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HB 5343

Relating to the reimbursement and payment of claims by certain health benefit plan issuers for telemedicine medical services, teledentistry dental services, and telehealth services.

89th Legislature (2025) Introduced by Ryan Guillen

Texas bill mandates health insurers reimburse telemedicine, teledentistry, and telehealth services at rates equal to comparable in-person care.

Referred to Insurance
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Bill Summary · HB 5343

Legislative bill overview

HB 5343 requires health benefit plan issuers in Texas to reimburse telemedicine, teledentistry, and telehealth services at rates comparable to in-person services. The bill aims to establish payment parity between remote healthcare delivery and traditional office visits, potentially removing financial barriers to telehealth adoption.

Why is this important

Telehealth has become a critical access point for patients in rural areas, those with mobility limitations, and busy professionals. Payment parity directly affects whether providers offer these services and whether patients can afford them, influencing healthcare accessibility across Texas's diverse geography and populations.

Potential points of contention

  • Cost implications for insurers: Mandating equivalent reimbursement rates could increase insurance premiums if telehealth is actually less expensive to deliver, shifting savings to providers rather than consumers
  • Defining "comparable" services: Determining appropriate parity is complex since telemedicine and in-person care involve different overhead costs, provider time allocations, and diagnostic capabilities that may justify different rates
  • Scope ambiguity: The bill's coverage of "certain health benefit plans" and what constitutes qualifying telehealth/teledentistry services requires clarification to prevent unintended gaps or overly broad mandates

Compiled from official sources — confirm details with the bill’s official record.

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