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The Texas Hospital Lien Statute: Limits on What a Hospital Can Claim

October 22, 2026 by Adam Loewy

The Texas hospital lien statute, found in Chapter 55 of the Texas Property Code, gives a hospital a lien on an injury case when a hospital admitted the victim within 72 hours of an accident that is attributed to the negligence of another person. The lien attaches to the victim’s case and to the money the victim recovers through a settlement or judgment, and the statute caps how much of the recovery the hospital can claim.

Conditions That Give a Hospital a Lien

Section 55.002 gives a hospital a lien on the victim’s case when all three conditions apply:

  • the victim received hospital services for injuries from an accident
  • the accident is attributed to the negligence of another person
  • the hospital admitted the victim no later than 72 hours after the accident

A hospital that receives the victim on a transfer for treatment of the injury has a lien too. In 2019 the Legislature added Section 55.0015, which treats an injured victim as admitted once the hospital allows access to any department of the hospital for any treatment, care, or service. A crash victim the emergency room treated and sent home without an overnight stay meets the statute’s definition of admitted.

Ambulances, Doctors, and Other Providers

Chapter 55 extends lien rights past the hospital’s own charges in three ways:

  • An ambulance or emergency medical services provider has a lien when it gives the victim emergency medical services within 72 hours of the accident in a county with a population of 800,000 or less, and Section 55.004(f) caps the ambulance lien at $1,000 for services the provider gave during the first 72 hours after the accident.
  • A hospital can add to its lien an emergency physician’s reasonable and necessary charges for emergency hospital care during the first seven days of hospitalization.
  • Physicians employed by a state university or other public institution of higher education have a lien of their own on the victim’s case when the hospital’s lien does not cover their charges, and the physician or the university can secure and enforce it.

Texas law measures a county’s population by the most recent federal census. The Census Bureau counted 1,290,188 residents in Travis County in 2020, so an ambulance provider that treats a crash victim in Travis County has no ambulance lien under Chapter 55. Williamson County counted 609,017 residents and Hays County counted 241,067, so an ambulance provider that treats a victim in Williamson or Hays County can claim one.

Chiropractors and physical therapy clinics fall outside Chapter 55, and they generally collect through the victim’s health insurance or through a letter of protection, an agreement to wait for payment until the case resolves.

Money a Hospital Lien Can Reach

Section 55.003 attaches a hospital lien to three sources of recovery:

  • the victim’s cause of action for damages arising from the injury
  • a Texas judgment, or a decision of a public agency, in a proceeding brought to recover damages for the injury, which covers a case a family member brings after the victim’s death
  • the proceeds of a settlement of the case

Chapter 55 keeps a hospital lien off three other kinds of recovery, listed in Section 55.003(b):

  • claims under the Texas workers’ compensation law
  • claims under the Federal Employees Liability Act or the Federal Longshore and Harbor Workers’ Compensation Act
  • insurance proceeds payable to the victim or the victim’s beneficiary, other than liability insurance

A settlement the at-fault party’s liability insurance company pays is subject to the lien, while personal injury protection (PIP) benefits the victim’s own auto insurance company pays stay outside it.

Limits on the Amount of a Hospital Lien

Section 55.004(b) sets the hospital lien at the lowest of three amounts:

  1. The 100-day charges. Charges the hospital billed for services it provided to the victim during the first 100 days of hospitalization.
  2. Half the recovery. Fifty percent of all amounts the victim recovers through the case, a judgment, or a settlement.
  3. The trial award, less fees. When a judge or jury states the amount it awarded for the hospital’s services, the award minus the victim’s pro rata share of the reasonable attorney’s fees and expenses the victim spent pursuing the case.

The Legislature added the third limit in 2021 through House Bill 2064, and the limit applies to liens for services a hospital provided on or after June 16, 2021.

An Example of the 50 Percent Limit

A hospital bills $90,000 for the first 100 days of a victim’s care, and the victim settles the case for $120,000. Half of the settlement is $60,000, so the hospital can claim no more than $60,000 even though its 100-day charges are $30,000 higher.

Charges the Lien Leaves Out

Section 55.004(d) keeps five kinds of charges out of a hospital lien, and three of them apply to a hospital stay after an accident:

  • charges for services above a reasonable and regular rate for the services
  • a physician’s charges that an insurance company paid in full or in part
  • charges the provider can no longer collect because it missed the billing deadline in Section 146.002 of the Civil Practice and Remedies Code, which generally falls on the first day of the 11th month after the provider gave the services

Steps a Hospital Takes to Secure the Lien

Section 55.005 lays out what a hospital has to do to secure its lien:

  1. Notice to the county clerk. A hospital files written notice of the lien with the county clerk in the county where it provided the services, and the notice has to be on file before anyone pays money to the victim or another party entitled to it because of the injury. The notice lists the victim’s name and address, the date of the accident, the hospital’s name and location, and the name of the party allegedly liable for the injury, if the hospital knows it.
  2. Recording and indexing. Next, the county clerk records the victim’s name, the accident date, and the hospital’s name and address, and indexes the record under the victim’s name. For a hospital in Travis County, the Travis County Clerk keeps the record.
  3. Notice to the victim. No later than the fifth business day after the clerk tells the hospital it recorded the lien, the hospital mails written notice to the victim or the victim’s representative at the last known address. In the mailed notice, the hospital states that the lien attaches to any case the victim has against another party for the injuries.

Even when the victim never receives the mailed notice, Section 55.005(g) keeps the lien valid.

Settling a Case With a Recorded Hospital Lien

Section 55.007 limits when a release of a case carrying a hospital lien is valid. A release the at-fault party’s insurance company asks the victim to sign in exchange for a settlement is valid only when one of three conditions applies:

  • someone paid the hospital’s charges in full before the victim signed and delivered the release
  • someone paid the hospital’s charges up to the full amount the other parties to the release paid the victim
  • the hospital joined the release as a party

Because a release that meets none of the three conditions is not valid, lawyers on both sides generally resolve a recorded hospital lien as part of the settlement, and the victim’s lawyer pays the hospital from the settlement funds before sending the victim the balance.

Reducing or Releasing a Hospital Lien

A victim’s lawyer can challenge all or part of a hospital lien on grounds drawn from Chapter 55 and Section 146.002:

  • the hospital admitted the victim more than 72 hours after the accident
  • the hospital had no notice on file with the county clerk before anyone paid money on the case
  • the bill reaches charges from after the first 100 days of hospitalization
  • the bill charges more than a reasonable and regular rate for a service
  • the hospital missed the billing deadline in Section 146.002
  • the lien claims more than half of the victim’s recovery

A lien that meets every requirement in Chapter 55 is still open to negotiation, and a victim’s lawyer can point to the lower rates the hospital accepts from health insurance companies for identical services when asking the hospital to reduce its charges.

Once someone pays the hospital or the hospital agrees to release its lien, Section 55.006 requires the hospital’s administrators or the officer in charge of its finances to sign a certificate stating the debt was paid or released and to submit it to the county clerk who recorded the lien notice. When the clerk records a memorandum of the certificate, Chapter 55 treats the lien as discharged.

Frequently Asked Questions About Texas Hospital Liens

Can a Hospital Put a Lien on a House in Texas?

A hospital lien under Chapter 55 attaches to the victim’s injury case, a judgment in the case, and the settlement proceeds. Chapter 55 requires the hospital to state in its mailed notice that the lien does not attach to a home or land the victim owns.

How Long Does a Hospital Lien Last in Texas?

A hospital lien stays on the victim’s case until someone pays the hospital’s charges or the hospital releases the lien and records its release certificate with the county clerk. A judgment that carries a hospital lien stays in effect until someone pays the hospital’s charges in full or to the extent the judgment specifies.

How Can an Injured Victim Find Out Whether a Hospital Filed a Lien?

The county clerk in the county where the hospital provided care indexes each hospital lien record under the injured victim’s name, so the victim or the victim’s lawyer can ask the clerk’s office to search the records by the victim’s name. The hospital mails its own notice to the victim within five business days after the clerk records the lien.

Get Answers About a Hospital Lien From Loewy Law Firm

Loewy Law Firm negotiates the liens on every injury case our lawyers take on, and we can use the hospital records Section 55.008 opens to a victim’s attorney to audit an itemized bill line by line against the 100-day limit, the reasonable-rate limit, and the billing deadline. When we ask a hospital to reduce its lien, we can tie the request to the specific Chapter 55 requirement the hospital failed to meet, and every dollar the hospital agrees to cut stays in the client’s share of the settlement. Our Austin personal injury lawyers can explain how much of a settlement the hospital can claim before a victim signs a release.

A consultation with our firm is free. We take injury cases on a contingency fee, so a client owes no attorney’s fee unless we recover money. You can reach our office at (512) 280-0800.

References and Additional Reading

The content on this website is for general informational purposes and should not be considered legal advice. Laws change, and case outcomes depend on specific facts. Viewing this material does not establish an attorney-client relationship. For legal guidance on your specific situation, consult a qualified attorney.

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