Sexual Assault Reimbursement Guidelines
(The maximum aggregate amount for which CVC will reimburse: $700.00)
On November 9, 2001, the OAG published guidelines concerning submission of requests for reimbursements by law enforcement agencies pursuant to Article 56.06 (a) of the Texas Code of Criminal Procedure. These guidelines, which were mailed to all Texas law enforcement agencies, are also available on the OAG website. The OAG has since formalized the guidelines by promulgation of administrative rules governing these reimbursements; the rules were adopted on July 30, 2002.
Reimbursement of reasonable costs is based on the Texas Workers' Compensation Commission Medical Fee Guidelines. The services and maximum reimbursement rates are listed in the new administrative rule.
For maximum reimbursement, submit itemized bills with individual charges listed for each service rendered. The maximum aggregate amount for which the OAG will reimburse a law enforcement agency for all costs associated with a forensic sexual assault examination of a victim will be $700.00.
Sexual Assault Examiner's Fees
- Forensic Sexual Assault Exam: $195.00*
Exam and Colposcopy procedure: $233.00*
Associated office visit for colposcopy (non-medical facility): $ 26.00
Additional evaluation and management services: $106.00 / hour **
* Please note these procedures may not be billed together.
** Requires Documentation of Procedure.
- Anoscopy procedure up to a maximum amount of $71.00
- Venipuncture procedure up to a maximum amount of $20.00
- Laboratory procedures up to a maximum amount of $150.00 including but not limited to:
- Pregnancy test $ 6.00
- Urine analysis $ 9.00
- Drug or alcohol screen $44.00
- Chlamydia culture $37.00
- Gonorrhea testing $16.00
- Syphilis test $11.00
- Sexual Assault kit up to a maximum amount of $50.00
- Supplies and material up to a maximum amount of $100.00
(Requires Documentation of Procedure)
- Handling / conveyance of the specimen up to a maximum amount of $20.00
- Healthcare facility must be certified by Medicare or by the Joint Commission Accreditation of Health Organizations or licensed by the Texas Department of Health as a certified facility.
- Charges for healthcare facilities must be on a UB92, including an itemized statement.
- Revenue code R-450 will be used for a medical treatment room
- Revenue code R-760 may be used for an emergency room
The maximum amount of the reimbursement for healthcare facility charges: $250.00
CVC will not reimburse:
- sexual assault examination of a suspected perpetrator
- laboratory analysis of victim's clothing, crime scene materials, or objects including weapons
- Paternity tests
- Multiple examinations of the same victim
Bills submitted under the prior guidelines may be sent to CVC for a supplemental audit. Copies of the original bill, original audit, and a new itemized bill must be attached to the audit request. If after the audit additional payments are needed, a supplemental warrant will be issued.