CMS-grounded analysis
Every charge benchmarked against the CMS Resource-Based Relative Value Scale (RBRVS) for the matching locality, by CPT/HCPCS code.
CMS 2025For personal injury defense
Controvert plaintiff medical bills in hours, not weeks.
BillXM analyzes bills against CMS published rates CMS RBRVS 2025, NCCI edits NCCI EDITS 2025, and FAIR Health benchmarks FAIR HEALTH FH BENCHMARKS — producing a defensible §18.001 controverting affidavit your associates can file the same day.
The §18.001 problem
Peer review is slow. The statute is fast.
The Texas Civil Practice and Remedies Code §18.001 lets plaintiffs prove medical damages by uncontroverted affidavit. Defense firms must produce a controverting affidavit from a qualified provider — historically through ExamWorks-style peer review, at $1,500–$4,000 per case and two-to-six week turnaround.
BillXM produces that controverting analysis in under five minutes, grounded in CMS-published rates, with citations to the same data sources a peer reviewer would reference. Your associate gets a Word-exported draft. Your retained provider signs. Your motion files on time.
What BillXM delivers
Three deliverables. One workflow.
Defense report (Word export)
One-click export to a Word document formatted for §18.001 filing — exhibits, citations, and per-line analysis ready for your associates to mark up.
Per-provider breakdown
Itemized by facility, specialty, and CPT/HCPCS category — so you can tell the chiropractor's spine of the case from the ED facility fee on day one.
Methodology
Three published data sources. No black box.
BillXM cites the same primary sources a qualified peer reviewer would use. Every finding is traceable to a published, government-verifiable rate.
CMS Physician Fee ScheduleCMS RBRVS 2025
Medicare-set fair value per CPT/HCPCS code, by locality. The single most-cited rate source in §18.001 controverting affidavits.
National Correct Coding InitiativeNCCI EDITS 2025
Bundling rules detecting duplicate or improperly unbundled procedures — the same edits CMS itself runs on Medicare claims.
FAIR Health FH BenchmarksFAIR HEALTH FH BENCHMARKS
Commercial rate database for non-Medicare comparisons where required (out-of-network, commercial-only codes, geographic deviation analysis).
Sample defense report
See what your associates would receive.
A real, deidentified BillXM analysis — exhibits, line-by-line citations, total overcharge calculation. The same artifact your retained provider signs and your associate files.
Who's using BillXM
First customer. Houston-based.
Customer
Our associates spend their time on strategy, not poring over CPT codes. BillXM does the medical-bill heavy-lifting in the background — and saves us money on every case.
— Marty Hill, Partner, Pagel, Davis & Hill, P.C.
Pagel, Davis & Hill, P.C.
A Houston-based personal injury defense firm. Marty Hill, partner.
Pricing
Per-firm SaaS or per-case.
Quoted to your volume. SOC 2 controls in progress.
FAQ
Defense-specific questions.
How does Texas CPRC §18.001 work?
Section 18.001 lets a plaintiff prove medical damages by uncontroverted affidavit — meaning the bill is presumed reasonable and necessary unless the defense files a counter-affidavit from a qualified provider. BillXM produces the analysis and citation backing that counter-affidavit, in hours instead of weeks.
How fast can my associates produce a controverting affidavit?
The analysis itself returns in under five minutes. From upload to a Word-exported draft your associate can edit and have a qualified provider sign: same business day. ExamWorks-style peer review averages two to six weeks at $1,500–$4,000 per case.
How is BillXM different from ExamWorks?
ExamWorks runs a peer reviewer through your case manually — you wait for their schedule. BillXM runs a deterministic analysis grounded in published rates and produces the citation chain for your in-house or contracted reviewer to sign. You get speed and a defensible methodology; the human signature stays with a qualified provider.
What data sources does BillXM cite?
CMS Resource-Based Relative Value Scale (RBRVS) for physician services, CMS Clinical Lab Fee Schedule for lab work, CMS Hospital Outpatient Prospective Payment System (OPPS) for facility codes, NCCI procedure-to-procedure edits for bundling, and FAIR Health FH Benchmarks for commercial-rate comparisons. Every charge in your report is traced back to a published source.
Can I export to Word?
Yes. The defense report exports to a Word .docx with standardized exhibit numbering, per-line citations, and a methodology section — formatted for direct §18.001 filing. Your associate edits in Word; nothing is locked into BillXM.
Do you handle out-of-state cases?
BillXM's rate analysis is national — every CPT/HCPCS code is benchmarked against the CMS schedule for the matching locality, so an Oklahoma facility, a California ASC, and a Houston hospital each get their correct local rate. The §18.001 framing is Texas-specific, but the underlying analysis works for any U.S. medical bill in any forum.