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Texas House Bill HB3140

Texas 2025 - 89th Regular

Texas House Bill HB3140 Compare Versions

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11 89R8049 SCF-F
22 By: Lopez of Cameron H.B. No. 3140
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77 A BILL TO BE ENTITLED
88 AN ACT
99 relating to network adequacy standards for preferred provider
1010 benefit plans.
1111 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1212 SECTION 1. Section 1301.0055, Insurance Code, is amended by
1313 amending Subsections (a) and (b) and adding Subsection (d) to read
1414 as follows:
1515 (a) The commissioner shall by rule adopt network adequacy
1616 standards that:
1717 (1) require an insurer offering a preferred provider
1818 benefit plan to:
1919 (A) monitor compliance with network adequacy
2020 standards, including provisions of this chapter relating to network
2121 adequacy, on an ongoing basis, reporting any material deviation
2222 from network adequacy standards to the department within 30 days of
2323 the date the material deviation occurred; and
2424 (B) promptly take any corrective action required
2525 to ensure that the network is compliant not later than the 90th day
2626 after the date the material deviation occurred unless:
2727 (i) there are no uncontracted licensed
2828 physicians or health care providers in the affected county; or
2929 (ii) the insurer requests a waiver under
3030 this subsection;
3131 (2) ensure availability of, and accessibility to, a
3232 full range of contracted physicians and health care providers to
3333 provide current and projected utilization of health care services
3434 for adult and minor insureds;
3535 (3) may allow a waiver for a departure from network
3636 adequacy standards for a period not to exceed one year if the
3737 commissioner determines [after receiving public testimony at a
3838 public hearing under Section 1301.00565] that good cause is shown
3939 and posts on the department's Internet website the name of the
4040 preferred provider benefit plan, the insurer offering the plan,
4141 each affected county, the specific network adequacy standards
4242 waived, and the insurer's access plan;
4343 (4) require disclosure by the insurer of the
4444 information described by Subdivision (3) in all promotion and
4545 advertisement of the preferred provider benefit plan for which a
4646 waiver is allowed under that subdivision; and
4747 (5) [except as provided by Subdivision (6), limit a
4848 waiver from being issued to a preferred provider benefit plan:
4949 [(A) more than twice consecutively for the same
5050 network adequacy standard in the same county unless the insurer
5151 demonstrates, in addition to the good cause described by
5252 Subdivision (3), multiple good faith attempts to bring the plan
5353 into compliance with the network adequacy standard during each of
5454 the prior consecutive waiver periods; or
5555 [(B) more than a total of four times within a
5656 21-year period for each county in a service area for issues that may
5757 be remedied through good faith efforts; and
5858 [(6)] authorize the commissioner to issue a waiver
5959 [that would otherwise be unavailable under Subdivision (5)] if the
6060 waiver request demonstrates, and the department confirms annually,
6161 that there are no uncontracted physicians or health care providers
6262 in the area to meet the specific standard for a county in a service
6363 area.
6464 (b) The standards described by Subsection (a)(2) must
6565 include factors regarding time and[,] distance[, and appointment
6666 availability]. The factors must:
6767 (1) require that all insureds are able to receive an
6868 appointment with a preferred provider within the maximum travel
6969 times and distances established under Sections 1301.00553 and
7070 1301.00554;
7171 (2) [require that all insureds are able to receive an
7272 appointment with a preferred provider within the maximum
7373 appointment wait times established under Section 1301.00555;
7474 [(3)] require a preferred provider benefit plan to
7575 ensure sufficient choice, access, and quality of physicians and
7676 health care providers, in number, size, and geographic
7777 distribution, to be capable of providing the health care services
7878 covered by the plan from preferred providers to at least 75 percent
7979 of [all] insureds within the insurer's designated service area,
8080 taking into account the insureds' characteristics, medical
8181 conditions, and health care needs, including:
8282 (A) the current utilization of covered health
8383 care services within the counties of the service area; and
8484 (B) an actuarial projection of utilization of
8585 covered health care services, physicians, and health care providers
8686 needed within the counties of the service area to meet the needs of
8787 the number of projected insureds;
8888 (3) [(4)] require a sufficient number of preferred
8989 providers of emergency medicine, anesthesiology, pathology,
9090 radiology, neonatology, oncology, including medical, surgical, and
9191 radiation oncology, surgery, and hospitalist, intensivist, and
9292 diagnostic services, including radiology and laboratory services,
9393 at each preferred hospital, ambulatory surgical center, or
9494 freestanding emergency medical care facility that credentials the
9595 particular specialty to ensure at least 75 percent of [all]
9696 insureds are able to receive covered benefits, including access to
9797 clinical trials covered by the health benefit plan, at that
9898 preferred location;
9999 (4) [(5)] require that all insureds have the ability
100100 to access a preferred institutional provider listed in Section
101101 1301.00553 within the maximum travel times and distances
102102 established under Section 1301.00553 for the corresponding county
103103 classification;
104104 (5) [(6)] require that insureds have the option of
105105 facilities, if available, of pediatric, for-profit, nonprofit, and
106106 tax-supported institutions, with special consideration to
107107 contracting with:
108108 (A) teaching hospitals that provide indigent
109109 care or care for uninsured individuals as a significant percentage
110110 of their overall patient load; and
111111 (B) teaching facilities that specialize in
112112 providing care for rare and complex medical conditions and
113113 conducting clinical trials;
114114 (6) [(7)] require that there is an adequate number of
115115 preferred provider physicians who have admitting privileges at one
116116 or more preferred provider hospitals located within the insurer's
117117 designated service area to make any necessary hospital admissions;
118118 (7) [(8)] provide for necessary hospital services by
119119 requiring contracting with general, pediatric, specialty, and
120120 psychiatric hospitals on a preferred benefit basis within the
121121 insurer's designated service area, as applicable;
122122 (8) [(9)] ensure that emergency care, as defined by
123123 Section 1301.155, is available and accessible 24 hours a day, seven
124124 days a week, by preferred providers;
125125 (9) [(10)] ensure that covered urgent care is
126126 available and accessible from preferred providers within the
127127 insurer's designated service area within 24 hours for medical and
128128 behavioral health conditions;
129129 (10) [(11)] require an adequate number of preferred
130130 providers to be available and accessible to insureds 24 hours a day,
131131 seven days a week, within the insurer's designated service area;
132132 and
133133 (11) [(12)] require sufficient numbers and classes of
134134 preferred providers to ensure choice, access, and quality of care
135135 across the insurer's designated service area.
136136 (d) For the purposes of this section, a preferred provider
137137 within the time and distance requirements of Section 1301.00553 is
138138 considered part of the network adequacy calculation, regardless of
139139 whether the provider's office is located in a different county than
140140 the insured or outside the insurer's service area.
141141 SECTION 2. Sections 1301.00553(c), (d), (e), (f), and (g),
142142 Insurance Code, are amended to read as follows:
143143 (c) Maximum travel time in minutes and maximum distance in
144144 miles for preferred provider benefit plans by preferred provider
145145 type for each large metro county are:
146146 (1) for the following physicians, as designated by
147147 physician specialty:
148148 Time Distance Time Distance
149149 Time Distance
150150 Allergy and Immunology 40 [30] 20 [15] Allergy and Immunology 40 [30] 20 [15]
151151 Allergy and Immunology 40 [30] 20 [15]
152152 Cardiology 30 [20] 15 [10] Cardiology 30 [20] 15 [10]
153153 Cardiology 30 [20] 15 [10]
154154 Cardiothoracic Surgery 40 [30] 20 [15] Cardiothoracic Surgery 40 [30] 20 [15]
155155 Cardiothoracic Surgery 40 [30] 20 [15]
156156 Dermatology 30 [20] 15 [10] Dermatology 30 [20] 15 [10]
157157 Dermatology 30 [20] 15 [10]
158158 Emergency Medicine 30 [20] 15 [10] Emergency Medicine 30 [20] 15 [10]
159159 Emergency Medicine 30 [20] 15 [10]
160160 Endocrinology 40 [30] 20 [15] Endocrinology 40 [30] 20 [15]
161161 Endocrinology 40 [30] 20 [15]
162162 Ear, Nose, and Throat/Otolaryngology 40 [30] 20 [15] Ear, Nose, and Throat/Otolaryngology 40 [30] 20 [15]
163163 Ear, Nose, and Throat/Otolaryngology 40 [30] 20 [15]
164164 Gastroenterology 30 [20] 15 [10] Gastroenterology 30 [20] 15 [10]
165165 Gastroenterology 30 [20] 15 [10]
166166 General Surgery 30 [20] 15 [10] General Surgery 30 [20] 15 [10]
167167 General Surgery 30 [20] 15 [10]
168168 Gynecology and Obstetrics 20 [10] 10 [5] Gynecology and Obstetrics 20 [10] 10 [5]
169169 Gynecology and Obstetrics 20 [10] 10 [5]
170170 Infectious Diseases 40 [30] 20 [15] Infectious Diseases 40 [30] 20 [15]
171171 Infectious Diseases 40 [30] 20 [15]
172172 Nephrology 40 [30] 20 [15] Nephrology 40 [30] 20 [15]
173173 Nephrology 40 [30] 20 [15]
174174 Neurology 30 [20] 15 [10] Neurology 30 [20] 15 [10]
175175 Neurology 30 [20] 15 [10]
176176 Neurosurgery 40 [30] 20 [15] Neurosurgery 40 [30] 20 [15]
177177 Neurosurgery 40 [30] 20 [15]
178178 Oncology: Medical, Surgical 30 [20] 15 [10] Oncology: Medical, Surgical 30 [20] 15 [10]
179179 Oncology: Medical, Surgical 30 [20] 15 [10]
180180 Oncology: Radiation 40 [30] 20 [15] Oncology: Radiation 40 [30] 20 [15]
181181 Oncology: Radiation 40 [30] 20 [15]
182182 Ophthalmology 30 [20] 15 [10] Ophthalmology 30 [20] 15 [10]
183183 Ophthalmology 30 [20] 15 [10]
184184 Orthopedic Surgery 30 [20] 15 [10] Orthopedic Surgery 30 [20] 15 [10]
185185 Orthopedic Surgery 30 [20] 15 [10]
186186 Physical Medicine and Rehabilitation 40 [30] 20 [15] Physical Medicine and Rehabilitation 40 [30] 20 [15]
187187 Physical Medicine and Rehabilitation 40 [30] 20 [15]
188188 Plastic Surgery 40 [30] 20 [15] Plastic Surgery 40 [30] 20 [15]
189189 Plastic Surgery 40 [30] 20 [15]
190190 Primary Care: Adults 20 [10] 10 [5] Primary Care: Adults 20 [10] 10 [5]
191191 Primary Care: Adults 20 [10] 10 [5]
192192 Primary Care: Pediatric 20 [10] 10 [5] Primary Care: Pediatric 20 [10] 10 [5]
193193 Primary Care: Pediatric 20 [10] 10 [5]
194194 Psychiatry 30 [20] 15 [10] Psychiatry 30 [20] 15 [10]
195195 Psychiatry 30 [20] 15 [10]
196196 Pulmonology 30 [20] 15 [10] Pulmonology 30 [20] 15 [10]
197197 Pulmonology 30 [20] 15 [10]
198198 Rheumatology 40 [30] 20 [15] Rheumatology 40 [30] 20 [15]
199199 Rheumatology 40 [30] 20 [15]
200200 Urology 30 [20] 15 [10] Urology 30 [20] 15 [10]
201201 Urology 30 [20] 15 [10]
202202 Vascular Surgery 40 [30] 20 [15] Vascular Surgery 40 [30] 20 [15]
203203 Vascular Surgery 40 [30] 20 [15]
204204 (2) for health care practitioners in the following
205205 disciplines:
206206 Time Distance Time Distance
207207 Time Distance
208208 Chiropractic 40 [30] 20 [15] Chiropractic 40 [30] 20 [15]
209209 Chiropractic 40 [30] 20 [15]
210210 Occupational Therapy 30 [20] 15 [10] Occupational Therapy 30 [20] 15 [10]
211211 Occupational Therapy 30 [20] 15 [10]
212212 Physical Therapy 30 [20] 15 [10] Physical Therapy 30 [20] 15 [10]
213213 Physical Therapy 30 [20] 15 [10]
214214 Podiatry 30 [20] 15 [10] Podiatry 30 [20] 15 [10]
215215 Podiatry 30 [20] 15 [10]
216216 Speech Therapy 30 [20] 15 [10] Speech Therapy 30 [20] 15 [10]
217217 Speech Therapy 30 [20] 15 [10]
218218 (3) for the following types of institutional
219219 providers:
220220 Time Distance Time Distance
221221 Time Distance
222222 Acute Inpatient Hospitals (Emergency Services Available 24/7) 30 [20] 15 [10] Acute Inpatient Hospitals (Emergency Services Available 24/7) 30 [20] 15 [10]
223223 Acute Inpatient Hospitals (Emergency Services Available 24/7) 30 [20] 15 [10]
224224 Acute Inpatient Hospitals (Emergency Services Available 24/7) 30 [20] 15 [10] Acute Inpatient Hospitals (Emergency Services Available 24/7) 30 [20] 15 [10]
225225 Acute Inpatient Hospitals (Emergency Services Available 24/7) 30 [20] 15 [10]
226226 Cardiac Catheterization Services 40 [30] 20 [15] Cardiac Catheterization Services 40 [30] 20 [15]
227227 Cardiac Catheterization Services 40 [30] 20 [15]
228228 Cardiac Surgery Program 40 [30] 20 [15] Cardiac Surgery Program 40 [30] 20 [15]
229229 Cardiac Surgery Program 40 [30] 20 [15]
230230 Critical Care Services: Intensive Care Units 30 [20] 15 [10] Critical Care Services: Intensive Care Units 30 [20] 15 [10]
231231 Critical Care Services: Intensive Care Units 30 [20] 15 [10]
232232 Diagnostic Radiology (Freestanding; Hospital Outpatient; Ambulatory Health Facilities with Diagnostic Radiology) 30 [20] 15 [10] Diagnostic Radiology (Freestanding; Hospital Outpatient; Ambulatory Health Facilities with Diagnostic Radiology) 30 [20] 15 [10]
233233 Diagnostic Radiology (Freestanding; Hospital Outpatient; Ambulatory Health Facilities with Diagnostic Radiology) 30 [20] 15 [10]
234234 Diagnostic Radiology (Freestanding; Hospital Outpatient; Ambulatory Health Facilities with Diagnostic Radiology) 30 [20] 15 [10] Diagnostic Radiology (Freestanding; Hospital Outpatient; Ambulatory Health Facilities with Diagnostic Radiology) 30 [20] 15 [10]
235235 Diagnostic Radiology (Freestanding; Hospital Outpatient; Ambulatory Health Facilities with Diagnostic Radiology) 30 [20] 15 [10]
236236 Diagnostic Radiology (Freestanding; Hospital Outpatient; Ambulatory Health Facilities with Diagnostic Radiology) 30 [20] 15 [10] Diagnostic Radiology (Freestanding; Hospital Outpatient; Ambulatory Health Facilities with Diagnostic Radiology) 30 [20] 15 [10]
237237 Diagnostic Radiology (Freestanding; Hospital Outpatient; Ambulatory Health Facilities with Diagnostic Radiology) 30 [20] 15 [10]
238238 Inpatient or Residential Behavioral Health Facility Services 40 [30] 20 [15] Inpatient or Residential Behavioral Health Facility Services 40 [30] 20 [15]
239239 Inpatient or Residential Behavioral Health Facility Services 40 [30] 20 [15]
240240 Inpatient or Residential Behavioral Health Facility Services 40 [30] 20 [15] Inpatient or Residential Behavioral Health Facility Services 40 [30] 20 [15]
241241 Inpatient or Residential Behavioral Health Facility Services 40 [30] 20 [15]
242242 Mammography 30 [20] 15 [10] Mammography 30 [20] 15 [10]
243243 Mammography 30 [20] 15 [10]
244244 Outpatient Infusion/Chemotherapy 30 [20] 15 [10] Outpatient Infusion/Chemotherapy 30 [20] 15 [10]
245245 Outpatient Infusion/Chemotherapy 30 [20] 15 [10]
246246 Skilled Nursing Facilities 30 [20] 15 [10] Skilled Nursing Facilities 30 [20] 15 [10]
247247 Skilled Nursing Facilities 30 [20] 15 [10]
248248 Surgical Services (Outpatient or Ambulatory Surgical Center) 30 [20] 15 [10] Surgical Services (Outpatient or Ambulatory Surgical Center) 30 [20] 15 [10]
249249 Surgical Services (Outpatient or Ambulatory Surgical Center) 30 [20] 15 [10]
250250 Surgical Services (Outpatient or Ambulatory Surgical Center) 30 [20] 15 [10] Surgical Services (Outpatient or Ambulatory Surgical Center) 30 [20] 15 [10]
251251 Surgical Services (Outpatient or Ambulatory Surgical Center) 30 [20] 15 [10]
252252 (4) for the following settings:
253253 Time Distance Time Distance
254254 Time Distance
255255 Outpatient Clinical Behavioral Health (Licensed, Accredited, or Certified) 20 [10] 10 [5] Outpatient Clinical Behavioral Health (Licensed, Accredited, or Certified) 20 [10] 10 [5]
256256 Outpatient Clinical Behavioral Health (Licensed, Accredited, or Certified) 20 [10] 10 [5]
257257 Outpatient Clinical Behavioral Health (Licensed, Accredited, or Certified) 20 [10] 10 [5] Outpatient Clinical Behavioral Health (Licensed, Accredited, or Certified) 20 [10] 10 [5]
258258 Outpatient Clinical Behavioral Health (Licensed, Accredited, or Certified) 20 [10] 10 [5]
259259 Urgent Care 30 [20] 15 [10] Urgent Care 30 [20] 15 [10]
260260 Urgent Care 30 [20] 15 [10]
261261 (d) Maximum travel time in minutes and maximum distance in
262262 miles for preferred provider benefit plans by preferred provider
263263 type for each metro county are:
264264 (1) for the following physicians, as designated by
265265 physician specialty:
266266 Time Distance Time Distance
267267 Time Distance
268268 Allergy and Immunology 60 [45] 40 [30] Allergy and Immunology 60 [45] 40 [30]
269269 Allergy and Immunology 60 [45] 40 [30]
270270 Cardiology 45 [30] 30 [20] Cardiology 45 [30] 30 [20]
271271 Cardiology 45 [30] 30 [20]
272272 Cardiothoracic Surgery 75 [60] 50 [40] Cardiothoracic Surgery 75 [60] 50 [40]
273273 Cardiothoracic Surgery 75 [60] 50 [40]
274274 Dermatology 60 [45] 40 [30] Dermatology 60 [45] 40 [30]
275275 Dermatology 60 [45] 40 [30]
276276 Emergency Medicine 60 [45] 40 [30] Emergency Medicine 60 [45] 40 [30]
277277 Emergency Medicine 60 [45] 40 [30]
278278 Endocrinology 75 [60] 50 [40] Endocrinology 75 [60] 50 [40]
279279 Endocrinology 75 [60] 50 [40]
280280 Ear, Nose, and Throat/Otolaryngology 60 [45] 40 [30] Ear, Nose, and Throat/Otolaryngology 60 [45] 40 [30]
281281 Ear, Nose, and Throat/Otolaryngology 60 [45] 40 [30]
282282 Gastroenterology 60 [45] 40 [30] Gastroenterology 60 [45] 40 [30]
283283 Gastroenterology 60 [45] 40 [30]
284284 General Surgery 45 [30] 30 [20] General Surgery 45 [30] 30 [20]
285285 General Surgery 45 [30] 30 [20]
286286 Gynecology and Obstetrics 30 [15] 20 [10] Gynecology and Obstetrics 30 [15] 20 [10]
287287 Gynecology and Obstetrics 30 [15] 20 [10]
288288 Infectious Diseases 75 [60] 50 [40] Infectious Diseases 75 [60] 50 [40]
289289 Infectious Diseases 75 [60] 50 [40]
290290 Nephrology 60 [45] 40 [30] Nephrology 60 [45] 40 [30]
291291 Nephrology 60 [45] 40 [30]
292292 Neurology 60 [45] 40 [30] Neurology 60 [45] 40 [30]
293293 Neurology 60 [45] 40 [30]
294294 Neurosurgery 75 [60] 50 [40] Neurosurgery 75 [60] 50 [40]
295295 Neurosurgery 75 [60] 50 [40]
296296 Oncology: Medical, Surgical 60 [45] 40 [30] Oncology: Medical, Surgical 60 [45] 40 [30]
297297 Oncology: Medical, Surgical 60 [45] 40 [30]
298298 Oncology: Radiation 75 [60] 50 [40] Oncology: Radiation 75 [60] 50 [40]
299299 Oncology: Radiation 75 [60] 50 [40]
300300 Ophthalmology 45 [30] 30 [20] Ophthalmology 45 [30] 30 [20]
301301 Ophthalmology 45 [30] 30 [20]
302302 Orthopedic Surgery 45 [30] 30 [20] Orthopedic Surgery 45 [30] 30 [20]
303303 Orthopedic Surgery 45 [30] 30 [20]
304304 Physical Medicine and Rehabilitation 60 [45] 40 [30] Physical Medicine and Rehabilitation 60 [45] 40 [30]
305305 Physical Medicine and Rehabilitation 60 [45] 40 [30]
306306 Plastic Surgery 75 [60] 50 [40] Plastic Surgery 75 [60] 50 [40]
307307 Plastic Surgery 75 [60] 50 [40]
308308 Primary Care: Adults 30 [15] 20 [10] Primary Care: Adults 30 [15] 20 [10]
309309 Primary Care: Adults 30 [15] 20 [10]
310310 Primary Care: Pediatric 30 [15] 20 [10] Primary Care: Pediatric 30 [15] 20 [10]
311311 Primary Care: Pediatric 30 [15] 20 [10]
312312 Psychiatry 60 [45] 40 [30] Psychiatry 60 [45] 40 [30]
313313 Psychiatry 60 [45] 40 [30]
314314 Pulmonology 60 [45] 40 [30] Pulmonology 60 [45] 40 [30]
315315 Pulmonology 60 [45] 40 [30]
316316 Rheumatology 75 [60] 50 [40] Rheumatology 75 [60] 50 [40]
317317 Rheumatology 75 [60] 50 [40]
318318 Urology 60 [45] 40 [30] Urology 60 [45] 40 [30]
319319 Urology 60 [45] 40 [30]
320320 Vascular Surgery 75 [60] 50 [40] Vascular Surgery 75 [60] 50 [40]
321321 Vascular Surgery 75 [60] 50 [40]
322322 (2) for health care practitioners in the following
323323 disciplines:
324324 Time Distance Time Distance
325325 Time Distance
326326 Chiropractic 60 [45] 40 [30] Chiropractic 60 [45] 40 [30]
327327 Chiropractic 60 [45] 40 [30]
328328 Occupational Therapy 60 [45] 40 [30] Occupational Therapy 60 [45] 40 [30]
329329 Occupational Therapy 60 [45] 40 [30]
330330 Physical Therapy 60 [45] 40 [30] Physical Therapy 60 [45] 40 [30]
331331 Physical Therapy 60 [45] 40 [30]
332332 Podiatry 60 [45] 40 [30] Podiatry 60 [45] 40 [30]
333333 Podiatry 60 [45] 40 [30]
334334 Speech Therapy 60 [45] 40 [30] Speech Therapy 60 [45] 40 [30]
335335 Speech Therapy 60 [45] 40 [30]
336336 (3) for the following types of institutional
337337 providers:
338338 Time Distance Time Distance
339339 Time Distance
340340 Acute Inpatient Hospitals (Emergency Services Available 24/7) 60 [45] 40 [30] Acute Inpatient Hospitals (Emergency Services Available 24/7) 60 [45] 40 [30]
341341 Acute Inpatient Hospitals (Emergency Services Available 24/7) 60 [45] 40 [30]
342342 Acute Inpatient Hospitals (Emergency Services Available 24/7) 60 [45] 40 [30] Acute Inpatient Hospitals (Emergency Services Available 24/7) 60 [45] 40 [30]
343343 Acute Inpatient Hospitals (Emergency Services Available 24/7) 60 [45] 40 [30]
344344 Cardiac Catheterization Services 75 [60] 50 [40] Cardiac Catheterization Services 75 [60] 50 [40]
345345 Cardiac Catheterization Services 75 [60] 50 [40]
346346 Cardiac Surgery Program 75 [60] 50 [40] Cardiac Surgery Program 75 [60] 50 [40]
347347 Cardiac Surgery Program 75 [60] 50 [40]
348348 Critical Care Services: Intensive Care Units 60 [45] 40 [30] Critical Care Services: Intensive Care Units 60 [45] 40 [30]
349349 Critical Care Services: Intensive Care Units 60 [45] 40 [30]
350350 Diagnostic Radiology (Freestanding; Hospital Outpatient; Ambulatory Health Facilities with Diagnostic Radiology) 60 [45] 40 [30] Diagnostic Radiology (Freestanding; Hospital Outpatient; Ambulatory Health Facilities with Diagnostic Radiology) 60 [45] 40 [30]
351351 Diagnostic Radiology (Freestanding; Hospital Outpatient; Ambulatory Health Facilities with Diagnostic Radiology) 60 [45] 40 [30]
352352 Diagnostic Radiology (Freestanding; Hospital Outpatient; Ambulatory Health Facilities with Diagnostic Radiology) 60 [45] 40 [30] Diagnostic Radiology (Freestanding; Hospital Outpatient; Ambulatory Health Facilities with Diagnostic Radiology) 60 [45] 40 [30]
353353 Diagnostic Radiology (Freestanding; Hospital Outpatient; Ambulatory Health Facilities with Diagnostic Radiology) 60 [45] 40 [30]
354354 Diagnostic Radiology (Freestanding; Hospital Outpatient; Ambulatory Health Facilities with Diagnostic Radiology) 60 [45] 40 [30] Diagnostic Radiology (Freestanding; Hospital Outpatient; Ambulatory Health Facilities with Diagnostic Radiology) 60 [45] 40 [30]
355355 Diagnostic Radiology (Freestanding; Hospital Outpatient; Ambulatory Health Facilities with Diagnostic Radiology) 60 [45] 40 [30]
356356 Inpatient or Residential Behavioral Health Facility Services 85 [70] 55 [45] Inpatient or Residential Behavioral Health Facility Services 85 [70] 55 [45]
357357 Inpatient or Residential Behavioral Health Facility Services 85 [70] 55 [45]
358358 Inpatient or Residential Behavioral Health Facility Services 85 [70] 55 [45] Inpatient or Residential Behavioral Health Facility Services 85 [70] 55 [45]
359359 Inpatient or Residential Behavioral Health Facility Services 85 [70] 55 [45]
360360 Mammography 60 [45] 40 [30] Mammography 60 [45] 40 [30]
361361 Mammography 60 [45] 40 [30]
362362 Outpatient Infusion/Chemotherapy 60 [45] 40 [30] Outpatient Infusion/Chemotherapy 60 [45] 40 [30]
363363 Outpatient Infusion/Chemotherapy 60 [45] 40 [30]
364364 Skilled Nursing Facilities 60 [45] 40 [30] Skilled Nursing Facilities 60 [45] 40 [30]
365365 Skilled Nursing Facilities 60 [45] 40 [30]
366366 Surgical Services (Outpatient or Ambulatory Surgical Center) 60 [45] 40 [30] Surgical Services (Outpatient or Ambulatory Surgical Center) 60 [45] 40 [30]
367367 Surgical Services (Outpatient or Ambulatory Surgical Center) 60 [45] 40 [30]
368368 Surgical Services (Outpatient or Ambulatory Surgical Center) 60 [45] 40 [30] Surgical Services (Outpatient or Ambulatory Surgical Center) 60 [45] 40 [30]
369369 Surgical Services (Outpatient or Ambulatory Surgical Center) 60 [45] 40 [30]
370370 (4) for the following settings:
371371 Time Distance Time Distance
372372 Time Distance
373373 Outpatient Clinical Behavioral Health (Licensed, Accredited, or Certified) 30 [15] 20 [10] Outpatient Clinical Behavioral Health (Licensed, Accredited, or Certified) 30 [15] 20 [10]
374374 Outpatient Clinical Behavioral Health (Licensed, Accredited, or Certified) 30 [15] 20 [10]
375375 Outpatient Clinical Behavioral Health (Licensed, Accredited, or Certified) 30 [15] 20 [10] Outpatient Clinical Behavioral Health (Licensed, Accredited, or Certified) 30 [15] 20 [10]
376376 Outpatient Clinical Behavioral Health (Licensed, Accredited, or Certified) 30 [15] 20 [10]
377377 Urgent Care 60 [45] 40 [30] Urgent Care 60 [45] 40 [30]
378378 Urgent Care 60 [45] 40 [30]
379379 (e) Maximum travel time in minutes and maximum distance in
380380 miles for preferred provider benefit plans by preferred provider
381381 type for each micro county are:
382382 (1) for the following physicians, as designated by
383383 physician specialty:
384384 Time Distance Time Distance
385385 Time Distance
386386 Allergy and Immunology 110 [80] 80 [60] Allergy and Immunology 110 [80] 80 [60]
387387 Allergy and Immunology 110 [80] 80 [60]
388388 Cardiology 80 [50] 55 [35] Cardiology 80 [50] 55 [35]
389389 Cardiology 80 [50] 55 [35]
390390 Cardiothoracic Surgery 130 [100] 95 [75] Cardiothoracic Surgery 130 [100] 95 [75]
391391 Cardiothoracic Surgery 130 [100] 95 [75]
392392 Dermatology 90 [60] 65 [45] Dermatology 90 [60] 65 [45]
393393 Dermatology 90 [60] 65 [45]
394394 Emergency Medicine 110 [80] 80 [60] Emergency Medicine 110 [80] 80 [60]
395395 Emergency Medicine 110 [80] 80 [60]
396396 Endocrinology 130 [100] 95 [75] Endocrinology 130 [100] 95 [75]
397397 Endocrinology 130 [100] 95 [75]
398398 Ear, Nose, and Throat/Otolaryngology 110 [80] 80 [60] Ear, Nose, and Throat/Otolaryngology 110 [80] 80 [60]
399399 Ear, Nose, and Throat/Otolaryngology 110 [80] 80 [60]
400400 Gastroenterology 90 [60] 65 [45] Gastroenterology 90 [60] 65 [45]
401401 Gastroenterology 90 [60] 65 [45]
402402 General Surgery 80 [50] 55 [35] General Surgery 80 [50] 55 [35]
403403 General Surgery 80 [50] 55 [35]
404404 Gynecology and Obstetrics 60 [30] 40 [20] Gynecology and Obstetrics 60 [30] 40 [20]
405405 Gynecology and Obstetrics 60 [30] 40 [20]
406406 Infectious Diseases 130 [100] 95 [75] Infectious Diseases 130 [100] 95 [75]
407407 Infectious Diseases 130 [100] 95 [75]
408408 Nephrology 110 [80] 80 [60] Nephrology 110 [80] 80 [60]
409409 Nephrology 110 [80] 80 [60]
410410 Neurology 90 [60] 65 [45] Neurology 90 [60] 65 [45]
411411 Neurology 90 [60] 65 [45]
412412 Neurosurgery 130 [100] 95 [75] Neurosurgery 130 [100] 95 [75]
413413 Neurosurgery 130 [100] 95 [75]
414414 Oncology: Medical, Surgical 90 [60] 65 [45] Oncology: Medical, Surgical 90 [60] 65 [45]
415415 Oncology: Medical, Surgical 90 [60] 65 [45]
416416 Oncology: Radiation 130 [100] 95 [75] Oncology: Radiation 130 [100] 95 [75]
417417 Oncology: Radiation 130 [100] 95 [75]
418418 Ophthalmology 80 [50] 55 [35] Ophthalmology 80 [50] 55 [35]
419419 Ophthalmology 80 [50] 55 [35]
420420 Orthopedic Surgery 80 [50] 55 [35] Orthopedic Surgery 80 [50] 55 [35]
421421 Orthopedic Surgery 80 [50] 55 [35]
422422 Physical Medicine and Rehabilitation 110 [80] 80 [60] Physical Medicine and Rehabilitation 110 [80] 80 [60]
423423 Physical Medicine and Rehabilitation 110 [80] 80 [60]
424424 Plastic Surgery 130 [100] 95 [75] Plastic Surgery 130 [100] 95 [75]
425425 Plastic Surgery 130 [100] 95 [75]
426426 Primary Care: Adults 60 [30] 40 [20] Primary Care: Adults 60 [30] 40 [20]
427427 Primary Care: Adults 60 [30] 40 [20]
428428 Primary Care: Pediatric 60 [30] 40 [20] Primary Care: Pediatric 60 [30] 40 [20]
429429 Primary Care: Pediatric 60 [30] 40 [20]
430430 Psychiatry 90 [60] 65 [45] Psychiatry 90 [60] 65 [45]
431431 Psychiatry 90 [60] 65 [45]
432432 Pulmonology 90 [60] 65 [45] Pulmonology 90 [60] 65 [45]
433433 Pulmonology 90 [60] 65 [45]
434434 Rheumatology 130 [100] 95 [75] Rheumatology 130 [100] 95 [75]
435435 Rheumatology 130 [100] 95 [75]
436436 Urology 90 [60] 65 [45] Urology 90 [60] 65 [45]
437437 Urology 90 [60] 65 [45]
438438 Vascular Surgery 130 [100] 95 [75] Vascular Surgery 130 [100] 95 [75]
439439 Vascular Surgery 130 [100] 95 [75]
440440 (2) for health care practitioners in the following
441441 disciplines:
442442 Time Distance Time Distance
443443 Time Distance
444444 Chiropractic 110 [80] 80 [60] Chiropractic 110 [80] 80 [60]
445445 Chiropractic 110 [80] 80 [60]
446446 Occupational Therapy 110 [80] 80 [60] Occupational Therapy 110 [80] 80 [60]
447447 Occupational Therapy 110 [80] 80 [60]
448448 Physical Therapy 110 [80] 80 [60] Physical Therapy 110 [80] 80 [60]
449449 Physical Therapy 110 [80] 80 [60]
450450 Podiatry 90 [60] 65 [45] Podiatry 90 [60] 65 [45]
451451 Podiatry 90 [60] 65 [45]
452452 Speech Therapy 110 [80] 80 [60] Speech Therapy 110 [80] 80 [60]
453453 Speech Therapy 110 [80] 80 [60]
454454 (3) for the following types of institutional
455455 providers:
456456 Time Distance Time Distance
457457 Time Distance
458458 Acute Inpatient Hospitals (Emergency Services Available 24/7) 110 [80] 80 [60] Acute Inpatient Hospitals (Emergency Services Available 24/7) 110 [80] 80 [60]
459459 Acute Inpatient Hospitals (Emergency Services Available 24/7) 110 [80] 80 [60]
460460 Acute Inpatient Hospitals (Emergency Services Available 24/7) 110 [80] 80 [60] Acute Inpatient Hospitals (Emergency Services Available 24/7) 110 [80] 80 [60]
461461 Acute Inpatient Hospitals (Emergency Services Available 24/7) 110 [80] 80 [60]
462462 Cardiac Catheterization Services 190 [160] 140 [120] Cardiac Catheterization Services 190 [160] 140 [120]
463463 Cardiac Catheterization Services 190 [160] 140 [120]
464464 Cardiac Surgery Program 190 [160] 140 [120] Cardiac Surgery Program 190 [160] 140 [120]
465465 Cardiac Surgery Program 190 [160] 140 [120]
466466 Critical Care Services: Intensive Care Units 190 [160] 140 [120] Critical Care Services: Intensive Care Units 190 [160] 140 [120]
467467 Critical Care Services: Intensive Care Units 190 [160] 140 [120]
468468 Diagnostic Radiology (Freestanding; Hospital Outpatient; Ambulatory Health Facilities with Diagnostic Radiology) 110 [80] 80 [60] Diagnostic Radiology (Freestanding; Hospital Outpatient; Ambulatory Health Facilities with Diagnostic Radiology) 110 [80] 80 [60]
469469 Diagnostic Radiology (Freestanding; Hospital Outpatient; Ambulatory Health Facilities with Diagnostic Radiology) 110 [80] 80 [60]
470470 Diagnostic Radiology (Freestanding; Hospital Outpatient; Ambulatory Health Facilities with Diagnostic Radiology) 110 [80] 80 [60] Diagnostic Radiology (Freestanding; Hospital Outpatient; Ambulatory Health Facilities with Diagnostic Radiology) 110 [80] 80 [60]
471471 Diagnostic Radiology (Freestanding; Hospital Outpatient; Ambulatory Health Facilities with Diagnostic Radiology) 110 [80] 80 [60]
472472 Diagnostic Radiology (Freestanding; Hospital Outpatient; Ambulatory Health Facilities with Diagnostic Radiology) 110 [80] 80 [60] Diagnostic Radiology (Freestanding; Hospital Outpatient; Ambulatory Health Facilities with Diagnostic Radiology) 110 [80] 80 [60]
473473 Diagnostic Radiology (Freestanding; Hospital Outpatient; Ambulatory Health Facilities with Diagnostic Radiology) 110 [80] 80 [60]
474474 Inpatient or Residential Behavioral Health Facility Services 130 [100] 95 [75] Inpatient or Residential Behavioral Health Facility Services 130 [100] 95 [75]
475475 Inpatient or Residential Behavioral Health Facility Services 130 [100] 95 [75]
476476 Inpatient or Residential Behavioral Health Facility Services 130 [100] 95 [75] Inpatient or Residential Behavioral Health Facility Services 130 [100] 95 [75]
477477 Inpatient or Residential Behavioral Health Facility Services 130 [100] 95 [75]
478478 Mammography 110 [80] 80 [60] Mammography 110 [80] 80 [60]
479479 Mammography 110 [80] 80 [60]
480480 Outpatient Infusion/Chemotherapy 110 [80] 80 [60] Outpatient Infusion/Chemotherapy 110 [80] 80 [60]
481481 Outpatient Infusion/Chemotherapy 110 [80] 80 [60]
482482 Skilled Nursing Facilities 110 [80] 80 [60] Skilled Nursing Facilities 110 [80] 80 [60]
483483 Skilled Nursing Facilities 110 [80] 80 [60]
484484 Surgical Services (Outpatient or Ambulatory Surgical Center) 110 [80] 80 [60] Surgical Services (Outpatient or Ambulatory Surgical Center) 110 [80] 80 [60]
485485 Surgical Services (Outpatient or Ambulatory Surgical Center) 110 [80] 80 [60]
486486 Surgical Services (Outpatient or Ambulatory Surgical Center) 110 [80] 80 [60] Surgical Services (Outpatient or Ambulatory Surgical Center) 110 [80] 80 [60]
487487 Surgical Services (Outpatient or Ambulatory Surgical Center) 110 [80] 80 [60]
488488 (4) for the following settings:
489489 Time Distance Time Distance
490490 Time Distance
491491 Outpatient Clinical Behavioral Health (Licensed, Accredited, or Certified) 60 [30] 40 [20] Outpatient Clinical Behavioral Health (Licensed, Accredited, or Certified) 60 [30] 40 [20]
492492 Outpatient Clinical Behavioral Health (Licensed, Accredited, or Certified) 60 [30] 40 [20]
493493 Outpatient Clinical Behavioral Health (Licensed, Accredited, or Certified) 60 [30] 40 [20] Outpatient Clinical Behavioral Health (Licensed, Accredited, or Certified) 60 [30] 40 [20]
494494 Outpatient Clinical Behavioral Health (Licensed, Accredited, or Certified) 60 [30] 40 [20]
495495 Urgent Care 110 [80] 80 [60] Urgent Care 110 [80] 80 [60]
496496 Urgent Care 110 [80] 80 [60]
497497 (f) Maximum travel time in minutes and maximum distance in
498498 miles for preferred provider benefit plans by preferred provider
499499 type for each rural county are:
500500 (1) for the following physicians, as designated by
501501 physician specialty:
502502 Time Distance Time Distance
503503 Time Distance
504504 Allergy and Immunology 120 [90] 95 [75] Allergy and Immunology 120 [90] 95 [75]
505505 Allergy and Immunology 120 [90] 95 [75]
506506 Cardiology 105 [75] 80 [60] Cardiology 105 [75] 80 [60]
507507 Cardiology 105 [75] 80 [60]
508508 Cardiothoracic Surgery 140 [110] 110 [90] Cardiothoracic Surgery 140 [110] 110 [90]
509509 Cardiothoracic Surgery 140 [110] 110 [90]
510510 Dermatology 105 [75] 80 [60] Dermatology 105 [75] 80 [60]
511511 Dermatology 105 [75] 80 [60]
512512 Emergency Medicine 105 [75] 80 [60] Emergency Medicine 105 [75] 80 [60]
513513 Emergency Medicine 105 [75] 80 [60]
514514 Endocrinology 140 [110] 110 [90] Endocrinology 140 [110] 110 [90]
515515 Endocrinology 140 [110] 110 [90]
516516 Ear, Nose, and Throat/Otolaryngology 120 [90] 95 [75] Ear, Nose, and Throat/Otolaryngology 120 [90] 95 [75]
517517 Ear, Nose, and Throat/Otolaryngology 120 [90] 95 [75]
518518 Gastroenterology 105 [75] 80 [60] Gastroenterology 105 [75] 80 [60]
519519 Gastroenterology 105 [75] 80 [60]
520520 General Surgery 105 [75] 80 [60] General Surgery 105 [75] 80 [60]
521521 General Surgery 105 [75] 80 [60]
522522 Gynecology and Obstetrics 70 [40] 50 [30] Gynecology and Obstetrics 70 [40] 50 [30]
523523 Gynecology and Obstetrics 70 [40] 50 [30]
524524 Infectious Diseases 140 [110] 110 [90] Infectious Diseases 140 [110] 110 [90]
525525 Infectious Diseases 140 [110] 110 [90]
526526 Nephrology 120 [90] 95 [75] Nephrology 120 [90] 95 [75]
527527 Nephrology 120 [90] 95 [75]
528528 Neurology 105 [75] 80 [60] Neurology 105 [75] 80 [60]
529529 Neurology 105 [75] 80 [60]
530530 Neurosurgery 140 [110] 110 [90] Neurosurgery 140 [110] 110 [90]
531531 Neurosurgery 140 [110] 110 [90]
532532 Oncology: Medical, Surgical 105 [75] 80 [60] Oncology: Medical, Surgical 105 [75] 80 [60]
533533 Oncology: Medical, Surgical 105 [75] 80 [60]
534534 Oncology: Radiation 140 [110] 110 [90] Oncology: Radiation 140 [110] 110 [90]
535535 Oncology: Radiation 140 [110] 110 [90]
536536 Ophthalmology 105 [75] 80 [60] Ophthalmology 105 [75] 80 [60]
537537 Ophthalmology 105 [75] 80 [60]
538538 Orthopedic Surgery 105 [75] 80 [60] Orthopedic Surgery 105 [75] 80 [60]
539539 Orthopedic Surgery 105 [75] 80 [60]
540540 Physical Medicine and Rehabilitation 120 [90] 95 [75] Physical Medicine and Rehabilitation 120 [90] 95 [75]
541541 Physical Medicine and Rehabilitation 120 [90] 95 [75]
542542 Plastic Surgery 140 [110] 110 [90] Plastic Surgery 140 [110] 110 [90]
543543 Plastic Surgery 140 [110] 110 [90]
544544 Primary Care: Adults 70 [40] 50 [30] Primary Care: Adults 70 [40] 50 [30]
545545 Primary Care: Adults 70 [40] 50 [30]
546546 Primary Care: Pediatric 70 [40] 50 [30] Primary Care: Pediatric 70 [40] 50 [30]
547547 Primary Care: Pediatric 70 [40] 50 [30]
548548 Psychiatry 105 [75] 80 [60] Psychiatry 105 [75] 80 [60]
549549 Psychiatry 105 [75] 80 [60]
550550 Pulmonology 105 [75] 80 [60] Pulmonology 105 [75] 80 [60]
551551 Pulmonology 105 [75] 80 [60]
552552 Rheumatology 140 [110] 110 [90] Rheumatology 140 [110] 110 [90]
553553 Rheumatology 140 [110] 110 [90]
554554 Urology 105 [75] 80 [60] Urology 105 [75] 80 [60]
555555 Urology 105 [75] 80 [60]
556556 Vascular Surgery 140 [110] 110 [90] Vascular Surgery 140 [110] 110 [90]
557557 Vascular Surgery 140 [110] 110 [90]
558558 (2) for health care practitioners in the following
559559 disciplines:
560560 Time Distance Time Distance
561561 Time Distance
562562 Chiropractic 120 [90] 95 [75] Chiropractic 120 [90] 95 [75]
563563 Chiropractic 120 [90] 95 [75]
564564 Occupational Therapy 105 [75] 80 [60] Occupational Therapy 105 [75] 80 [60]
565565 Occupational Therapy 105 [75] 80 [60]
566566 Physical Therapy 105 [75] 80 [60] Physical Therapy 105 [75] 80 [60]
567567 Physical Therapy 105 [75] 80 [60]
568568 Podiatry 105 [75] 80 [60] Podiatry 105 [75] 80 [60]
569569 Podiatry 105 [75] 80 [60]
570570 Speech Therapy 105 [75] 80 [60] Speech Therapy 105 [75] 80 [60]
571571 Speech Therapy 105 [75] 80 [60]
572572 (3) for the following types of institutional
573573 providers:
574574 Time Distance Time Distance
575575 Time Distance
576576 Acute Inpatient Hospitals (Emergency Services Available 24/7) 105 [75] 80 [60] Acute Inpatient Hospitals (Emergency Services Available 24/7) 105 [75] 80 [60]
577577 Acute Inpatient Hospitals (Emergency Services Available 24/7) 105 [75] 80 [60]
578578 Acute Inpatient Hospitals (Emergency Services Available 24/7) 105 [75] 80 [60] Acute Inpatient Hospitals (Emergency Services Available 24/7) 105 [75] 80 [60]
579579 Acute Inpatient Hospitals (Emergency Services Available 24/7) 105 [75] 80 [60]
580580 Cardiac Catheterization Services 175 [145] 140 [120] Cardiac Catheterization Services 175 [145] 140 [120]
581581 Cardiac Catheterization Services 175 [145] 140 [120]
582582 Cardiac Surgery Program 175 [145] 140 [120] Cardiac Surgery Program 175 [145] 140 [120]
583583 Cardiac Surgery Program 175 [145] 140 [120]
584584 Critical Care Services: Intensive Care Units 175 [145] 140 [120] Critical Care Services: Intensive Care Units 175 [145] 140 [120]
585585 Critical Care Services: Intensive Care Units 175 [145] 140 [120]
586586 Diagnostic Radiology (Freestanding; Hospital Outpatient; Ambulatory Health Facilities with Diagnostic Radiology) 105 [75] 80 [60] Diagnostic Radiology (Freestanding; Hospital Outpatient; Ambulatory Health Facilities with Diagnostic Radiology) 105 [75] 80 [60]
587587 Diagnostic Radiology (Freestanding; Hospital Outpatient; Ambulatory Health Facilities with Diagnostic Radiology) 105 [75] 80 [60]
588588 Diagnostic Radiology (Freestanding; Hospital Outpatient; Ambulatory Health Facilities with Diagnostic Radiology) 105 [75] 80 [60] Diagnostic Radiology (Freestanding; Hospital Outpatient; Ambulatory Health Facilities with Diagnostic Radiology) 105 [75] 80 [60]
589589 Diagnostic Radiology (Freestanding; Hospital Outpatient; Ambulatory Health Facilities with Diagnostic Radiology) 105 [75] 80 [60]
590590 Diagnostic Radiology (Freestanding; Hospital Outpatient; Ambulatory Health Facilities with Diagnostic Radiology) 105 [75] 80 [60] Diagnostic Radiology (Freestanding; Hospital Outpatient; Ambulatory Health Facilities with Diagnostic Radiology) 105 [75] 80 [60]
591591 Diagnostic Radiology (Freestanding; Hospital Outpatient; Ambulatory Health Facilities with Diagnostic Radiology) 105 [75] 80 [60]
592592 Inpatient or Residential Behavioral Health Facility Services 120 [90] 95 [75] Inpatient or Residential Behavioral Health Facility Services 120 [90] 95 [75]
593593 Inpatient or Residential Behavioral Health Facility Services 120 [90] 95 [75]
594594 Inpatient or Residential Behavioral Health Facility Services 120 [90] 95 [75] Inpatient or Residential Behavioral Health Facility Services 120 [90] 95 [75]
595595 Inpatient or Residential Behavioral Health Facility Services 120 [90] 95 [75]
596596 Mammography 105 [75] 80 [60] Mammography 105 [75] 80 [60]
597597 Mammography 105 [75] 80 [60]
598598 Outpatient Infusion/Chemotherapy 105 [75] 80 [60] Outpatient Infusion/Chemotherapy 105 [75] 80 [60]
599599 Outpatient Infusion/Chemotherapy 105 [75] 80 [60]
600600 Skilled Nursing Facilities 105 [75] 80 [60] Skilled Nursing Facilities 105 [75] 80 [60]
601601 Skilled Nursing Facilities 105 [75] 80 [60]
602602 Surgical Services (Outpatient or Ambulatory Surgical Center) 105 [75] 80 [60] Surgical Services (Outpatient or Ambulatory Surgical Center) 105 [75] 80 [60]
603603 Surgical Services (Outpatient or Ambulatory Surgical Center) 105 [75] 80 [60]
604604 Surgical Services (Outpatient or Ambulatory Surgical Center) 105 [75] 80 [60] Surgical Services (Outpatient or Ambulatory Surgical Center) 105 [75] 80 [60]
605605 Surgical Services (Outpatient or Ambulatory Surgical Center) 105 [75] 80 [60]
606606 (4) for the following settings:
607607 Time Distance Time Distance
608608 Time Distance
609609 Outpatient Clinical Behavioral Outpatient Clinical Behavioral
610610 Outpatient Clinical Behavioral
611611 Health (Licensed, Accredited, or Certified) 70 [40] 50 [30] Health (Licensed, Accredited, or Certified) 70 [40] 50 [30]
612612 Health (Licensed, Accredited, or Certified) 70 [40] 50 [30]
613613 Urgent Care 105 [75] 80 [60] Urgent Care 105 [75] 80 [60]
614614 Urgent Care 105 [75] 80 [60]
615615 (g) Maximum travel time in minutes and maximum distance in
616616 miles for preferred provider benefit plans by preferred provider
617617 type for each county with extreme access considerations are:
618618 (1) for the following physicians, as designated by
619619 physician specialty:
620620 Time Distance Time Distance
621621 Time Distance
622622 Allergy and Immunology 155 [125] 140 [110] Allergy and Immunology 155 [125] 140 [110]
623623 Allergy and Immunology 155 [125] 140 [110]
624624 Cardiology 125 [95] 115 [85] Cardiology 125 [95] 115 [85]
625625 Cardiology 125 [95] 115 [85]
626626 Cardiothoracic Surgery 175 [145] 160 [130] Cardiothoracic Surgery 175 [145] 160 [130]
627627 Cardiothoracic Surgery 175 [145] 160 [130]
628628 Dermatology 140 [110] 130 [100] Dermatology 140 [110] 130 [100]
629629 Dermatology 140 [110] 130 [100]
630630 Emergency Medicine 140 [110] 130 [100] Emergency Medicine 140 [110] 130 [100]
631631 Emergency Medicine 140 [110] 130 [100]
632632 Endocrinology 175 [145] 160 [130] Endocrinology 175 [145] 160 [130]
633633 Endocrinology 175 [145] 160 [130]
634634 Ear, Nose, and Throat/Otolaryngology 155 [125] 140 [110] Ear, Nose, and Throat/Otolaryngology 155 [125] 140 [110]
635635 Ear, Nose, and Throat/Otolaryngology 155 [125] 140 [110]
636636 Gastroenterology 140 [110] 130 [100] Gastroenterology 140 [110] 130 [100]
637637 Gastroenterology 140 [110] 130 [100]
638638 General Surgery 125 [95] 115 [85] General Surgery 125 [95] 115 [85]
639639 General Surgery 125 [95] 115 [85]
640640 Gynecology and Obstetrics 100 [70] 90 [60] Gynecology and Obstetrics 100 [70] 90 [60]
641641 Gynecology and Obstetrics 100 [70] 90 [60]
642642 Infectious Diseases 175 [145] 160 [130] Infectious Diseases 175 [145] 160 [130]
643643 Infectious Diseases 175 [145] 160 [130]
644644 Nephrology 155 [125] 140 [110] Nephrology 155 [125] 140 [110]
645645 Nephrology 155 [125] 140 [110]
646646 Neurology 140 [110] 130 [100] Neurology 140 [110] 130 [100]
647647 Neurology 140 [110] 130 [100]
648648 Neurosurgery 175 [145] 160 [130] Neurosurgery 175 [145] 160 [130]
649649 Neurosurgery 175 [145] 160 [130]
650650 Oncology: Medical, Surgical 140 [110] 130 [100] Oncology: Medical, Surgical 140 [110] 130 [100]
651651 Oncology: Medical, Surgical 140 [110] 130 [100]
652652 Oncology: Radiation 175 [145] 160 [130] Oncology: Radiation 175 [145] 160 [130]
653653 Oncology: Radiation 175 [145] 160 [130]
654654 Ophthalmology 125 [95] 115 [85] Ophthalmology 125 [95] 115 [85]
655655 Ophthalmology 125 [95] 115 [85]
656656 Orthopedic Surgery 125 [95] 115 [85] Orthopedic Surgery 125 [95] 115 [85]
657657 Orthopedic Surgery 125 [95] 115 [85]
658658 Physical Medicine and Rehabilitation 155 [125] 140 [110] Physical Medicine and Rehabilitation 155 [125] 140 [110]
659659 Physical Medicine and Rehabilitation 155 [125] 140 [110]
660660 Plastic Surgery 175 [145] 160 [130] Plastic Surgery 175 [145] 160 [130]
661661 Plastic Surgery 175 [145] 160 [130]
662662 Primary Care: Adults 100 [70] 90 [60] Primary Care: Adults 100 [70] 90 [60]
663663 Primary Care: Adults 100 [70] 90 [60]
664664 Primary Care: Pediatric 100 [70] 90 [60] Primary Care: Pediatric 100 [70] 90 [60]
665665 Primary Care: Pediatric 100 [70] 90 [60]
666666 Psychiatry 140 [110] 130 [100] Psychiatry 140 [110] 130 [100]
667667 Psychiatry 140 [110] 130 [100]
668668 Pulmonology 140 [110] 130 [100] Pulmonology 140 [110] 130 [100]
669669 Pulmonology 140 [110] 130 [100]
670670 Rheumatology 175 [145] 160 [130] Rheumatology 175 [145] 160 [130]
671671 Rheumatology 175 [145] 160 [130]
672672 Urology 140 [110] 130 [100] Urology 140 [110] 130 [100]
673673 Urology 140 [110] 130 [100]
674674 Vascular Surgery 175 [145] 160 [130] Vascular Surgery 175 [145] 160 [130]
675675 Vascular Surgery 175 [145] 160 [130]
676676 (2) for health care practitioners in the following
677677 disciplines:
678678 Time Distance Time Distance
679679 Time Distance
680680 Chiropractic 155 [125] 140 [110] Chiropractic 155 [125] 140 [110]
681681 Chiropractic 155 [125] 140 [110]
682682 Occupational Therapy 140 [110] 130 [100] Occupational Therapy 140 [110] 130 [100]
683683 Occupational Therapy 140 [110] 130 [100]
684684 Physical Therapy 140 [110] 130 [100] Physical Therapy 140 [110] 130 [100]
685685 Physical Therapy 140 [110] 130 [100]
686686 Podiatry 140 [110] 130 [100] Podiatry 140 [110] 130 [100]
687687 Podiatry 140 [110] 130 [100]
688688 Speech Therapy 140 [110] 130 [100] Speech Therapy 140 [110] 130 [100]
689689 Speech Therapy 140 [110] 130 [100]
690690 (3) for the following institutional providers:
691691 Time Distance Time Distance
692692 Time Distance
693693 Acute Inpatient Hospitals (Emergency Services Available 24/7) 140 [110] 130 [100] Acute Inpatient Hospitals (Emergency Services Available 24/7) 140 [110] 130 [100]
694694 Acute Inpatient Hospitals (Emergency Services Available 24/7) 140 [110] 130 [100]
695695 Acute Inpatient Hospitals (Emergency Services Available 24/7) 140 [110] 130 [100] Acute Inpatient Hospitals (Emergency Services Available 24/7) 140 [110] 130 [100]
696696 Acute Inpatient Hospitals (Emergency Services Available 24/7) 140 [110] 130 [100]
697697 Cardiac Catheterization Services 185 [155] 170 [140] Cardiac Catheterization Services 185 [155] 170 [140]
698698 Cardiac Catheterization Services 185 [155] 170 [140]
699699 Cardiac Surgery Program 185 [155] 170 [140] Cardiac Surgery Program 185 [155] 170 [140]
700700 Cardiac Surgery Program 185 [155] 170 [140]
701701 Critical Care Services: Intensive Care Units 185 [155] 170 [140] Critical Care Services: Intensive Care Units 185 [155] 170 [140]
702702 Critical Care Services: Intensive Care Units 185 [155] 170 [140]
703703 Diagnostic Radiology (Freestanding; Hospital Outpatient; Ambulatory Health Facilities with Diagnostic Radiology) 140 [110] 130 [100] Diagnostic Radiology (Freestanding; Hospital Outpatient; Ambulatory Health Facilities with Diagnostic Radiology) 140 [110] 130 [100]
704704 Diagnostic Radiology (Freestanding; Hospital Outpatient; Ambulatory Health Facilities with Diagnostic Radiology) 140 [110] 130 [100]
705705 Diagnostic Radiology (Freestanding; Hospital Outpatient; Ambulatory Health Facilities with Diagnostic Radiology) 140 [110] 130 [100] Diagnostic Radiology (Freestanding; Hospital Outpatient; Ambulatory Health Facilities with Diagnostic Radiology) 140 [110] 130 [100]
706706 Diagnostic Radiology (Freestanding; Hospital Outpatient; Ambulatory Health Facilities with Diagnostic Radiology) 140 [110] 130 [100]
707707 Diagnostic Radiology (Freestanding; Hospital Outpatient; Ambulatory Health Facilities with Diagnostic Radiology) 140 [110] 130 [100] Diagnostic Radiology (Freestanding; Hospital Outpatient; Ambulatory Health Facilities with Diagnostic Radiology) 140 [110] 130 [100]
708708 Diagnostic Radiology (Freestanding; Hospital Outpatient; Ambulatory Health Facilities with Diagnostic Radiology) 140 [110] 130 [100]
709709 Inpatient or Residential Behavioral Health Facility Services 185 [155] 170 [140] Inpatient or Residential Behavioral Health Facility Services 185 [155] 170 [140]
710710 Inpatient or Residential Behavioral Health Facility Services 185 [155] 170 [140]
711711 Inpatient or Residential Behavioral Health Facility Services 185 [155] 170 [140] Inpatient or Residential Behavioral Health Facility Services 185 [155] 170 [140]
712712 Inpatient or Residential Behavioral Health Facility Services 185 [155] 170 [140]
713713 Mammography 140 [110] 130 [100] Mammography 140 [110] 130 [100]
714714 Mammography 140 [110] 130 [100]
715715 Outpatient Infusion/Chemotherapy 140 [110] 130 [100] Outpatient Infusion/Chemotherapy 140 [110] 130 [100]
716716 Outpatient Infusion/Chemotherapy 140 [110] 130 [100]
717717 Skilled Nursing Facilities 125 [95] 115 [85] Skilled Nursing Facilities 125 [95] 115 [85]
718718 Skilled Nursing Facilities 125 [95] 115 [85]
719719 Surgical Services (Outpatient or Ambulatory Surgical Center) 140 [110] 130 [100] Surgical Services (Outpatient or Ambulatory Surgical Center) 140 [110] 130 [100]
720720 Surgical Services (Outpatient or Ambulatory Surgical Center) 140 [110] 130 [100]
721721 Surgical Services (Outpatient or Ambulatory Surgical Center) 140 [110] 130 [100] Surgical Services (Outpatient or Ambulatory Surgical Center) 140 [110] 130 [100]
722722 Surgical Services (Outpatient or Ambulatory Surgical Center) 140 [110] 130 [100]
723723 (4) for the following settings:
724724 Time Distance Time Distance
725725 Time Distance
726726 Outpatient Clinical Behavioral Outpatient Clinical Behavioral
727727 Outpatient Clinical Behavioral
728728 Health (Licensed, Accredited, or Certified) 100 [70] 90 [60] Health (Licensed, Accredited, or Certified) 100 [70] 90 [60]
729729 Health (Licensed, Accredited, or Certified) 100 [70] 90 [60]
730730 Urgent Care 140 [110] 130 [100] Urgent Care 140 [110] 130 [100]
731731 Urgent Care 140 [110] 130 [100]
732732 SECTION 3. Section 1301.0056(a-1), Insurance Code, is
733733 amended to read as follows:
734734 (a-1) An insurer is subject to a qualifying examination of
735735 the insurer's preferred provider benefit plans and subsequent
736736 quality of care and network adequacy examinations by the
737737 commissioner at least once every three years[, in connection with a
738738 public hearing under Section 1301.00565 concerning a material
739739 deviation from network adequacy standards by a previously
740740 authorized plan or a request for a waiver of a network adequacy
741741 standard,] and whenever the commissioner considers an examination
742742 necessary. Documentation provided to the commissioner during an
743743 examination conducted under this section is confidential and is not
744744 subject to disclosure as public information under Chapter 552,
745745 Government Code.
746746 SECTION 4. Section 1301.009(b), Insurance Code, is amended
747747 to read as follows:
748748 (b) The report shall:
749749 (1) be verified by at least two principal officers;
750750 (2) be in a form prescribed by the commissioner; and
751751 (3) include:
752752 (A) a financial statement of the insurer,
753753 including its balance sheet and receipts and disbursements for the
754754 preceding calendar year, certified by an independent public
755755 accountant;
756756 (B) the number of individuals enrolled during the
757757 preceding calendar year, the number of enrollees as of the end of
758758 that year, and the number of enrollments terminated during that
759759 year; and
760760 (C) a statement of:
761761 (i) an evaluation of enrollee satisfaction;
762762 (ii) an evaluation of quality of care;
763763 (iii) coverage areas;
764764 (iv) accreditation status;
765765 (v) premium costs;
766766 (vi) plan costs;
767767 (vii) premium increases;
768768 (viii) the range of benefits provided;
769769 (ix) copayments and deductibles;
770770 (x) the accuracy and speed of claims
771771 payment by the insurer for the plan;
772772 (xi) the credentials of physicians who are
773773 preferred providers;
774774 (xii) the number of preferred providers;
775775 (xiii) any waiver requests made and waivers
776776 of network adequacy standards granted under Section 1301.0055
777777 [1301.00565];
778778 (xiv) any material deviation from network
779779 adequacy standards reported to the department under Section
780780 1301.0055; and
781781 (xv) any corrective actions, sanctions, or
782782 penalties assessed against the insurer by the department for
783783 deficiencies related to the preferred provider benefit plan.
784784 SECTION 5. Sections 1301.00555 and 1301.00565, Insurance
785785 Code, are repealed.
786786 SECTION 6. The changes in law made by this Act apply only to
787787 an insurance policy that is delivered, issued for delivery, or
788788 renewed on or after January 1, 2026. A policy delivered, issued
789789 for delivery, or renewed before January 1, 2026, is governed by the
790790 law as it existed immediately before the effective date of this Act,
791791 and that law is continued in effect for that purpose.
792792 SECTION 7. This Act takes effect September 1, 2025.
793793
794794
795795
796796 Time Distance
797797
798798
799799
800800 Allergy and Immunology 40 [30] 20 [15]
801801
802802
803803
804804 Cardiology 30 [20] 15 [10]
805805
806806
807807
808808 Cardiothoracic Surgery 40 [30] 20 [15]
809809
810810
811811
812812 Dermatology 30 [20] 15 [10]
813813
814814
815815
816816 Emergency Medicine 30 [20] 15 [10]
817817
818818
819819
820820 Endocrinology 40 [30] 20 [15]
821821
822822
823823
824824 Ear, Nose, and Throat/Otolaryngology 40 [30] 20 [15]
825825
826826
827827
828828 Gastroenterology 30 [20] 15 [10]
829829
830830
831831
832832 General Surgery 30 [20] 15 [10]
833833
834834
835835
836836 Gynecology and Obstetrics 20 [10] 10 [5]
837837
838838
839839
840840 Infectious Diseases 40 [30] 20 [15]
841841
842842
843843
844844 Nephrology 40 [30] 20 [15]
845845
846846
847847
848848 Neurology 30 [20] 15 [10]
849849
850850
851851
852852 Neurosurgery 40 [30] 20 [15]
853853
854854
855855
856856 Oncology: Medical, Surgical 30 [20] 15 [10]
857857
858858
859859
860860 Oncology: Radiation 40 [30] 20 [15]
861861
862862
863863
864864 Ophthalmology 30 [20] 15 [10]
865865
866866
867867
868868 Orthopedic Surgery 30 [20] 15 [10]
869869
870870
871871
872872 Physical Medicine and Rehabilitation 40 [30] 20 [15]
873873
874874
875875
876876 Plastic Surgery 40 [30] 20 [15]
877877
878878
879879
880880 Primary Care: Adults 20 [10] 10 [5]
881881
882882
883883
884884 Primary Care: Pediatric 20 [10] 10 [5]
885885
886886
887887
888888 Psychiatry 30 [20] 15 [10]
889889
890890
891891
892892 Pulmonology 30 [20] 15 [10]
893893
894894
895895
896896 Rheumatology 40 [30] 20 [15]
897897
898898
899899
900900 Urology 30 [20] 15 [10]
901901
902902
903903
904904 Vascular Surgery 40 [30] 20 [15]
905905
906906
907907
908908 Time Distance
909909
910910
911911
912912 Chiropractic 40 [30] 20 [15]
913913
914914
915915
916916 Occupational Therapy 30 [20] 15 [10]
917917
918918
919919
920920 Physical Therapy 30 [20] 15 [10]
921921
922922
923923
924924 Podiatry 30 [20] 15 [10]
925925
926926
927927
928928 Speech Therapy 30 [20] 15 [10]
929929
930930
931931
932932 Time Distance
933933
934934
935935
936936 Acute Inpatient Hospitals (Emergency Services Available 24/7) 30 [20] 15 [10]
937937
938938
939939
940940 Acute Inpatient Hospitals (Emergency Services Available 24/7) 30 [20] 15 [10]
941941
942942
943943
944944 Cardiac Catheterization Services 40 [30] 20 [15]
945945
946946
947947
948948 Cardiac Surgery Program 40 [30] 20 [15]
949949
950950
951951
952952 Critical Care Services: Intensive Care Units 30 [20] 15 [10]
953953
954954
955955
956956 Diagnostic Radiology (Freestanding; Hospital Outpatient; Ambulatory Health Facilities with Diagnostic Radiology) 30 [20] 15 [10]
957957
958958
959959
960960 Diagnostic Radiology (Freestanding; Hospital Outpatient; Ambulatory Health Facilities with Diagnostic Radiology) 30 [20] 15 [10]
961961
962962
963963
964964 Diagnostic Radiology (Freestanding; Hospital Outpatient; Ambulatory Health Facilities with Diagnostic Radiology) 30 [20] 15 [10]
965965
966966
967967
968968 Inpatient or Residential Behavioral Health Facility Services 40 [30] 20 [15]
969969
970970
971971
972972 Inpatient or Residential Behavioral Health Facility Services 40 [30] 20 [15]
973973
974974
975975
976976 Mammography 30 [20] 15 [10]
977977
978978
979979
980980 Outpatient Infusion/Chemotherapy 30 [20] 15 [10]
981981
982982
983983
984984 Skilled Nursing Facilities 30 [20] 15 [10]
985985
986986
987987
988988 Surgical Services (Outpatient or Ambulatory Surgical Center) 30 [20] 15 [10]
989989
990990
991991
992992 Surgical Services (Outpatient or Ambulatory Surgical Center) 30 [20] 15 [10]
993993
994994
995995
996996 Time Distance
997997
998998
999999
10001000 Outpatient Clinical Behavioral Health (Licensed, Accredited, or Certified) 20 [10] 10 [5]
10011001
10021002
10031003
10041004 Outpatient Clinical Behavioral Health (Licensed, Accredited, or Certified) 20 [10] 10 [5]
10051005
10061006
10071007
10081008 Urgent Care 30 [20] 15 [10]
10091009
10101010
10111011
10121012 Time Distance
10131013
10141014
10151015
10161016 Allergy and Immunology 60 [45] 40 [30]
10171017
10181018
10191019
10201020 Cardiology 45 [30] 30 [20]
10211021
10221022
10231023
10241024 Cardiothoracic Surgery 75 [60] 50 [40]
10251025
10261026
10271027
10281028 Dermatology 60 [45] 40 [30]
10291029
10301030
10311031
10321032 Emergency Medicine 60 [45] 40 [30]
10331033
10341034
10351035
10361036 Endocrinology 75 [60] 50 [40]
10371037
10381038
10391039
10401040 Ear, Nose, and Throat/Otolaryngology 60 [45] 40 [30]
10411041
10421042
10431043
10441044 Gastroenterology 60 [45] 40 [30]
10451045
10461046
10471047
10481048 General Surgery 45 [30] 30 [20]
10491049
10501050
10511051
10521052 Gynecology and Obstetrics 30 [15] 20 [10]
10531053
10541054
10551055
10561056 Infectious Diseases 75 [60] 50 [40]
10571057
10581058
10591059
10601060 Nephrology 60 [45] 40 [30]
10611061
10621062
10631063
10641064 Neurology 60 [45] 40 [30]
10651065
10661066
10671067
10681068 Neurosurgery 75 [60] 50 [40]
10691069
10701070
10711071
10721072 Oncology: Medical, Surgical 60 [45] 40 [30]
10731073
10741074
10751075
10761076 Oncology: Radiation 75 [60] 50 [40]
10771077
10781078
10791079
10801080 Ophthalmology 45 [30] 30 [20]
10811081
10821082
10831083
10841084 Orthopedic Surgery 45 [30] 30 [20]
10851085
10861086
10871087
10881088 Physical Medicine and Rehabilitation 60 [45] 40 [30]
10891089
10901090
10911091
10921092 Plastic Surgery 75 [60] 50 [40]
10931093
10941094
10951095
10961096 Primary Care: Adults 30 [15] 20 [10]
10971097
10981098
10991099
11001100 Primary Care: Pediatric 30 [15] 20 [10]
11011101
11021102
11031103
11041104 Psychiatry 60 [45] 40 [30]
11051105
11061106
11071107
11081108 Pulmonology 60 [45] 40 [30]
11091109
11101110
11111111
11121112 Rheumatology 75 [60] 50 [40]
11131113
11141114
11151115
11161116 Urology 60 [45] 40 [30]
11171117
11181118
11191119
11201120 Vascular Surgery 75 [60] 50 [40]
11211121
11221122
11231123
11241124 Time Distance
11251125
11261126
11271127
11281128 Chiropractic 60 [45] 40 [30]
11291129
11301130
11311131
11321132 Occupational Therapy 60 [45] 40 [30]
11331133
11341134
11351135
11361136 Physical Therapy 60 [45] 40 [30]
11371137
11381138
11391139
11401140 Podiatry 60 [45] 40 [30]
11411141
11421142
11431143
11441144 Speech Therapy 60 [45] 40 [30]
11451145
11461146
11471147
11481148 Time Distance
11491149
11501150
11511151
11521152 Acute Inpatient Hospitals (Emergency Services Available 24/7) 60 [45] 40 [30]
11531153
11541154
11551155
11561156 Acute Inpatient Hospitals (Emergency Services Available 24/7) 60 [45] 40 [30]
11571157
11581158
11591159
11601160 Cardiac Catheterization Services 75 [60] 50 [40]
11611161
11621162
11631163
11641164 Cardiac Surgery Program 75 [60] 50 [40]
11651165
11661166
11671167
11681168 Critical Care Services: Intensive Care Units 60 [45] 40 [30]
11691169
11701170
11711171
11721172 Diagnostic Radiology (Freestanding; Hospital Outpatient; Ambulatory Health Facilities with Diagnostic Radiology) 60 [45] 40 [30]
11731173
11741174
11751175
11761176 Diagnostic Radiology (Freestanding; Hospital Outpatient; Ambulatory Health Facilities with Diagnostic Radiology) 60 [45] 40 [30]
11771177
11781178
11791179
11801180 Diagnostic Radiology (Freestanding; Hospital Outpatient; Ambulatory Health Facilities with Diagnostic Radiology) 60 [45] 40 [30]
11811181
11821182
11831183
11841184 Inpatient or Residential Behavioral Health Facility Services 85 [70] 55 [45]
11851185
11861186
11871187
11881188 Inpatient or Residential Behavioral Health Facility Services 85 [70] 55 [45]
11891189
11901190
11911191
11921192 Mammography 60 [45] 40 [30]
11931193
11941194
11951195
11961196 Outpatient Infusion/Chemotherapy 60 [45] 40 [30]
11971197
11981198
11991199
12001200 Skilled Nursing Facilities 60 [45] 40 [30]
12011201
12021202
12031203
12041204 Surgical Services (Outpatient or Ambulatory Surgical Center) 60 [45] 40 [30]
12051205
12061206
12071207
12081208 Surgical Services (Outpatient or Ambulatory Surgical Center) 60 [45] 40 [30]
12091209
12101210
12111211
12121212 Time Distance
12131213
12141214
12151215
12161216 Outpatient Clinical Behavioral Health (Licensed, Accredited, or Certified) 30 [15] 20 [10]
12171217
12181218
12191219
12201220 Outpatient Clinical Behavioral Health (Licensed, Accredited, or Certified) 30 [15] 20 [10]
12211221
12221222
12231223
12241224 Urgent Care 60 [45] 40 [30]
12251225
12261226
12271227
12281228 Time Distance
12291229
12301230
12311231
12321232 Allergy and Immunology 110 [80] 80 [60]
12331233
12341234
12351235
12361236 Cardiology 80 [50] 55 [35]
12371237
12381238
12391239
12401240 Cardiothoracic Surgery 130 [100] 95 [75]
12411241
12421242
12431243
12441244 Dermatology 90 [60] 65 [45]
12451245
12461246
12471247
12481248 Emergency Medicine 110 [80] 80 [60]
12491249
12501250
12511251
12521252 Endocrinology 130 [100] 95 [75]
12531253
12541254
12551255
12561256 Ear, Nose, and Throat/Otolaryngology 110 [80] 80 [60]
12571257
12581258
12591259
12601260 Gastroenterology 90 [60] 65 [45]
12611261
12621262
12631263
12641264 General Surgery 80 [50] 55 [35]
12651265
12661266
12671267
12681268 Gynecology and Obstetrics 60 [30] 40 [20]
12691269
12701270
12711271
12721272 Infectious Diseases 130 [100] 95 [75]
12731273
12741274
12751275
12761276 Nephrology 110 [80] 80 [60]
12771277
12781278
12791279
12801280 Neurology 90 [60] 65 [45]
12811281
12821282
12831283
12841284 Neurosurgery 130 [100] 95 [75]
12851285
12861286
12871287
12881288 Oncology: Medical, Surgical 90 [60] 65 [45]
12891289
12901290
12911291
12921292 Oncology: Radiation 130 [100] 95 [75]
12931293
12941294
12951295
12961296 Ophthalmology 80 [50] 55 [35]
12971297
12981298
12991299
13001300 Orthopedic Surgery 80 [50] 55 [35]
13011301
13021302
13031303
13041304 Physical Medicine and Rehabilitation 110 [80] 80 [60]
13051305
13061306
13071307
13081308 Plastic Surgery 130 [100] 95 [75]
13091309
13101310
13111311
13121312 Primary Care: Adults 60 [30] 40 [20]
13131313
13141314
13151315
13161316 Primary Care: Pediatric 60 [30] 40 [20]
13171317
13181318
13191319
13201320 Psychiatry 90 [60] 65 [45]
13211321
13221322
13231323
13241324 Pulmonology 90 [60] 65 [45]
13251325
13261326
13271327
13281328 Rheumatology 130 [100] 95 [75]
13291329
13301330
13311331
13321332 Urology 90 [60] 65 [45]
13331333
13341334
13351335
13361336 Vascular Surgery 130 [100] 95 [75]
13371337
13381338
13391339
13401340 Time Distance
13411341
13421342
13431343
13441344 Chiropractic 110 [80] 80 [60]
13451345
13461346
13471347
13481348 Occupational Therapy 110 [80] 80 [60]
13491349
13501350
13511351
13521352 Physical Therapy 110 [80] 80 [60]
13531353
13541354
13551355
13561356 Podiatry 90 [60] 65 [45]
13571357
13581358
13591359
13601360 Speech Therapy 110 [80] 80 [60]
13611361
13621362
13631363
13641364 Time Distance
13651365
13661366
13671367
13681368 Acute Inpatient Hospitals (Emergency Services Available 24/7) 110 [80] 80 [60]
13691369
13701370
13711371
13721372 Acute Inpatient Hospitals (Emergency Services Available 24/7) 110 [80] 80 [60]
13731373
13741374
13751375
13761376 Cardiac Catheterization Services 190 [160] 140 [120]
13771377
13781378
13791379
13801380 Cardiac Surgery Program 190 [160] 140 [120]
13811381
13821382
13831383
13841384 Critical Care Services: Intensive Care Units 190 [160] 140 [120]
13851385
13861386
13871387
13881388 Diagnostic Radiology (Freestanding; Hospital Outpatient; Ambulatory Health Facilities with Diagnostic Radiology) 110 [80] 80 [60]
13891389
13901390
13911391
13921392 Diagnostic Radiology (Freestanding; Hospital Outpatient; Ambulatory Health Facilities with Diagnostic Radiology) 110 [80] 80 [60]
13931393
13941394
13951395
13961396 Diagnostic Radiology (Freestanding; Hospital Outpatient; Ambulatory Health Facilities with Diagnostic Radiology) 110 [80] 80 [60]
13971397
13981398
13991399
14001400 Inpatient or Residential Behavioral Health Facility Services 130 [100] 95 [75]
14011401
14021402
14031403
14041404 Inpatient or Residential Behavioral Health Facility Services 130 [100] 95 [75]
14051405
14061406
14071407
14081408 Mammography 110 [80] 80 [60]
14091409
14101410
14111411
14121412 Outpatient Infusion/Chemotherapy 110 [80] 80 [60]
14131413
14141414
14151415
14161416 Skilled Nursing Facilities 110 [80] 80 [60]
14171417
14181418
14191419
14201420 Surgical Services (Outpatient or Ambulatory Surgical Center) 110 [80] 80 [60]
14211421
14221422
14231423
14241424 Surgical Services (Outpatient or Ambulatory Surgical Center) 110 [80] 80 [60]
14251425
14261426
14271427
14281428 Time Distance
14291429
14301430
14311431
14321432 Outpatient Clinical Behavioral Health (Licensed, Accredited, or Certified) 60 [30] 40 [20]
14331433
14341434
14351435
14361436 Outpatient Clinical Behavioral Health (Licensed, Accredited, or Certified) 60 [30] 40 [20]
14371437
14381438
14391439
14401440 Urgent Care 110 [80] 80 [60]
14411441
14421442
14431443
14441444 Time Distance
14451445
14461446
14471447
14481448 Allergy and Immunology 120 [90] 95 [75]
14491449
14501450
14511451
14521452 Cardiology 105 [75] 80 [60]
14531453
14541454
14551455
14561456 Cardiothoracic Surgery 140 [110] 110 [90]
14571457
14581458
14591459
14601460 Dermatology 105 [75] 80 [60]
14611461
14621462
14631463
14641464 Emergency Medicine 105 [75] 80 [60]
14651465
14661466
14671467
14681468 Endocrinology 140 [110] 110 [90]
14691469
14701470
14711471
14721472 Ear, Nose, and Throat/Otolaryngology 120 [90] 95 [75]
14731473
14741474
14751475
14761476 Gastroenterology 105 [75] 80 [60]
14771477
14781478
14791479
14801480 General Surgery 105 [75] 80 [60]
14811481
14821482
14831483
14841484 Gynecology and Obstetrics 70 [40] 50 [30]
14851485
14861486
14871487
14881488 Infectious Diseases 140 [110] 110 [90]
14891489
14901490
14911491
14921492 Nephrology 120 [90] 95 [75]
14931493
14941494
14951495
14961496 Neurology 105 [75] 80 [60]
14971497
14981498
14991499
15001500 Neurosurgery 140 [110] 110 [90]
15011501
15021502
15031503
15041504 Oncology: Medical, Surgical 105 [75] 80 [60]
15051505
15061506
15071507
15081508 Oncology: Radiation 140 [110] 110 [90]
15091509
15101510
15111511
15121512 Ophthalmology 105 [75] 80 [60]
15131513
15141514
15151515
15161516 Orthopedic Surgery 105 [75] 80 [60]
15171517
15181518
15191519
15201520 Physical Medicine and Rehabilitation 120 [90] 95 [75]
15211521
15221522
15231523
15241524 Plastic Surgery 140 [110] 110 [90]
15251525
15261526
15271527
15281528 Primary Care: Adults 70 [40] 50 [30]
15291529
15301530
15311531
15321532 Primary Care: Pediatric 70 [40] 50 [30]
15331533
15341534
15351535
15361536 Psychiatry 105 [75] 80 [60]
15371537
15381538
15391539
15401540 Pulmonology 105 [75] 80 [60]
15411541
15421542
15431543
15441544 Rheumatology 140 [110] 110 [90]
15451545
15461546
15471547
15481548 Urology 105 [75] 80 [60]
15491549
15501550
15511551
15521552 Vascular Surgery 140 [110] 110 [90]
15531553
15541554
15551555
15561556 Time Distance
15571557
15581558
15591559
15601560 Chiropractic 120 [90] 95 [75]
15611561
15621562
15631563
15641564 Occupational Therapy 105 [75] 80 [60]
15651565
15661566
15671567
15681568 Physical Therapy 105 [75] 80 [60]
15691569
15701570
15711571
15721572 Podiatry 105 [75] 80 [60]
15731573
15741574
15751575
15761576 Speech Therapy 105 [75] 80 [60]
15771577
15781578
15791579
15801580 Time Distance
15811581
15821582
15831583
15841584 Acute Inpatient Hospitals (Emergency Services Available 24/7) 105 [75] 80 [60]
15851585
15861586
15871587
15881588 Acute Inpatient Hospitals (Emergency Services Available 24/7) 105 [75] 80 [60]
15891589
15901590
15911591
15921592 Cardiac Catheterization Services 175 [145] 140 [120]
15931593
15941594
15951595
15961596 Cardiac Surgery Program 175 [145] 140 [120]
15971597
15981598
15991599
16001600 Critical Care Services: Intensive Care Units 175 [145] 140 [120]
16011601
16021602
16031603
16041604 Diagnostic Radiology (Freestanding; Hospital Outpatient; Ambulatory Health Facilities with Diagnostic Radiology) 105 [75] 80 [60]
16051605
16061606
16071607
16081608 Diagnostic Radiology (Freestanding; Hospital Outpatient; Ambulatory Health Facilities with Diagnostic Radiology) 105 [75] 80 [60]
16091609
16101610
16111611
16121612 Diagnostic Radiology (Freestanding; Hospital Outpatient; Ambulatory Health Facilities with Diagnostic Radiology) 105 [75] 80 [60]
16131613
16141614
16151615
16161616 Inpatient or Residential Behavioral Health Facility Services 120 [90] 95 [75]
16171617
16181618
16191619
16201620 Inpatient or Residential Behavioral Health Facility Services 120 [90] 95 [75]
16211621
16221622
16231623
16241624 Mammography 105 [75] 80 [60]
16251625
16261626
16271627
16281628 Outpatient Infusion/Chemotherapy 105 [75] 80 [60]
16291629
16301630
16311631
16321632 Skilled Nursing Facilities 105 [75] 80 [60]
16331633
16341634
16351635
16361636 Surgical Services (Outpatient or Ambulatory Surgical Center) 105 [75] 80 [60]
16371637
16381638
16391639
16401640 Surgical Services (Outpatient or Ambulatory Surgical Center) 105 [75] 80 [60]
16411641
16421642
16431643
16441644 Time Distance
16451645
16461646
16471647
16481648 Outpatient Clinical Behavioral
16491649
16501650
16511651
16521652 Health (Licensed, Accredited, or Certified) 70 [40] 50 [30]
16531653
16541654
16551655
16561656 Urgent Care 105 [75] 80 [60]
16571657
16581658
16591659
16601660 Time Distance
16611661
16621662
16631663
16641664 Allergy and Immunology 155 [125] 140 [110]
16651665
16661666
16671667
16681668 Cardiology 125 [95] 115 [85]
16691669
16701670
16711671
16721672 Cardiothoracic Surgery 175 [145] 160 [130]
16731673
16741674
16751675
16761676 Dermatology 140 [110] 130 [100]
16771677
16781678
16791679
16801680 Emergency Medicine 140 [110] 130 [100]
16811681
16821682
16831683
16841684 Endocrinology 175 [145] 160 [130]
16851685
16861686
16871687
16881688 Ear, Nose, and Throat/Otolaryngology 155 [125] 140 [110]
16891689
16901690
16911691
16921692 Gastroenterology 140 [110] 130 [100]
16931693
16941694
16951695
16961696 General Surgery 125 [95] 115 [85]
16971697
16981698
16991699
17001700 Gynecology and Obstetrics 100 [70] 90 [60]
17011701
17021702
17031703
17041704 Infectious Diseases 175 [145] 160 [130]
17051705
17061706
17071707
17081708 Nephrology 155 [125] 140 [110]
17091709
17101710
17111711
17121712 Neurology 140 [110] 130 [100]
17131713
17141714
17151715
17161716 Neurosurgery 175 [145] 160 [130]
17171717
17181718
17191719
17201720 Oncology: Medical, Surgical 140 [110] 130 [100]
17211721
17221722
17231723
17241724 Oncology: Radiation 175 [145] 160 [130]
17251725
17261726
17271727
17281728 Ophthalmology 125 [95] 115 [85]
17291729
17301730
17311731
17321732 Orthopedic Surgery 125 [95] 115 [85]
17331733
17341734
17351735
17361736 Physical Medicine and Rehabilitation 155 [125] 140 [110]
17371737
17381738
17391739
17401740 Plastic Surgery 175 [145] 160 [130]
17411741
17421742
17431743
17441744 Primary Care: Adults 100 [70] 90 [60]
17451745
17461746
17471747
17481748 Primary Care: Pediatric 100 [70] 90 [60]
17491749
17501750
17511751
17521752 Psychiatry 140 [110] 130 [100]
17531753
17541754
17551755
17561756 Pulmonology 140 [110] 130 [100]
17571757
17581758
17591759
17601760 Rheumatology 175 [145] 160 [130]
17611761
17621762
17631763
17641764 Urology 140 [110] 130 [100]
17651765
17661766
17671767
17681768 Vascular Surgery 175 [145] 160 [130]
17691769
17701770
17711771
17721772 Time Distance
17731773
17741774
17751775
17761776 Chiropractic 155 [125] 140 [110]
17771777
17781778
17791779
17801780 Occupational Therapy 140 [110] 130 [100]
17811781
17821782
17831783
17841784 Physical Therapy 140 [110] 130 [100]
17851785
17861786
17871787
17881788 Podiatry 140 [110] 130 [100]
17891789
17901790
17911791
17921792 Speech Therapy 140 [110] 130 [100]
17931793
17941794
17951795
17961796 Time Distance
17971797
17981798
17991799
18001800 Acute Inpatient Hospitals (Emergency Services Available 24/7) 140 [110] 130 [100]
18011801
18021802
18031803
18041804 Acute Inpatient Hospitals (Emergency Services Available 24/7) 140 [110] 130 [100]
18051805
18061806
18071807
18081808 Cardiac Catheterization Services 185 [155] 170 [140]
18091809
18101810
18111811
18121812 Cardiac Surgery Program 185 [155] 170 [140]
18131813
18141814
18151815
18161816 Critical Care Services: Intensive Care Units 185 [155] 170 [140]
18171817
18181818
18191819
18201820 Diagnostic Radiology (Freestanding; Hospital Outpatient; Ambulatory Health Facilities with Diagnostic Radiology) 140 [110] 130 [100]
18211821
18221822
18231823
18241824 Diagnostic Radiology (Freestanding; Hospital Outpatient; Ambulatory Health Facilities with Diagnostic Radiology) 140 [110] 130 [100]
18251825
18261826
18271827
18281828 Diagnostic Radiology (Freestanding; Hospital Outpatient; Ambulatory Health Facilities with Diagnostic Radiology) 140 [110] 130 [100]
18291829
18301830
18311831
18321832 Inpatient or Residential Behavioral Health Facility Services 185 [155] 170 [140]
18331833
18341834
18351835
18361836 Inpatient or Residential Behavioral Health Facility Services 185 [155] 170 [140]
18371837
18381838
18391839
18401840 Mammography 140 [110] 130 [100]
18411841
18421842
18431843
18441844 Outpatient Infusion/Chemotherapy 140 [110] 130 [100]
18451845
18461846
18471847
18481848 Skilled Nursing Facilities 125 [95] 115 [85]
18491849
18501850
18511851
18521852 Surgical Services (Outpatient or Ambulatory Surgical Center) 140 [110] 130 [100]
18531853
18541854
18551855
18561856 Surgical Services (Outpatient or Ambulatory Surgical Center) 140 [110] 130 [100]
18571857
18581858
18591859
18601860 Time Distance
18611861
18621862
18631863
18641864 Outpatient Clinical Behavioral
18651865
18661866
18671867
18681868 Health (Licensed, Accredited, or Certified) 100 [70] 90 [60]
18691869
18701870
18711871
18721872 Urgent Care 140 [110] 130 [100]