RxCheckUp
TX · External Review Available

Prior Authorization in Texas

Texas enacted SB 1137 (2023) comprehensive PA reform requiring insurers to respond within 5 business days for standard requests and 24 hours for urgent requests. The law also mandates gold card exemptions for physicians with 90%+ PA approval rates and requires peer-to-peer review before PA denials.

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Key Facts About PA in Texas

  • Standard PA decisions required within 5 business days; urgent within 24 hours
  • Gold card exemptions for physicians with 90%+ approval rates (effective Sept 2025)
  • Peer-to-peer review required before PA denials
  • Texas Department of Insurance provides external review process

Quick Stats

  • Typical Appeal Filing Window: 30 days
  • External Review Available: Yes
  • Major Payers: 4

Top Payers in Texas

RxCheckUp generates payer-specific Letters of Medical Necessity for each of these Texas carriers:

BCBS of Texas (HCSC)UnitedHealthcareAetnaCigna