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Current as of January 01, 2024 | Updated by Findlaw Staff
(a) A health benefit plan that provides coverage for medically necessary diagnostic or surgical treatment of conditions affecting skeletal joints must provide comparable coverage for diagnostic or surgical treatment of conditions affecting the temporomandibular joint if the treatment is medically necessary as a result of:
(1) an accident;
(2) a trauma;
(3) a congenital defect;
(4) a developmental defect; or
(5) a pathology.
(b) Coverage required under this section may be subject to any provision in the health benefit plan that is generally applicable to surgical treatment, including a requirement for precertification of coverage.
Cite this article: FindLaw.com - Texas Insurance Code - INS § 1360.004. Coverage Required - last updated January 01, 2024 | https://codes.findlaw.com/tx/insurance-code/ins-sect-1360-004/
FindLaw Codes may not reflect the most recent version of the law in your jurisdiction. Please verify the status of the code you are researching with the state legislature before relying on it for your legal needs.
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