The fight is line by line
Under Ortiz v. Nelapatla, 734 S.W.3d 400 (Tex. 2026), unchallenged charges stay admissible, and the reasonable amount a counteraffidavit states becomes evidence.
Reasonableness of medical charges · § 18.001
Counteraffidavits built to survive the strike motion.
Line-by-line analysis of medical bills, built on public data anyone can obtain and verify. The same method whether you represent the plaintiff or the defense. Delivered in 24–48 hours.
Line-item analysisFrom a recent case
| Service | Billed | Reasonable |
|---|---|---|
| Epidural steroid injection, surgery center facility fee | $29,300 | $10,600 |
| Specialist new patient visit | $1,700 | $460 |
| MRI, lumbar spine (below benchmark, accepted as billed) | $4,500 | $4,500 |
| Case total, all providers | ~$125,000 | ~$80,000 |
Figures rounded; provider names withheld. Charges at or below the benchmark are accepted as billed; every line states its basis.
Neutral by design
Fair numbers settle cases.
In every engagement to date, the medical expenses were resolved before a deposition was ever needed. When both sides can check each number against the same public data, there is little left to argue about.
That is the point: an analysis built to be fair to both sides, so it holds up no matter who is reading it.
Past results do not guarantee the outcome of any other case.
Plaintiff or defenseThe same data and the same analysis, whoever retains us.
Charges onlyReasonableness of charges. No necessity opinions.
Why it matters now
The rules changed in 2026. Every number has to hold up.
Deadlines decide cases
Without a timely, compliant counteraffidavit, § 18.001 affidavits prove the bills. In one reported case, $693,484.52 in past medical expenses went in unchallenged.
Weak methods get struck
Late service, unqualified affiants, unsourced numbers, and Medicare multiples are recurring grounds for striking counteraffidavits.
The method
Public, verifiable, and Texas-specific.
- PUDFTexas hospital discharge data (THCIC), 80th percentile billed charges
- VAVA Reasonable Charges by code
- CMSCMS ambulance fee data for Texas, with BLS medical CPI inflation adjustment
- NCCINCCI bundling edits and MUE unit limits
- —No proprietary database: the other side can check every number against the same sources
Reviewers with “national and regional bases on which to compare prices” are “generally well-suited to determine the reasonableness of medical expenses.”Gunn v. McCoy, 554 S.W.3d 645 (Tex. 2018)
Services
Flat, capped, and fast.
Counteraffidavit
From$1,000
Priced by number of providers, with a cap. Every charge analyzed line by line. 24–48 hour turnaround, no rush fee.
Expert report and testimony
Full written report for designation, plus deposition and trial testimony.
Rebuttal
Analysis of the opposing billing expert’s method and numbers, for cross-examination or a motion to strike. Served with a counteraffidavit? The challenged charges now need expert testimony.
View a sample report (PDF, fictional case). Full fee schedule and repeat-client panel rates available on request.
MD · JD
Venu Julapalli, MD, JD
A practicing gastroenterologist with Integral Gastroenterology Center PLLC in the Houston area, focused on the reasonableness of medical charges.
Dr. Julapalli also holds a JD and is licensed to practice law in Texas. He serves only as an independent expert, not as counsel, and no legal services are offered through this practice.
Curriculum vitae available on request.
Try it on your next case
Send the bills. Get a number in 24 hours, free.
We will tell you how much we can take off before you commit to anything.
billingexpert@igcmed.com 281-880-4887