To treat injured workers, Texas law requires health care providers to register with the Texas Division of Workers’ Compensation (TX DWC) and meet certain requirements.

To outline those requirements, the agency released an updated checklist for becoming a Texas workers’ compensation treating doctor. Below, we review important details of this checklist, which every Texas provider should download for their reference.

The TX DWC is to be congratulated for its proactive approach to keeping doctors informed. Read on to learn how to become eligible to treat injured workers—and receive reimbursement—in the Lone Star State.

TX Workers’ Compensation Treating Doctor Requirements

Per Texas Labor Code, the TX DWC must maintain a list of doctors approved to treat the state’s injured workers.

In June 2024, the TX DWC updated its prerequisite checklist (pictured in part below), which guides providers in registering with the agency and confirming basic requirements. Providers can download the checklist here.

As shown above and discussed in the TX DWC’s recent webinar, there are three main steps to qualifying as a workers’ comp treating doctor:

1. Having appropriate licensure
2. Establishing a TXCOMP profile
3. Submitting financial disclosures to the state

Additionally, to treat an injured worker restricted to a certified Health Care Network (HCN), the provider must be contracted with that HCN (we’ll explore HCN requirements in more detail in future articles—stay tuned).

Step One: Doctor’s Licensure

Put simply, this is a license held by a doctor. Texas Labor Code Section 401.011(17) defines a “doctor” as follows:  

• Doctor of Medicine
• Doctor of Osteopathic Medicine
• Optometrist
• Podiatrist
• Dentist
• Chiropractor

Doctors who fall into the categories provided by the definition must then satisfy the following two conditions:

1. Have an active medical license to practice in their jurisdiction and;
2. Have no disciplinary orders restricting participation in the workers’ comp system.

If you meet the conditions above, congratulations—you’re one-third of the way to becoming a workers’ compensation treating doctor.

Bear in mind that per Texas Insurance Code Section 1305.103, HCNs may “determine the specialty or specialties of doctors who may serve as treating doctors.” For example, some HCNs may not allow chiropractors to serve as treating doctors.

Step Two: TXCOMP Practitioner Profile

TXCOMP is an automated system maintained by the Texas Department of Insurance (TDI), which facilitates communication between workers' compensation system participants.

The TX DWC strongly encourages providers who are willing to treat injured workers to establish a TXCOMP profile; doing so is a necessary component of completing Step 3: financial disclosures.

Instructions for accessing TXCOMP, including a short video, are available here. For further assistance, the TDI has also offers an instructional PDF.

Step Three: Financial Disclosure

According to Texas Labor Code Section 413.041, workers’ compensation treating doctors must disclose to the state any financial interest in other providers to whom they may refer injured workers for treatment:

“Each health care practitioner shall disclose to the division the identity of any health care provider in which the health care practitioner, or the health care provider that employs the health care practitioner, has a financial interest.”

Financial interest in this context can include:

• Direct or indirect ownership or investment in the referred-to provider or
• A direct or indirect compensation arrangement with the referred-to provider.

A doctor must disclose all new financial interest to the TX DWC within 30 days after an initial referral of an injured worker, unless the doctor has previously disclosed this financial relationship.

Providers must submit financial disclosures through their TXCOMP profile, under the Financial Disclosures section. Doctors who fail to timely disclose financial interests can be subject to sanctions, penalties, and/or forfeiture of reimbursement.

Reminder: Treating HCN-Covered Injured Workers

Providers who complete the three steps above may treat all injured workers who are not restricted to an HCN, and expect correct reimbursement.

However, about half of injured workers in Texas must seek treatment within one of the state’s certified HCNs—which is why we strongly recommend establishing whether or not an injured worker is subject to an HCN as part of your intake process.

To treat injured workers subject to an HCN, in addition to completing the three steps above a provider must also either:

• Be under contract with the HCN in question, or
• Have specific permission for out-of-network care (excepting emergency treatment)

We’ll cover HCN requirements in more detail in future articles. For now, further information on establishing membership in Texas workers’ comp networks is available here. Providers can direct further questions about treating doctor requirements to the TX DWC via CompConnection.

For any and all questions about billing for injured worker treatment in Texas (including fast and easy e-billing) talk to our experts using the pink chat icon in the bottom right of this page, or email us at info@daisybill.com.

Yes, you can electronically submit bills (and supporting documents) for workers’ comp treatment in Texas. Get a free demonstration below.

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