# Tex. Insurance Code § 1360.004: COVERAGE REQUIRED

> Texas · Statutes · In force

URL: https://www.frixlaw.com/law-library/statutes/STATE_TX_Cin_C1360_S1360.004

## Section

- **Citation:** Tex. Insurance Code § 1360.004
- **Heading:** COVERAGE REQUIRED
- **Jurisdiction:** Texas
- **Kind:** Statutes
- **Status:** In force
- **Text as of:** August 14, 2026
- **Source:** Compiled text
- **Location:** TX Code / Code in / Chapter 1360 / Section 1360.004

## Text

(a) A health benefit plan that provides coverage for medically necessary diagnostic or surgical treatment of conditions affecting skeletal joints must provide comparable coverage for diagnostic or surgical treatment of conditions affecting the temporomandibular joint if the treatment is medically necessary as a result of:

(1) an accident;

(2) a trauma;

(3) a congenital defect;

(4) a developmental defect; or

(5) a pathology.

(b) Coverage required under this section may be subject to any provision in the health benefit plan that is generally applicable to surgical treatment, including a requirement for precertification of coverage.

## Nearby sections

- [Tex. Insurance Code § 1360.001 § 1360.001. DEFINITION.](https://www.frixlaw.com/law-library/statutes/STATE_TX_Cin_C1360_S1360.001.md)
- [Tex. Insurance Code § 1360.002 § 1360.002. APPLICABILITY OF CHAPTER.](https://www.frixlaw.com/law-library/statutes/STATE_TX_Cin_C1360_S1360.002.md)
- [Tex. Insurance Code § 1360.003 § 1360.003. EXCEPTION.](https://www.frixlaw.com/law-library/statutes/STATE_TX_Cin_C1360_S1360.003.md)
- [Tex. Insurance Code § 1360.004 § 1360.004. COVERAGE REQUIRED.](https://www.frixlaw.com/law-library/statutes/STATE_TX_Cin_C1360_S1360.004.md)
- [Tex. Insurance Code § 1360.005 § 1360.005. DENTAL SERVICES COVERAGE NOT REQUIRED.](https://www.frixlaw.com/law-library/statutes/STATE_TX_Cin_C1360_S1360.005.md)

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Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/STATE_TX_Cin_C1360_S1360.004. Check the current official text before relying on it. Not legal advice.