Texas Medical Malpractice Payments

Texas accounts for 5.4% of all NPDB malpractice payments nationwide, with 28,613 total payment reports totaling $5.0B. The state ranks #7 nationally by total payout volume.

The average malpractice payment in Texas is $174K, which is 32% below the national average of $258K. The median payment is $98K, compared to the national median of $98K. This lower average may reflect the impact of damage caps, tort reform, or case mix differences in Texas.

The largest single payment in Texas’s NPDB records is $22.5M. Payments of this magnitude typically involve catastrophic outcomes — permanent brain injury, wrongful death, or birth injuries requiring lifetime care.

Texas has a damage cap on malpractice awards: $250K non-economic cap per provider. States with damage caps average $217K per payment, compared to $292K in states without caps — a 34% difference. This cap directly impacts the settlement landscape in Texas.

This analysis is based on the National Practitioner Data Bank (NPDB) Public Use Data File, maintained by the Health Resources and Services Administration (HRSA). The NPDB contains every medical malpractice payment report filed in the United States since September 1, 1990.

Our dataset covers 529,804 payment reports from 2000 through 2025, totaling $136.4B in payments. State attribution is based on the practitioner’s work state at the time of the incident.

Important Caveats

• Payments include settlements, judgments, and arbitration awards — not all represent proven malpractice.
• The NPDB does not capture cases settled without payment or dismissed claims.
• State-level averages can be heavily influenced by a small number of very large payments.
• Damage caps affect the maximum recoverable amount and therefore the average, but not the case count.