Texas Medicaid Provider Bond
If you supply DME to Texas Medicaid patients, you could owe two separate $50,000 surety bonds — not one. The Texas Health and Human Services Commission requires its own $50,000-per-location bond under 1 Tex. Admin. Code §352.15 to enroll in Texas Medicaid. CMS requires an unrelated $50,000 bond under 42 C.F.R. §424.57(d) to bill Medicare. Same dollar amount, same “DME bond” name billing services use interchangeably, two different obligees, two compliance calendars that rarely line up. Getting this wrong — buying one when you need both, or filing the wrong form with the wrong obligee — is the single most common mistake we see from Texas DME suppliers.
- Who requires it: The Texas Health and Human Services Commission (HHSC), under 1 Tex. Admin. Code §352.15, as a Texas Medicaid enrollment condition. CMS separately requires a $50,000 DMEPOS bond to bill Medicare.
- Amount: No less than $50,000 for each enrolled location, with no aggregate cap stated in the rule text. Five locations read $250,000 and ten locations read $500,000.
- Typical cost (estimate): about 1% to 12% of the bond amount a year, roughly $500 to $6,000 per $50,000 location bond depending on credit. The surety sets the final price.
- Timing: Same-day submission; most quotes within one business day.
HHSC bond vs. CMS DMEPOS bond — they are not the same paperwork
Both bonds happen to start at $50,000, which is exactly why suppliers assume one purchase covers both obligations. It doesn't. HHSC's bond is filed on the State of Texas Medicaid Provider Surety Bond form (F00092) with HHSC named as the sole obligee under 1 Tex. Admin. Code §352.15. CMS's bond is a completely separate federal instrument under 42 C.F.R. §424.57(d), tied to your Medicare billing privileges and National Provider Identifier, not your Texas Medicaid enrollment.
Texas HHSC bond vs. federal CMS DMEPOS bond
Same $50,000 starting figure, different obligees, different triggers
| Bond | Obligee / authority | Amount | Who it reaches |
|---|---|---|---|
| HHSC Medicaid Provider Bond | Texas HHSC — 1 Tex. Admin. Code §352.15 (Form F00092) | $50,000 minimum per enrolled location; no stated aggregate cap | Provider types HHSC designates fraud/waste/abuse risk — DME named specifically — or individual providers flagged by conduct |
| CMS DMEPOS Bond | CMS — 42 C.F.R. §424.57(d) | $50,000 base per NPI, +$50,000 per adverse action (10-yr lookback) | All DMEPOS suppliers billing Medicare, minus narrow solo-practice exemptions |
A DME supplier billing both Texas Medicaid and Medicare fee-for-service can owe both bonds simultaneously, sized independently.
Sources: 1 Tex. Admin. Code §352.15; Tex. Hum. Res. Code §32.0321; 42 C.F.R. §424.57(d).
Our Medicaid & Medicare provider bond hub covers how these two federal and state layers interact nationally; the rest of this page walks through exactly how Texas applies its half of that equation.
Why HHSC names DME suppliers by name
1 Tex. Admin. Code §352.15 doesn't bond every Medicaid provider — it's a conditional rule. HHSC can require a bond from any provider type “identified by federal or state agencies to have a significant history of, or potential for, fraud, waste, or abuse,” or from an individual provider HHSC flags based on conduct like falsifying information. The rulemaking authority behind it, Tex. Hum. Res. Code §32.0321, lets the HHSC executive commissioner require a bond for provider types with demonstrated fraud potential — and, separately, must require one where HHSC has identified a pattern of suspected fraud tied to a provider's services.
DME and medical-supply companies are the provider type HHSC applies this to consistently. The Texas Medicaid Provider Procedures Manual states it as a flat enrollment condition, not a case-by-case determination:
Official Texas Requirements
"All newly enrolling and re-enrolling durable medical equipment (DME) providers must, as a condition of enrollment and continued participation into Texas Medicaid, obtain a surety bond that complies with Title 1, Texas Administrative Code (TAC) §352.15."Texas Medicaid Provider Procedures Manual (TMHP) — DME and Supplies • 1 Tex. Admin. Code §352.15
Home health agencies, non-emergency medical transport providers, and other Medicaid provider types can also be required to bond if HHSC identifies fraud potential in that category, or in your specific enrollment record — but DME is the type where bonding is applied as a standing rule rather than a discretionary flag.
The stacking math has no ceiling
1 Tex. Admin. Code §352.15 requires a bond “in an amount of no less than $50,000” for each enrolled location. The rule text sets a floor, not a formula — there's no billing-volume multiplier like some states use, and no published statewide aggregate cap. A five-location DME supplier reads $250,000 in required HHSC bond coverage. A ten-location supplier reads $500,000. Confirm your exact per-location count and current figure with HHSC before you buy — but plan on the requirement scaling linearly with your footprint, not plateauing.
How the $50,000 HHSC bond stacks per enrolled Texas location
One bond line per enrolled location under 1 TAC §352.15 — no aggregate cap in the rule text
1 location
$50,000
The 1 TAC §352.15 statutory floor.
2 locations
$100,000
One HHSC bond line per enrolled location.
3 locations
$150,000
Still climbing — no aggregate relief in the rule text.
5 locations
$250,000
Where Florida’s statewide cap would stop you. Texas keeps going.
10 locations
$500,000
No statutory ceiling identified under 1 TAC §352.15 — confirm current figures with HHSC.
1 Tex. Admin. Code §352.15. Confirm the current per-location figure and any updated guidance directly with HHSC before purchasing — enrollment notices control the exact amount.
Not sure if you need one bond or two?
Tell us which programs you bill — we'll tell you exactly which obligee(s) you owe.
An annual state clock and a 3-year federal clock, running independently
A DME supplier billing both programs is tracking two enrollment-maintenance deadlines that were never designed to align, and missing either one interrupts revenue.
HHSC bond: 12-month term, annual continuation
The State of Texas Medicaid Provider Surety Bond (Form F00092) is issued for a 12-month term. Providers must submit proof of continuation before it expires to stay enrolled — a once-a-year filing obligation, separate from anything CMS requires.
CMS revalidation: every 3 years, DMEPOS-specific
Under 42 C.F.R. §424.57(g), DMEPOS suppliers must revalidate their Medicare billing privileges every 3 years — a shorter cycle than the standard 5-year revalidation most other Medicare provider types face. CMS sets your specific due date after your billing privileges are first granted.
HHSC will not reimburse a provider for items or services furnished during a period without a current surety bond, where one is required. A federal revalidation notice landing mid-cycle on your state bond's 12-month term is not a coincidence you can ignore — it's two agencies checking different things on different schedules, and either lapse stops payment on its own.
Canceling the bond starts a two-year tail — it doesn't end liability
1 Tex. Admin. Code §352.15 makes your surety liable for uncollected overpayments determined to have occurred during the bond's term, “regardless of when the overpayments are discovered.” That liability doesn't stop the moment the bond lapses. If you don't renew, liability extends for an additional two years past the expiration date. If HHSC terminates your program participation, the same two-year tail applies from the termination date. Because Medicaid audits routinely look back several years, closing a location or letting a bond expire is not the same thing as closing out your exposure for the billing that happened while it was in force.
This is the same structural risk our guide to indemnity agreements covers: when a surety pays out on a claim — even one surfaced years after the bond ended — it recovers the full amount from you as principal.
Which Texas providers actually get this requirement
DME and medical-supply companies
Named specifically in the TMHP provider manual as required to bond at enrollment and re-enrollment — not a discretionary determination for this group.
Other flagged provider types
Any provider category HHSC or a federal agency identifies as high-risk for fraud, waste, or abuse, or an individual provider HHSC determines needs one based on conduct such as falsifying information or material misrepresentation.
If your enrollment notice doesn't mention a bond requirement, you likely don't need the HHSC bond — but a DME supplier should assume it applies unless HHSC states otherwise.
What the HHSC bond actually costs
The $50,000 penal sum is what HHSC requires you to post — it's not what you pay. Your annual premium is a small percentage of that figure, priced primarily on personal and business credit. Multi- location suppliers pay this rate on each location's $50,000 bond line.
Texas HHSC Medicaid Provider Bond — Annual Premium by Credit Score
Based on a $50,000 bond amount
- 740+ (excellent)Rate: 1% – 2%$500 – $1,000
- 680 – 739 (good)Rate: 2% – 4%$1,000 – $2,000
- 650 – 679 (fair)Rate: 4% – 8%$2,000 – $4,000
- Below 650 (challenged)Rate: 8% – 12%$4,000 – $6,000
Per-location premium on a single $50,000 HHSC bond line. A multi-location supplier multiplies by enrolled locations; a supplier also carrying the federal CMS DMEPOS bond prices that bond separately.
See our general guide to what surety bonds cost for how underwriters weigh credit, time in business, and financials on government-obligee bonds like this one.
What to have ready before you request a quote
Count of enrolled Texas Medicaid locations
Each one needs its own $50,000 HHSC bond line — the math scales linearly, no cap.
Your HHSC enrollment or re-enrollment notice
States whether the bond is required for your provider type and the exact deadline.
Whether you also bill Medicare fee-for-service
Determines whether you also need the separate federal CMS DMEPOS bond.
Your NPI(s) if pursuing the CMS bond
The federal bond attaches to Medicare billing privileges per NPI, not your HHSC enrollment.
Any adverse actions in the last 10 years
Can trigger CMS’s elevated federal bond in $50,000 increments — doesn’t affect the HHSC bond.
Prior surety bond history, if renewing
HHSC requires proof of continuation before your current 12-month term expires.
Other bonds Texas healthcare and DME providers carry
Two bonds, two clocks, one tail liability — answered
Do I need the Texas HHSC bond, the federal CMS DMEPOS bond, or both?
It depends on which programs you bill and which obligee is asking. The HHSC bond (1 Tex. Admin. Code §352.15, filed on Form F00092) is a Texas Medicaid enrollment condition — HHSC is the sole obligee. The CMS DMEPOS bond (42 C.F.R. §424.57(d)) is a separate federal requirement for Medicare billing privileges, with CMS as the obligee. Neither one satisfies the other. A Texas DME supplier billing only Medicaid needs just the HHSC bond; one billing only Medicare needs just the CMS bond; a supplier billing both — the common case for multi-payer DME companies — needs both, sized independently at $50,000 each at minimum.
Does Texas cap the total bond amount for a multi-location DME supplier the way Florida does?
No. 1 Tex. Admin. Code §352.15 requires a bond of "no less than $50,000... for each enrolled location," and unlike Florida’s $250,000 statewide aggregate cap under its AHCA program, Texas rule text does not set an upper limit. A DME supplier with 10 enrolled Texas Medicaid locations is reading $500,000 in required HHSC bond coverage, not a capped figure — confirm your exact per-location count with HHSC before assuming a ceiling applies.
My HHSC bond renews annually — why did I also get a CMS revalidation notice on a different schedule?
Because the two bonds run on two different regulatory clocks, and DMEPOS suppliers get a shorter federal cycle than most Medicare providers. HHSC’s Medicaid Provider Surety Bond is issued for a 12-month term, and Texas requires providers to submit proof of continuation before it expires to stay enrolled. Separately, 42 C.F.R. §424.57(g) requires DMEPOS suppliers specifically to revalidate their Medicare billing privileges every 3 years — shorter than the standard 5-year cycle that applies to most other Medicare provider types. A DME supplier billing both programs is tracking an annual state deadline and a 3-year federal deadline simultaneously, and they will almost never land on the same date.
If I close a location or let my HHSC bond lapse, am I done with liability?
Not immediately. 1 Tex. Admin. Code §352.15 makes the surety liable for uncollected overpayments discovered during the bond’s term, and that liability extends for an additional two years after the bond’s expiration date if it isn’t renewed, or two years after HHSC terminates your program participation. Closing a location or canceling coverage doesn’t erase exposure for billing that happened while the bond was in force — it starts a two-year tail, not an immediate release.
Is every Texas Medicaid provider required to post this bond, or just DME suppliers?
The bond is conditional, not universal. Under 1 Tex. Admin. Code §352.15 (adopted under the rulemaking authority in Tex. Hum. Res. Code §32.0321), HHSC can require a surety bond for any provider type identified by federal or state agencies as having a significant history of, or potential for, fraud, waste, or abuse, or for an individual provider HHSC determines needs one based on conduct like falsifying information. DME and medical-supply providers are named specifically: per the Texas Medicaid Provider Procedures Manual, all newly enrolling and re-enrolling DME providers must obtain a compliant bond as a condition of enrollment. Other provider types generally don’t see this requirement unless HHSC flags them individually.
What is the "elevated" federal bond, and could it apply to me?
CMS can raise your DMEPOS bond above the $50,000 base under 42 C.F.R. §424.57(d) by adding $50,000 for each covered adverse legal action — think revocations, exclusions, or certain felony convictions — within the 10 years preceding your enrollment, revalidation, or reenrollment. This is a federal add-on layered on top of your base CMS bond and has no bearing on your separate HHSC bond amount, which is set purely by your enrolled-location count.
All content is researched from official state and federal sources (.gov). BuySuretyBonds.com works with Treasury-listed surety carriers.
General information, not legal, billing-compliance, or underwriting advice. HHSC bond amounts, per-location requirements, and covered provider types change with rulemaking and enrollment policy updates; CMS DMEPOS bond terms change with federal rulemaking. Confirm the exact requirement on your current HHSC enrollment notice or CMS revalidation notice before purchasing a bond, and consult counsel for your specific enrollment structure.
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HHSC only, CMS only, or both. We size each bond against the right obligee, so you're not paying for coverage you don't need or missing coverage HHSC or CMS will reject you without.
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