Texas SB1090 limits bundling and down-coding practices by dental benefit providers.

Texas SB1090 amends the Insurance Code to add Section 1451.210, which limits bundling and down-coding practices by providers of dental benefits. Bundling refers to combining distinct dental procedures into one for billing, while down-coding involves adjusting a procedure code to reflect a less complex or lower-cost procedure. The bill prohibits providers or issuers from changing a dentist's submitted procedure codes through these practices unless a professional review determines the original coding was incorrect, fragmented, or unbundled.

Texas SB1090 limits bundling and down-coding practices by dental benefit providers.

Texas SB1090 amends the Insurance Code to add Section 1451.210, which limits bundling and down-coding practices by providers of dental benefits. Bundling refers to combining distinct dental procedures into one for billing, while down-coding involves adjusting a procedure code to reflect a less complex or lower-cost procedure. The bill prohibits providers or issuers from changing a dentist's submitted procedure codes through these practices unless a professional review determines the original coding was incorrect, fragmented, or unbundled.