HB 5504

relating to the supervision by allopathic or osteopathic physicians
of certain persons performing certain procedures.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1.  This Act may be cited as the Texas Interventional
Pain Management and Treatment Act.
SECTION 2.  Section 172.1(2), Administrative Code, is
amended by adding Subsections (3) and (4) to read as follows:
(3)  "Fluoroscope" is a radiologic instrument equipped with
a fluorescent screen on which opaque internal structures can be
viewed as moving shadow images formed by the differential
transmission of X-rays throughout the body; and
(4)  "Interventional pain management" means the practice of
medicine devoted to the diagnosis and treatment of chronic pain,
through the use of techniques such as:
(A)  Ablation of targeted nerves,
(B)  Percutaneous precision needle placement within
the spinal column with placement of drugs such as local
anesthetics, steroids, analgesics in targeted areas of the spinal
(C)  Surgical techniques, such as laser or endoscopic
discectomy, intrathecal infusion pumps and spinal cord
stimulators, peripheral nerve stimulation; or
(D)  Minimally invasive surgical spine interventions.
(3)(5) Post-surgical, post-procedure, persistent
non-chronic pain--pain that occurs due to trauma caused by the
surgery or procedure; or an underlying condition, disease, or
injury causing persistent non-chronic pain.  These types of pain
last 90 days or less, but more than 30 days, from the date of initial
prescriptions for opioids during a period of treatment.
SECTION 3.  Section 169.26(b), Administrative Code, is
amended by adding Subsections (1), (2) and (3) to read as follows:
(1)  It shall be unlawful to practice or offer to practice
interventional pain management in the state of Texas unless such a
person is licensed to practice medicine by the Texas Medical Board.
(2)  Nothing in this section shall be construed to forbid the
administration of non-fluoroscopically guided lumbar interlaminar
epidural injections, peripheral nerve blocks and peripheral joint
injections by a certified Advanced Practice Provider when requested
to do so by a physician and under the supervision of an allopathic
or osteopathic physician licensed in Texas and under conditions in
which timely on-site consultation by an allopathic or osteopathic
(3)  A certified Advanced Practice Provider shall not
operate an interventional pain management clinic, specializing in
diagnosing and treating chronic pain-related disorders.  Only a
qualified pain management physician, as recognized by the Texas
Medical Board, can operate an interventional pain management
clinic.  A certified Advanced Practice Providers may only perform
procedures listed in item 2c under the direct supervision of a
licensed physician who is Board Certified or Board Eligible in Pain
Management as recognized by the Texas Medical Board.
SECTION 4.  This Act takes effect September 1, 2025.