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Texas Department of Insurance
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DWC medical state reporting public use data file (PUDF)

The Texas Department of Insurance, Division of Workers' Compensation (DWC) maintains a database of medical service charges, payments, and treatments in the workers' compensation system. DWC uses the data to identify and detect treatment practices and patterns and perform comparative analysis to develop fee and treatment guidelines. The Texas Labor Code requires DWC to make this information available for public access. 

What's in these datasets? 

These datasets have header and detail files by medical billing service type. The current PUDF contains information on services from the past five years. Services more than five years old going back to 2010 are stored in a separate PUDF file. 

The datasets below are free through the Texas.gov Open Data Portal (ODP), which allows users to view, sort, filter, and export: 

  • Professional Medical Billing Services Datasets. SV1 bill types contain professional services billed on a CMS-1500 form. 

Header | Detail 

  • Institutional Medical Billing Services Datasets. SV2 bill types contain institutional (hospital, medical facility) services billed on a CMS-1450 form (UB-92, UB-04). 

Header | Detail  

  • Pharmacy Medical Billing Services Datasets. SV4 bill types contain pharmacy services billed on a DWC Form-066, Statement of Pharmacy Services. 

Header |Detail 

Refer to the data dictionary for additional information about these datasets. 

File structure 

The header file contains billing level information, such as the provider's name and identification number. The detail file contains itemized service-level information, such as the treatment code. Both the header and detail files contain a Bill ID number as a primary key that links the bill-level and line-level data. 

Bills are grouped into the reporting period based on the earliest date of service. 

What's not in these datasets? 

The PUDFs exclude records that DWC: 

  • rejected because they failed to pass electronic data interchange reporting edits; 
  • replaced, updated, or deleted through later submissions and bill sequencing; or 
  • eliminated because they were duplicates of other records. 

Some variables are also unpopulated because they are optional or conditional and not populated based on reporting requirements.  

Injured employee confidentiality 

The identities of injured employees and beneficiaries must not be disclosed under Texas Labor Code Sections 402.082, 402.083, and 413.007. DWC has removed or encrypted certain data elements contained in the source medical billing and payment database to comply with these confidentiality requirements  

Citation 

Any reporting or analysis based on the data from the PUDF must cite the source as: 

DWC Medical State Reporting Public Use Data File (PUDF). Texas Department of Insurance, Division of Workers' Compensation, Austin, TX. 

Disclaimer 

DWC provides the PUDF as a public service. Users of this data are responsible for checking the accuracy, completeness, and suitability of all information. DWC assumes no responsibility for errors or for how you use the information. DWC also makes no representations, guarantees, or warranties on the accuracy, completeness, or suitability of this information. 

DWC expressly disclaims all implied warranties of merchantability and fitness for a particular purpose. Use this data at your own risk. DWC is not liable for any direct, indirect, incidental, special, punitive, or consequential damages that result from you relying on or using the PUDF.  

Last updated: 5/26/2022