Pre-treatment plans for dental services are required and written authorization for dental services is recommended. Examinations and x-rays do not require authorization and may be paid upon approval of the OAG. Pursuant to Tex. Code Crim. Proc. Art. 56.34(d), after investigation, the OAG has determined that there is a reasonable health care justification for deviation from the Texas Workers' Compensation Commission Medical Fee Guidelines, and that reimbursement for dental services shall be subject to fair and reasonable guidelines. For dental services normally associated with criminally injurious conduct, the OAG has determined that fair and reasonable reimbursements will be paid at the amount billed or the mean amount published in the current American Dental Association Survey of Dental Fees, whichever is less.

Source Note:The provisions of this §61.506 adopted to be effective December 15, 2002, 27 TexReg 11513; amended to be effective May 8, 2005, 30 TexReg 2491.