A new Texas law removes a reimbursement barrier for telehealth providers serving patients across state lines—but only if certain conditions are met.
Most health services owners don't realize that Texas health plans have been able to reimburse out-of-state telehealth differently than in-state telehealth—or not at all. HB1052 changes that, effective September 1, 2025, but the provision is narrow and comes with specific requirements.
Under HB1052, health benefit plans delivered, issued for delivery, or renewed on or after September 1, 2025, must cover telehealth services at the same reimbursement rate and on the same terms whether the provider or patient site is located outside Texas. In plain terms: a plan cannot pay less for a telehealth visit with an out-of-state provider than it would for the same service delivered in-state.
This applies to telemedicine, teledentistry, and telehealth appointments. The change is codified in Section 2 of HB1052, which adds Subsection (e) to Section 1455.004 of the Texas Insurance Code.
The provision applies only to health benefit plans (commercial insurance, not Medicare or Medicaid directly, though some managed Medicaid plans may be affected). It covers telehealth services where the patient primarily resides in Texas.
Critically, the out-of-state provider must hold a Texas license and maintain a physical office location in Texas. This is not a blanket permission to reimburse any out-of-state provider. The provider must have a legitimate Texas presence.
The law does not apply to plans delivered, issued, or renewed before September 1, 2025. Existing plans may continue under prior terms until renewal.
For telehealth-enabled practices, this removes a significant reimbursement uncertainty. Previously, a practice with a Texas license and office could face plan-by-plan negotiation over whether out-of-state service delivery would be covered at parity rates. HB1052 mandates parity for all qualifying plans renewing after the effective date.
This can expand service delivery options—practices can serve Texas patients from out-of-state locations without fear of automatic reimbursement penalties. It also levels the playing field: in-state and out-of-state providers meeting the licensing and office requirements now face the same reimbursement terms.
For practices considering multi-state operations or remote staffing, this removes one barrier to scaling telehealth services into Texas.
If you operate telehealth services or are considering it, review your current health plan contracts to understand how out-of-state services are currently reimbursed. Starting September 1, 2025, you can expect plans to update their policies to comply with HB1052.
Ensure your practice holds a valid Texas license and maintains a physical office in Texas if you plan to rely on this provision. The law is specific on these points.
If you're negotiating new or renewed contracts with health plans after September 1, 2025, cite this provision if a plan attempts to offer lower reimbursement rates for out-of-state service delivery.
Source: HB1052, 88th Texas Legislature; Section 2, adding Subsection (e) to Section 1455.004, Texas Insurance Code; effective September 1, 2025.