Texas requires pain management clinics (PMC) to be registered with Texas Medical Board.
A “pain management clinic” is 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.
Please visit Chapter 172 of the Board Rules for the complete regulations.
The physician owner of a pain management clinic must register with the TMB. 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.
When applying for PMC registration the following documentation will be requested:
- NPDB/HPDB – The clinic’s primary owner, the clinic’s proposed medical director if different, and all physician owners must contact the National Practitioner Data Bank (NPDB)/Healthcare Integrity and Protection Databank (HIPDB) at https://www.npdb.hrsa.gov/ and perform a self-query.
- List of current employees and their license numbers - A complete list of current clinic employees, including contract physicians and other healthcare providers, and their applicable education, qualifications, training, and professional licenses. Providers at the clinic involved in any part of patient care should have completed at least ten hours of continuing education related to pain management. Please include current CME certificates for staff as appropriate.
- Proof of ownership of the clinic – Documents that may demonstrate ownership include:
- For FEIN (Federal Employer Identification Numbers) tax IDs issued by the IRS used on registration:
- IRS issued Form SS-4 ;
- IRS issued form LTR 147c;
- IRS records for the clinic,
- certificates of ownership for unincorporated entities issued by a state county. If there are differences in names that can be explained by DBA records with the county, those records should also be submitted.
- For State Issued Tax IDs (including State Franchise Tax IDs) tax IDs issued by the SOS used on registration:
- filings with the Secretary of State,
- state franchise tax documents,
- For DBA or Assumed Names the Clinic operates under other than the name listed on the IRS or SOS
- Certificates of ownership for Assumed names or DBAs issued by a state county.
- Assumed name certificates filed with the SOS
- The TMB may require additional documentation if proof of ownership documents submitted are inconclusive for purposes of determining ownership for each owner of the clinic.
- For FEIN (Federal Employer Identification Numbers) tax IDs issued by the IRS used on registration:
- Clinic protocols and standing delegation orders – A copy of any protocols and standing delegation orders issued by licensed physicians to healthcare providers.
- Attestation regarding clinic ownership - A separate attestation page is required to be signed by each physician owner (and the medical director, if different).
Registration is valid for two years and must be renewed. TMB will send notice of upcoming renewal 60-90 days before actual expiration. Failure to renew will results in loss of registration and ceasing operation as a PMC.
There are several types of facilities and clinics that may be exempt from registration. Those are listed in Chapter 168 of the Texas Occupations Code. Exemptions must be supported with documentation to prove qualification for the exemption. If you are claiming a clinic location is exempt, please request an exemption worksheet from the Registration Department.
At this time there is no charge for a pain management clinic certification. To apply for an initial pain management clinic certification, please download and fill out the form below.
To withdraw a pending application or cancel certification, please submit the withdrawal/cancellation form. (Please note that the acceptance of a request to cancel a pain management clinic certificate does not in any way confirm that said clinic meets one of the registration exemptions outlined in statute.)
Renewal forms will be sent out to both the clinic’s registered physician owner as well as the pain management clinic address at least 90 days in advance of the expiration date.
At this time, registered pain management clinics are not able to use the online Change of Address option. To submit a change of address for a registered clinic location, please use the form below.
Please mail or fax completed forms to the following address:
Texas Medical Board
P.O. Box 2029
Austin, TX 78768
fax) 512-463-9416
Helpful Documents
To ensure compliance with state law and Chapter 172 of the Board rules, TMB utilizes audits, inspections, and investigations.
The requirements of each of these methods are described fully in Board Rule 172.5. These methods are used to determine and verify if a clinic needs to be registered, is properly registered, or is exempt. Also, audits and inspections are both non-disciplinary verification processes.
You may view the Board Rules on pain management clinic in detail on our website under Board Rules, Chapter 172.
Please check the Pain Management Clinics - Spreadsheet of Current Certificate Status to confirm registration of a pain management clinic. The pain management clinic registration information below is updated regularly. This information can also be verified through Look up a License tool.
The Search Board Actions tool will allow a search of any Board action issued (Board order, remedial plan, cease and desist, etc.), including those issued to pain management clinics. After clicking the link below and accepting the usage terms, click on the "License Type" dropdown, select "Pain Management Clinic" and click "Search" to view all clinics with a Board action.
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.
A pain management clinic may not operate in Texas without obtaining a certificate from the Texas Medical Board (TMB). Certain exemptions apply and can be found in Texas Occupations Code (TOC) §168.002.
A pain management clinic may now apply to be designated as a "Gold Designated Practice." Clinics that choose to apply for the “Gold Designated Practice” may be verified by an initial audit that is valid for five years. Audits are non-disciplinary reviews and are conducted as an off-site document review.
Once approved as a “Gold Designated Practice”, no further audits or inspections will be conducted during the clinic’s five-year "Gold Designated Practice" period, unless:
- A complaint is received or initiated by the Board concerning operation of the clinic or operators at the clinic;
- The clinic changes location; or
- The clinic's ownership structure changes to a majority of new owners.
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Gold Designated Practice - Approved Clinics
In order to be eligible for a "Gold Designated Practice" status, one of the following must be true:
- If a clinic is exempt from PMC registration under TOC 168.002(7), the clinic must
- Be operated by a majority of physicians who currently hold or previously held ABMS or AOA Board-certification or subspecialty certification in pain management, and
- Have a majority of physicians perform or properly supervise delegates in providing other forms of treatment besides qualifying pain management prescriptions to a majority of the patients at the clinic;
- The clinic's providers utilize a Medical Home Agreement signed by the primary prescriber and the patient; or
- Have a written collaborative, coordinated care agreement or a memorandum of understanding with the patient's primary physician for treating and managing the patient
- Be operated by a majority of physicians who currently hold or previously held ABMS or AOA Board-certification or subspecialty certification in pain management, and
OR
- If a clinic is currently certified by TMB as a Pain Management Clinic, the clinic must
- Be operated by physicians who currently hold or previously held an ABMS or AOA Board-certification or sub-specialty in pain management or hold a ABMS or AOA Board-certification in an area that is eligible for a pain management subspecialty, and
- Have a Medical Home Agreement signed by the primary prescriber and the patient; or
- A written collaborative coordinated care agreement or memorandum of understanding providing that each physician who prescribes qualifying prescriptions will consult with a pain specialist for the patient.
- Be operated by physicians who currently hold or previously held an ABMS or AOA Board-certification or sub-specialty in pain management or hold a ABMS or AOA Board-certification in an area that is eligible for a pain management subspecialty, and
To apply for the “Gold Designated Practice”, please complete the Pain Management Gold Designated Application Form and submit it along with the requested additional documentation:
- Medical Home Agreement – provide a copy of the Medical Home Agreement, written collaborative, coordinated care agreement or memorandum of understanding to provide management and treatments of pain, that describes measures that may be used for reduction of pain such as, but not limited to:
- Multimodal treatment such as surgery, injections, pain pumps, osteopathic Manipulation, epidurals, trigger point injections, dry needling, and topical creams or patches;
- Multi-disciplinary practices such as medication assisted tapering and weaning, computer-based training pain coaching, acupuncture, chiropractic, physical therapy, massage, and exercise/movement; or
- Collaborative care or other behavioral health integration services such as evidenced-based cognitive behavioral therapy interventions for mental health and pain reduction, medication management and opioid weaning, patient-centered education, regular monitoring and assessments of clinical status using validated tools, assessment of treatment adherence, motivational interviewing, and a structured approach to improving the biopsychosocial aspects of pain management.
- Board Certification - Copy of most recent Board certification for each operating physician.
The completed attestation and all supporting documentation should be sent as one packet directly to the Texas Medical Board office via email to the Registration Department.
Upon receipt of the request with the required documentation, TMB staff will evaluate the documentation and contact the clinic about the initial audit.
Helpful Document