Texas Children’s Urgent Care Insurance and Billing

Self-pay rates

If your child is not covered by insurance, Texas Children’s Urgent Care offers discounted self-pay rates at the time of service. Self-pay rates include all charges related to the diagnosis and treatment of your child as well as any lab tests or procedures performed in the clinic. They do not include any charges for lab tests performed outside of the clinic. Our staff will notify you before any outside lab work is sent.

There are 3 self-pay rates based on the complexity of the visit.

Tier 1: (Low Complexity)

Office visit and maximum of 3 procedures listed below (more than 3 procedures in Tier 1 will be a Tier 2 visit)

• Point of care testing (example: strep, flu, UPT, urine, blood glucose, etc.)
• Non-blood work Quest labs (separate bill from Quest Diagnostics)
• In-clinic rectal or oral over-the-counter medications

Tier 2: (Medium Complexity)

Office visit and maximum of 3 procedures listed below (more than 3 procedures in Tier 2 will be a Tier 3 visit)

• Urine catheterization
• Ear irrigation, Elephant Ear Wash system
• Fluorescein eye exam
• Crutches with patient education
• In-clinic oral/topical prescriptions

Tier 3: (High Complexity)

Office visit and procedures listed below

• Breathing inhalation treatment
• Deep suction
• Cervical spine stabilization
• Blood work (separate bill from Quest Diagnostics)
• X-ray
• Splinting (pre-formed/Ortho-Glass splinting system)
• Intravenous medication/rehydration
• Injectable medications
• Laceration repair (sutures/staples/skin adhesive)
• Foreign body removal
• Incision and drainage, nail cauterization
• Wound/burn care

If your child is covered by insurance, please bring your insurance card with you to simplify registration. We will submit charges directly to your insurance company. Your urgent care copay will be collected at the time of service. If your plan does not have an urgent care copay, we will collect the specialist copay listed on your card at the time of service.

About 30 days after your visit, you should receive a notice from your insurance company summarizing the charges and payment for service. If your insurance company has covered the full amount, it will send payment directly to us. If the insurance company has applied some of the charges to your deductible, we will send you a bill for the amount still owed.

Each insurance plan is a contract between you and your insurance company, and each plan is different. If you have questions about your plan benefits and which charges will be applied to your deductible, please contact your insurance company directly.