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FAQ - Designated Doctor Exams - Comptroller Private Letter Ruling No. PLR20220516113922, Sales Tax Applicability

Does this private letter ruling apply to required medical exams or exams for maximum medical improvement and impairment rating by a treating doctor or referral doctor?

No. The Comptroller’s private letter ruling applies only to designated doctor exams ordered by the Texas Department of Insurance, Division of Workers’ Compensation.

How can designated doctors bill to collect sales from insurance carriers?

Designated doctors can use Healthcare Common Procedure Coding System (HCPCS) Level II code S9999 on a CMS-1500 form to bill for the appropriate tax associated with a designated doctor exam.

Are designated doctors required to collect sales and use tax from insurance carriers that are tax-exempt, such as governmental entities?

Designated doctors may accept an exemption certificate instead of collecting tax on exams for exempt governmental entities described by Texas Tax Code Section 151.309, such as self-insured political subdivisions or religious, educational, and public service organizations described by Texas Tax Code Section 151.310.

Where do I get more information about collecting sales and use tax for designated doctor exams?

For questions about the ruling, email the Comptroller through their website at and reference Private Letter Ruling No. 20220516113922.

For more information, contact:

Last updated: 10/26/2022