Texas medical malpractice caps limit non-economic damages to $250,000 per claimant against all physicians combined, with a separate $250,000 cap per healthcare facility and a $500,000 ceiling when multiple facilities are liable, producing an absolute $750,000 non-economic ceiling in cases involving both doctors and institutions. Wrongful death claims operate under a different cap, with a base of $500,000 per claimant that adjusts for inflation. Economic damages, meaning medical bills and lost income, are not capped in non-fatal cases. These limits come from House Bill 4, passed in 2003, and the non-economic figures have not changed since.1Texas Legislature Online. Texas House Bill 4 – Reform of Certain Procedures and Remedies in Civil Actions
Non-Economic Damage Caps for Living Patients
Non-economic damages compensate for pain, emotional distress, disfigurement, and loss of companionship. Texas law splits the cap by defendant type under Section 74.301:
- All physicians and individual providers in a single case share one $250,000 cap per claimant, no matter how many doctors are named.2State of Texas. Texas Civil Practice and Remedies Code 74.301 – Limitation on Noneconomic Damages
- A single hospital or healthcare institution faces its own $250,000 cap per claimant.2State of Texas. Texas Civil Practice and Remedies Code 74.301 – Limitation on Noneconomic Damages
- When more than one facility is liable, each is capped at $250,000 individually, but the combined institutional total cannot exceed $500,000.2State of Texas. Texas Civil Practice and Remedies Code 74.301 – Limitation on Noneconomic Damages
Stacked together in the worst-case scenario for a defendant, the ceiling is $750,000: $250,000 from the physician side plus $500,000 from the institutional side. That number has been fixed since 2003 with no inflation adjustment written into the statute, so a dollar of pain-and-suffering recovery today buys roughly 40% less than it did when the cap took effect.
The caps touch only the non-economic side of the ledger. Economic damages, which include past and future medical expenses, rehabilitation, lost earnings, and other verifiable financial losses, remain uncapped in cases where the patient survives. For many claimants, the economic side ends up larger than the non-economic side, and that portion of the recovery is not limited by Chapter 74.
Wrongful Death and Survival Cases
When malpractice kills the patient, the cap structure changes completely. Section 74.303 replaces the per-defendant breakdown with a single all-inclusive ceiling: $500,000 per claimant as a base figure, adjusted for inflation from August 29, 1977 using the Consumer Price Index for Urban Wage Earners.3State of Texas. Texas Civil Practice and Remedies Code Chapter 74 – Section 74.303 Using early 2026 CPI-W figures, the adjusted cap falls in the range of roughly $2.6 million per claimant. The exact figure shifts each month as new CPI data is released, so the number is calculated at the time of final judgment or settlement rather than fixed in advance.
One carve-out is critical. The wrongful death cap does not apply to past or future medical, hospital, and custodial care expenses connected to the injury.3State of Texas. Texas Civil Practice and Remedies Code Chapter 74 – Section 74.303 When a patient lives for weeks, months, or years before dying from the malpractice, treatment costs during that period sit outside the cap entirely and can be recovered in full.
Unlike the living-patient caps, the wrongful death ceiling covers everything inside it: economic losses, non-economic losses, and punitive damages. A punitive award does not sit on top of the Section 74.303 cap; it is absorbed into it.
Punitive Damages
Punitive damages are available in malpractice cases, but rarely awarded. A jury must find unanimously, by clear and convincing evidence, that the harm resulted from fraud, malice, or gross negligence.4State of Texas. Texas Civil Practice and Remedies Code 41.003 – Standards for Recovery of Exemplary Damages Ordinary negligence, including serious errors, does not qualify.
When punitive damages are available, Chapter 41 caps them at the greater of:
- Two times the economic damages, plus an amount equal to any non-economic damages up to $750,000, or
- $200,000.
Whichever calculation produces the larger figure sets the ceiling.5State of Texas. Texas Civil Practice and Remedies Code 41.008 – Limitation on Amount of Recovery Cases with substantial future care costs can support a higher punitive award through the first formula. Cases built mostly on non-economic harm hit the sub-cap quickly, and cases with little provable economic loss default to the $200,000 floor.
Deadlines That Can Erase the Cap Question Entirely
Caps only matter if your case gets filed on time and survives the opening procedural hurdles. Texas has a two-year statute of limitations for medical malpractice, running from the date of the malpractice or the date treatment related to the claim was completed, whichever is later.6State of Texas. Texas Civil Practice and Remedies Code 74.251 – Statute of Limitations on Health Care Liability Claims Minors under 12 have until their 14th birthday.
On top of the two-year limit sits a 10-year statute of repose. No matter when the injury is discovered, no claim can be filed more than 10 years after the act or omission that caused it.6State of Texas. Texas Civil Practice and Remedies Code 74.251 – Statute of Limitations on Health Care Liability Claims The repose period runs even when the patient had no way of knowing the error occurred, and it catches people off guard more than any other deadline in Texas malpractice law.
Before filing, you must send written notice by certified mail to every provider you intend to sue, at least 60 days in advance, along with an authorization to release your health records.7State of Texas. Texas Civil Practice and Remedies Code 74.051 – Notice Sending the notice tolls the statute of limitations for 75 days, so it does not eat into your remaining filing window.
Within 120 days after each defendant files their initial response, you must serve a qualified expert report describing the standard of care, how the provider breached it, and how that breach caused your injury.8State of Texas. Texas Civil Practice and Remedies Code 74.351 – Expert Report Missing the deadline requires the court to dismiss the case with prejudice and award the defendant’s attorney fees and costs. A deficient report can earn a single 30-day extension to cure the defect, and no further chances.
Insurance Behind the Caps
Texas does not require physicians to carry malpractice insurance to hold a license. Practicing without coverage is legal, uncommon, and known in the industry as “going bare.” The practical requirement comes from hospitals, which generally condition staff privileges on proof of coverage.
Typical minimum policies start at $100,000 per claim and $300,000 per policy period. Higher limits run up to $1 million per claim and $3 million per policy period, with specialty groups and larger hospital systems often setting their own floors.9Texas Medical Liability Trust. Limits of Liability and Texas Tort Reform For a claimant, these numbers can matter more than the statutory cap. A physician with a $200,000 policy and limited personal assets may not have enough reachable money to pay the full $250,000 non-economic ceiling, let alone uncapped economic damages.
Physicians working at federally qualified health centers may be covered differently. Clinics funded under Section 330 of the Public Health Service Act can apply for coverage under the Federal Tort Claims Act through the Federally Supported Health Centers Assistance Act. Approved clinicians are treated as federal employees for malpractice purposes, and claims against them proceed against the federal government rather than through private insurance.