Texas Payment Resources
Summary of payment program
A sexual assault exam includes two parts: forensic evidence collection to be used in the investigation of the criminal case and medical care for the evaluation and treatment of injuries. Crime Victims Compensation (CVC) can reimburse both:
- Victims and providers for the medical costs of sexual assault exams; and
- Law enforcement agencies or medical providers for the forensic costs of sexual assault exams depending on date of exam.
Forensic and medical costs are billed separately. Victims cannot be billed for the forensic costs of a sexual assault exam. If medical care is received during a sexual assault exam, victims may be held financially responsible for those associated costs.
Crime Victims’ Compensation was created in 1979 by the Texas Legislature. Managed by the Office of the Attorney General, CVC has two primary goals:
- Encourage greater victim participation in the apprehension and prosecution of criminals, and
- Reimburse innocent victims for certain costs related to the crime.
Two Types of Compensation
(1) Crime Victims’ Compensation and (2) Emergency Medical Care Compensation – Sexual Assault Exam. The individual can apply for either compensation with the same application.
How the Crime Victims’ Compensation Program (CVC) Works:
Victims of violent crime, their families, or others who have taken on crime-related costs on behalf of a victim, apply for compensation.
CVC staff review the application and other information to ensure it meets eligibility criteria.
CVC verifies a crime occurred and the crime was reported to law enforcement.
CVC asks applicants to provide information about crime-related costs.
CVC staff review information to see what crime-related costs can be paid according to program rules.
This option allows you to apply for compensation for all eligible crime-related costs, including payment of the medical costs from the exam. To receive compensation for these costs, you must meet all CVC eligibility requirements.
How the Emergency Medical Care Compensation – Sexual Assault Exam Works:
Eligibility Requirements –
The patient may apply for compensation for only the emergency medical care they received during a sexual assault exam at a hospital after August 31, 2015.
The patient will not be considered for compensation for any other crime-related costs, such as follow-up medical care, mental health care, or lost wages. The patient has three years from the date of the crime to request compensation for other crime-related costs.
To receive reimbursement for only the emergency medical care costs, the patient does not need to meet all CVC eligibility requirements.
The patient must meet the following eligibility requirements:
1. The crime must occur in Texas to a U.S. resident; or the victim is a Texas resident and the crime occurred in a country that does not offer crime victims’ compensation.
2. They must apply within three (3) years from the date of the crime unless good cause is shown e.g., age of the victim, mental or physical capacity of the victim, etc.
3. They are:
A victim who received emergency medical care during a sexual assault exam at a hospital after August 31, 2015
A person who legally takes on the responsibilities or pays the cost of the eligible emergency medical care
Someone authorized to act on behalf of the victim listed above, such as a parent or guardian
4. They did not give false information to the program.
5. They were not incarcerated at the time of the crime.
For Medical Providers:
Once the service is provided and the application is approved, the medical provider may submit to CVC for payment. The bill(s) must be itemized and should include the victim’s CVC claim number.
Medical bills must be submitted on either a Center for Medicare and Medicaid Services Health Insurance (CMS 1500) claim form or a Uniform Bill (UB-04) (sample) claim form with a copy of the EOB from the insurance provider if insurance was used.
The CMS 1500 or UB-04 must include:
- A patient’s name and address
- Date(s) of service
- Type(s) of service(s) provided (diagnosis and procedure codes)
- A billed amount
- A provider’s license number, federal tax identification number (FEIN or SSN), business address, telephone number, signature or signature stamp, and billing dates
- Collateral source information
The bill(s) on the CMS 1500 and UB-04 forms and any accompanying documentation should be sent to CVC:
Crime Victim Services
P.O. Box 12198
Austin, Texas 78711-2198
For Law Enforcement:
Law Enforcement Request for Sexual Assault Exam Form
For all reported cases of sexual assault after 8/31/2019, law enforcement must complete an OAG’s Law Enforcement Request for Sexual Assault Exam form indicating whether a sexual assault exam was requested. If one was not, law enforcement must indicate the reasons for declining the request.
A copy of the completed form must be retained by law enforcement and copies provided to the hospital and/or provider and the victim.
Note: The OAG will not process a reimbursement application without a copy of the OAG’s Law Enforcement Request for Sexual Assault Exam form as proof the law enforcement agency requested the sexual assault exam. This does not apply to non-reported sexual assaults or exams conducted before 9/1/2019.
Sexual Assault Exam Reimbursement Guidelines
Texas Law Enforcement – Sexual Assault Exam Reimbursement Application
Texas Crime Victims’ Compensation Program Application | Spanish
Mail completed application to:
Attorney General of Texas
Crime Victims’ Compensation (009)
Law Enforcement Reimbursement for Sexual Assault Exams
P.O. Box 12880
Austin, Texas 78711-2880
Coordination with healthcare
A forensic sexual assault examination consists of four parts:
- History for the purpose of diagnosis and treatment
- Detailed head-to-toe assessment for trauma
- Detailed anogenital assessment for trauma; and
- Forensic evidence collection as indicated by history and findings
Texas Coalition Against Sexual Assault – Crisis Center Locator
Texas Sexual Assault Evidence Tracking System – Track-Kit Sign-in