Provider invoices must contain the following required information:

  • the provider's complete name and address (include payment address, if different);
  • the provider's contact name and telephone number;
  • the provider's 14-digit taxpayer Texas identification number (TIN);
  • DARS DBS office name and delivery address;
  • the DBS service authorization and/or purchase order number and/or contract number;
  • an itemized list of services being billed including quantity and cost of units billed (for example, 3 hours @ $50 each, or 1 evaluation @ $50, etc.);
  • dates of service;
  • consumer identification information (first name, first initial of last name); and
  • the total amount being billed.

The following information is optional:

  • the name of the DBS counselor or case manager, and
  • the provider's invoice number.