Medical Billing Services in Texas
Texas is big in every way that matters to billing: the second-largest provider market in the country, a 95-day Medicaid clock, and BCBSTX sitting at the center of the commercial market. We keep Texas practices paid on time.
Get a Free TX Revenue AnalysisPRMS Billing Solutions delivers complete billing and revenue cycle management for Texas providers, from Houston, Dallas-Fort Worth, San Antonio, and Austin groups to rural practices across the state's 254 counties. Texas billing rewards discipline: Texas Medicaid's filing deadline is measured in days, not months, and the payer mix shifts sharply between metro and rural markets. We run eligibility, coding, claims, denials, AR, and credentialing so nothing slips.
Medicare billing in Texas
Texas Part B claims are processed by Novitas Solutions, the Medicare Administrative Contractor for Jurisdiction H. We file to Novitas electronically and screen claims against its local coverage determinations before submission. Medicare Advantage is strong in Texas metros, led by UnitedHealthcare, Humana, Aetna, and Wellcare, so we verify MA enrollment at check-in and route accordingly.
Texas Medicaid (TMHP) billing
Texas Medicaid claims flow through TMHP (Texas Medicaid & Healthcare Partnership), and its signature rule is the one Texas practices learn the hard way: claims are due within 95 days of the date of service. Most members are enrolled in STAR, STAR+PLUS, STAR Kids, or CHIP managed-care plans, Superior HealthPlan, Amerigroup, Texas Children's Health Plan, Molina, Community Health Choice, Driscoll, and others that vary by service area. We confirm the member's plan and service area up front and file well inside the 95-day clock.
Commercial payers we bill in Texas
Blue Cross and Blue Shield of Texas (an HCSC plan) is the state's commercial anchor and its largest insurer. Alongside BCBSTX we bill UnitedHealthcare, Aetna, Cigna (with its major Houston presence), Humana, and the regional plans, Baylor Scott & White Health Plan in Central Texas and Community Health Choice in Houston. Texas is also a workers' compensation state with its own DWC fee guidelines, which we bill and appeal correctly for practices that see comp patients.
Specialties we serve across Texas
We bill 25+ specialties across Texas, with strong benches in the state's high-volume fields: family medicine and internal medicine (the backbone of Texas's rural markets), pain management, orthopedics, cardiology, urgent care (booming in TX metros), and emergency medicine.
Why Texas practices choose PRMS
The Texas-specific leaks we close: TMHP claims that die on the 95-day deadline, STAR/STAR+PLUS claims filed to the wrong MCO for the member's service area, and BCBSTX underpayments that never get compared against contract rates. Texas practices also lose revenue to unworked AR simply because volumes are high, so our dedicated follow-up team works every claim to resolution. Credentialing with TMHP, BCBSTX, and all major Texas payers is free for billing clients.
Texas medical billing FAQs
What is the timely filing deadline for Texas Medicaid?
95 days from the date of service for TMHP claims, among the shortest in the nation. Managed-care plans (Superior, Amerigroup, and others) apply their own windows on top. We track every Texas claim against its specific deadline.
Do you bill Texas STAR and STAR+PLUS managed care plans?
Yes. We bill all Texas Medicaid managed-care programs, STAR, STAR+PLUS, STAR Kids, and CHIP, across their MCOs, verifying each member's plan and service area before the claim is filed.
Which Medicare contractor processes Texas claims?
Novitas Solutions (Jurisdiction H) handles Texas Part B claims. Its local coverage determinations are built into our pre-submission scrubbing.
Do you work with rural Texas practices?
Yes. From metro groups in Houston and DFW to single-provider clinics in West Texas and the Panhandle, our service is fully remote, works in your existing software, and scales to any volume.
Related services
Explore our full medical billing & RCM services, denial management, and provider credentialing & payer enrollment (free for billing clients), or browse all 25+ specialties we bill and other states we serve.
See what your Texas practice is leaving on the table
Get a free, no-obligation revenue analysis. We measure your denial rate, days in AR, and recoverable revenue, specific to your payers.