1. (a) Health care providers shall submit medical bills for payment:

   1. (1) on standard forms used by the Centers for Medicare and Medicaid Services (CMS);
   2. (2) on applicable forms prescribed for pharmacists and dentists specified in subsections (b) and (c) of this section; or
   3. (3) in electronic format in accordance with Subchapter G of this chapter (relating to Electronic Medical Billing, Reimbursement, and Documentation).

2. (b) Pharmacists and pharmacy processing agents shall submit bills using the Division form DWC-66. A pharmacist or pharmacy processing agent may submit bills using an alternate billing form if:

   1. (1) the insurance carrier has approved the alternate billing form prior to submission by the pharmacist or pharmacy processing agent; and
   2. (2) the alternate billing form provides all information required on the Division form DWC-66.
3. (c) Dentists shall submit bills for dental services using the current American Dental Association claim form.
4. (d) All information submitted on required billing forms must be legible and completed in accordance with Division instructions.

Source Note:The provisions of this §133.10 adopted to be effective May 2, 2006, 31 TexReg 3544; amended to be effective December 24, 2006, 31 TexReg 10097; amended to be effective May 1, 2008, 33 TexReg 3443.