage, receivables.
Invoice-based case-management billing works in Texas today with no state-specific setup: the activity grid, the priced lines your invoice is built from, and aging by TPA so a slow payer shows up as a number.
The activity grid
Field visit, telephonic call, wait time at the appointment, the miles there and back — logged once, with the claim number, the adjuster and the referral source attached as you type.
The log behind the bill
A weekly narrative log per case file, dated and grouped, reproducing your own Word template — and where a payer wants a CMS-1500 the software fills one. It does not write an invoice document today: the dated, timed, priced lines that go on yours come off the grid.
Aging by payer
Texas Mutual, the carriers and the TPAs, each with billed, paid and still-owed, and an aging list that names who is sitting on your money.
It is the same week an Ohio vocational rehabilitation case manager works, in different nouns: case files instead of claimants, adjusters instead of MCO coordinators, billable hours and mileage instead of W-codes. Thirty-odd billable touches a day either way, and the same four documents behind every one of them. The nurse case manager page has the whole workflow.
Where the rules actually live.
Ask the Texas Department of Insurance — Division of Workers' Compensation (DWC) for
- the current text of Texas Labor Code §408.150; 28 TAC 133.500 and 133.20
We have not published a verified link set for Texas yet, and we would rather send you nowhere than somewhere out of date. If you have the current documents, send them over — admin@onservice.us.
How we keep this page honest
Every fact above is transcribed from the Texas Department of Insurance — Division of Workers' Compensation (DWC) or the statute named, dated July 2026, and reviewed when the agency republishes. Where we have not verified something we say so rather than filling the gap.
Found something out of date? Tell us and we will fix it the same week: (302) 202-3172 or admin@onservice.us.
See a Texas case-management caseload run itself.
Fifteen minutes, a case-management caseload on screen, and an honest answer about what Texas voc rehab would need. Or join the Texas voc-rehab list and we will write to you when there is something real to show.
There is a phone number and a person answers it: (302) 202-3172.
States that work like Texas
Questions, answered.
What is the 95-day rule?
Texas requires bills to be filed within 95 days of the date of service under 28 TAC 133.20 — the tightest timely-filing clock of any state we have researched. Current as of July 2026; verify with the Texas Division of Workers’ Compensation.
Is there private vocational rehabilitation in Texas?
It is carrier-optional under §408.150, alongside Texas Workforce Commission referrals, which means it exists but does not support a dependable private billing market. Nurse case management does.
Texas requires e-billing both directions. Do you submit?
No, and we will not describe it as shipped. We build the bill, the packet and the receivable and file your proof of what was sent. Direct electronic submission is on our roadmap.
Does it track the filing clock?
Every bill carries its date of service and its send date, and aging runs from the day it left. What actually protects you is that the bill leaves the same week as the work, which is what the grid is for.
Where does my data live?
On your computer. Cancel and the software goes read-only; nothing is deleted and everything exports.
See your own week run itself.
We load your state’s codes before the call, so you are looking at a caseload like yours inside the first two minutes — not a slide deck.