Pain Management Clinic Registration

Effective September 1, 2010, a pain management clinic may not operate in Texas without obtaining a certificate from the Texas Medical Board (TMB).

Please visit Chapter 195 for the complete regulations.

Application

To apply for the pain management clinic certification, please download and fill out the form below. 

Pain Management Clinic Registration form (PDF)

To withdraw a pending application or cancel certification, please download and fill out the form below.

Pain Management Clinic Certification Withdrawal/Cancellation form (PDF)

Please mail or fax the completed form to the following address:

Texas Medical Board
P.O. Box 2029 MC 240
Austin, TX 78768

(fax) 512-463-9416

Please check the spreadsheet below to confirm registration.

List of Pain Management Clinic Certificates

Pain management clinic registration information is updated regularly:

PM-Reg-Spreadsheet-for-web-01-27-2011.xls

List of Pain Management Clinics with Disciplinary Action

Frequently Asked Questions:

What is a “pain management clinic”?
A pain management clinic is defined in statute and rule as a publicly or privately owned facility for which a majority of patients are issued on a monthly basis, a prescription for opioids, benzodiazepines, barbiturates, or carisoprodol, but not including suboxone.

Who needs to register a pain management clinic?
The physician owner/operator of a pain management clinic must register with the TMB. Certificates, once issued, are not transferable or assignable. Only the primary physician owner is required to register with the board if there is more than one physician owner of the clinic.  Each clinic requires a separate certificate.

Who does not need to register a pain management clinic?
Regulations regarding the registration and operation of pain management clinics do not apply to the following settings: 

• a medical or dental school or an outpatient clinics associated with a medical or dental school;
• a hospital, including any outpatient facility or clinic of a hospital;
• a hospice established under 40 TAC §97.403 (relating to Standards Specific to Agencies Licensed to Provide Hospice Services) or defined by 42 CFR §418.3;
• a facility maintained or operated by this state;
• a clinic maintained or operated by the United States;
• a nonprofit health organization certified by the board under Chapter 177 of this title (relating to Certification of Non-Profit Health Organizations);
• a clinic owned or operated by a physician who treats patients within the physician's area of specialty who personally uses other forms or treatment, including surgery, with the issuance of a prescription for a majority of the patients; or
• a clinic owned or operated by an advanced practice nurse licensed in this state who treats patients in the nurse's area of specialty and personally uses other forms of treatment with the issuance of a prescription for a majority of the patients.

Note: The TMB cannot give legal advice. Please consult an attorney if you have questions regarding whether or not your clinic meets one of the exemptions listed above. However, the Board does have inspection authority, and owners of clinics that have not been properly registered can be investigated.

Who can own or operate a pain management clinic?
A pain management clinic may not operate in Texas unless the clinic is owned and operated by a medical director who:

• is a physician who practices in Texas
• has an unrestricted medical license
• holds a certificate of registration for that pain management clinic

In addition, the owner/operator of a pain management clinic, an employee of the clinic, or a person with whom a clinic contracts for services may not:

• have been denied, by any jurisdiction, a license issued by the Drug Enforcement Agency or a state public safety agency under which the person may prescribe, dispense, administer, supply, or sell a controlled substance;
• have held a license issued by the Drug Enforcement Agency or a state public safety agency in any jurisdiction, under which the person may prescribe, dispense, administer, supply, or sell a controlled substance, that has been restricted; or
• have been subject to disciplinary action by any licensing entity for conduct that was a result of inappropriately prescribing, dispensing, administering, supplying, or selling a controlled substance

A pain management clinic may not be owned wholly or partly by a person who has been convicted of, pled nolo contendere to, or received deferred adjudication for:

• an offense that constitutes a felony; or
• an offense that constitutes a misdemeanor, the facts of which relate to the distribution of illegal prescription drugs or a controlled substance as defined by Texas Occupations Code Annotated §551.003(11)

The medical director of a pain management clinic must operate the clinic in compliance with Drug Prevention and Control Act, 21 U.S.C.A. 801 et.seq. and the Texas Controlled Substances Act, Chapter 481 of the Texas Health and Safety Code, relating to the prescribing and dispensing of controlled substances.
The medical director of a pain management clinic must, on an annual basis, ensure that all personnel:

• are properly licensed, if applicable,
• are trained including 10 hours of continuing medical education related to pain management, and
• are qualified for employment.

How much does a pain management clinic registration cost?
At this time there is no charge to register a pain management clinic.

How often is registration required for pain management clinics?
Certificates will be valid for two years.  Registration forms will be mailed 60-90 days prior to the expiration date of a certificate.  Certificate holders shall have a 180-day grace period from the expiration date to renew the certificate, however, the owner or operator of the clinic may not continue to operate the clinic while the permit is expired.
Certificates must be timely renewed.  If a certificate is not renewed before the expiration of the grace period, the certificate will be automatically cancelled and the owner or operator of the clinic must reapply for original certification.

Please contact Pre-Licensure, Registration and Consumer Services at (512) 305-7030 if you have any additional questions.