Texas Insurance Code - INS § 1355.251. Definitions

(1) “Mental health benefit” means a benefit relating to an item or service for a mental health condition, as defined under the terms of a health benefit plan and in accordance with applicable federal and state law.

(2) “Nonquantitative treatment limitation” means a limit on the scope or duration of treatment that is not expressed numerically.  The term includes:

(3) “Quantitative treatment limitation” means a treatment limitation that determines whether, or to what extent, benefits are provided based on an accumulated amount such as an annual or lifetime limit on days of coverage or number of visits.  The term includes a deductible, a copayment, coinsurance, or another out-of-pocket expense or annual or lifetime limit, or another financial requirement.

(4) “Substance use disorder benefit” means a benefit relating to an item or service for a substance use disorder, as defined under the terms of a health benefit plan and in accordance with applicable federal and state law.