1. (a) The ground rules and the medical service standards and limitations as established by the fee guidelines shall be used to properly calculate the payments due to the health care providers.
2. (b) Health care providers shall bill the insurance carrier for all compensable injuries using the codes from the fee guidelines established by the commission. The health care provider shall bill the insurance carrier for the health care treatments and services performed, and medically necessary to relieve the effects of the compensable injury and promote recovery.
3. (c) Doctors of medicine, osteopathy, dentistry, chiropractic, podiatry, optometry, psychology, and registered nurses, physical therapists, occupational therapists, imaging or radiology centers, minor emergency centers, freestanding pathology centers, durable medical equipment suppliers, and orthotic and prosthetic suppliers shall bill the insurance carrier using the medical fee guideline described in §134.200 of this title (relating to Medical Fee Guideline).
4. (d) Pharmacists, in settings other than a hospital, shall bill according to the pharmaceutical fee guideline described in §134.501 of this title (relating to Pharmaceutical Fee Guideline).
5. (e) Hospitals, licensed by the Texas Department of Health or Texas Department of Mental Health and Mental Retardation, and ambulatory surgical centers, licensed by the Texas Department of Health, shall bill according to the hospital and ambulatory surgical center fee guideline described in §134.400 of this title (relating to Hospital and Ambulatory Surgical Center Fee Guideline).
6. (f) Reimbursement for services not identified in an established fee guideline shall be reimbursed at fair and reasonable rates as described in the Texas Workers' Compensation Act, §8.21(b), until such period that specific fee guidelines are established by the commission.

Source Note:The provisions of this §134.1 adopted to be effective October 7, 1991, 16 TexReg 5210.