Medical Records Copying Charges
This web page lists the various state statutes that control the amount of money doctors, hospitals, and other health care providers can charge a patient for copies of their medical records, as well as records provided to the patient's attorney or law firm for use in personal injury cases.
Note that under the Health Insurance Portability and Accountability Act (HIPAA) a covered entity can only charge "reasonable" cost-based fees for providing the medical records to patients. See 45 CFR 164.524(c). Arguably, fees that are not cost-based, even if permitted by a state statute, may be contrary to the HIPAA regulation and therefore preempted by this federal regulation.
We update this page when we learn of new statutes, or revisions to statutes already posted; as such, there is no regular time point at which we do this. We cannot and do not represent that all statutes are up-to-date. One type of revision which is especially hard for us to keep track of has to do with costs changes allowed annually by a statute and based on some indexed inflation rate.
Please always view the actual statute when there is a link available and/or check any "UPDATE" link which you may see for a particular state because these items may contain cost information that is more current than the synopsis text which appears on this web page.
If you are aware of additional statutes which should be posted on this web page, please send the following to Tom Lamb:
- a link to the relevant statute in your state; and a concise summary of the costs aspect of that statute.
- NOTE: If your state's statute is not available online, or you cannot provide us with a precise URL link for the statute, please fax or mail the official text of statute.
Likewise, any clarifications, corrections, or updates regarding the statutes on this web page should be submitted to Tom Lamb.
Please understand that the materials on this web page are for general information purposes only, and must not be regarded as legal advice.
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The reasonable costs of reproducing copies of written or typed documents, or reports shall not be more than:
- One dollar ($1) for each page of the first 25 pages
- Not more than 50 cents ($.50) for each page in excess of 25 pages
- A search fee of five dollars ($5)
- If the medical records are mailed to the person making the request, reasonable costs shall include the actual costs of mailing the medical records
- A person may charge in addition to the above fees, the actual cost of reproducing X-rays and other special medical records
Except as otherwise provided by law, a health care provider or contractor may charge a person who requests copies of medical records a reasonable fee for the production of the records. Except as necessary for continuity of care, a health care provider or contractor may require the payment of any fees in advance.
Medical Clinics and Doctors' Offices
- May charge no more than $0.50 for the first twenty-five (25) pages
- No more than $0.25 per page thereafter for existing records
- A labor charge not exceeding $15.00 may be added or a reasonable retrieval fee for off-site stored records
- Actual cost of any required postage may also be charged
Hospitals and Ambulance Providers
- May charge a "reasonable amount" for records retrieval and re-storage, in addition to the photocopy charges.
- Not more than $.10 per page for 8.5x14 inches or less
- $.20 per page for microfilm copies
- actual costs for the reproduction of oversize documents or the reproduction of documents requiring special processing which are made in response to a subpoena
- reasonable clerical costs incurred in locating and making the records available to be billed at the maximum rate of twenty-four dollars ($24) per hour per person, computed on the basis of six dollars ($6) per
quarter hour or fraction thereof
- actual postage charges
If a patient's attorney requests the medical records:
- Ten cents ($.10) per page for documents 8.5x14 inches or less
- Twenty cents ($.20) per page for document copies from microfilm
- Actual costs for oversize documents or special processing
- Reasonable clerical costs to retrieve records; $4.00 per quarter hour or less
- Actual postage charges
For a representative of the patient, other than a "personal representative" as defined in (HIPAA) 45 CFR 164.502(g):
- $16.50 for the first 10 or fewer pages
- $.75 per page for pages 11-40
- $.50 per page for every additional page
- The per-page fee for records copied from microfilm shall be $1.50 per page
- Actual postage or shipping costs and applicable sales tax, if any, also may be charged.
For the discharged patient or personal representative:
- Reasonable cost not to exceed $14.00 for the first 10 or fewer pages
- $.50 per page for pages 11-40
- $.33 per page for every additional page
- Actual postage may be charged
- Per-page fees for microfilm shall be $1.50 per page
Upon a written request of a patient, his attorney or authorized representative, or pursuant to a written authorization, a provider, except as provided in section 4-194, shall furnish to the person making such request a copy of the patient's health record, including but not limited to, bills, x-rays and copies of laboratory reports, contact lens specifications based on examinations and final contact lens fittings given within the preceding three months or such longer period of time as determined by the provider but no longer than six months, records of prescriptions and other technical information used in assessing the patient's health condition. No provider shall charge more than:
- Sixty-five cents per page, including any research fees, handling fees or related costs, and the cost of first class postage, if applicable.
- Except such provider may charge a patient the amount necessary to cover the cost of materials for furnishing a copy of an x-ray, provided no such charge shall be made for furnishing a health record or part thereof to a patient, his attorney or authorized representative if the record or part thereof is necessary for the purpose of supporting a claim or appeal under any provision of the Social Security Act and the request is accompanied by documentation of the claim or appeal.
- A provider shall furnish a health record requested pursuant to this section within thirty days of the request.
Upon the written request of a patient or the patient's attorney or authorized representative, or pursuant to a written authorization, an institution licensed pursuant to this chapter shall furnish to the person making such request a copy of the patient's health record, including but not limited to, copies of bills, laboratory reports, prescriptions, and other technical information used in assessing the patient's health condition.
- No institution shall charge more than sixty-five cents per page, including any research fees, clerical fees, handling fees, or related costs, and the cost of first class postage.
Delaware Administrative Code, Title 24: 24 Del. Code, Chapter 1700, Section 29
A new rule, effective November 11, 2009, limits the fees a practice may charge Delaware patients for copies of the patient’s medical records that it provides either directly to the patient or to another physician. These fee limits apply to both electronic and paper copies.
- $2.00 per page for pages 1-10
- $1.00 per page for pages 11-20
- $0.90 per page for pages 21-60
- $0.50 per page for pages 61 and above
In addition to the fees above, practices may charge the following:
- When the records are mailed, practices may charge the actual cost of postage or shipping.
- When the type of record requested cannot be photocopied (such as radiology films or fetal monitoring strips), practices may charge the cost of reproducing the records.
Practices may require payment of all costs in advance of releasing the records except for records related to an application for a disability benefits program.
Regarding records from hospitals:
- Exclusive charge for copies may include sales tax and actual postage
- Non-paper records not to exceed $2.00 per page
- Paper records not to exceed $1.00 per page
- An additional $1.00 may be charged for each year of records requested
- The facility may not charge the patient for making such verification records available; however, the facility may charge its usual fee for providing copies of records as specified in s. 395.3025.
Regarding records from physicians:
- No more than $1.00 per page for the first 25 pages of written material
- $.25 for each additional page
- Actual cost of reproducing nonwritten records such as x-rays
- "Recognizing that patient access to medical records is important and necessary to assure continuity of patient care, the Board of Medicine urges physicians to provide their patients a copy of their medical records, upon request, without cost, especially when the patient is economically disadvantaged."
- A charge of up to $25.88 may be collected for search, retrieval, and
other direct administrative costs
- A fee for certifying the medical records may also be charged not to exceed $9.70 for each record certified
- The actual cost of postage incurred in mailing the requested records may also be charged
- Copying costs for a record which is in paper form shall not exceed
- $0.97 per page for the first 20 pages of the patient's records which are copied
- $0.83 per page for pages 21 through 100
- $0.66 for each page copied in excess of 100 pages
- These numbers reflect July 1, 2011 increase for inflation.
- For medical records which are not in paper form, including but not limited to radiology films, the provider shall be entitled to recover the full reasonable cost of such reproduction.
- Reasonable costs incurred by a health care provider in making copies of medical records shall be borne by the requesting person.
The practitioner shall be reimbursed by the person requesting such records at the time of such copying, for all reasonable expenses, including the costs of independent copy service companies, incurred by the practitioner in connection with such copying not to exceed:
- a $24.81 handling charge for processing the request for copies
- $0.93 cents per page for the first through 25th pages
- $0.62 cents per page for the 26th through 50th pages
- $0.31 cents per page for all pages in excess of 50
- the charge shall not exceed $1.55 per page for any copies made from microfiche or microfilm
- and actual shipping costs
These rates shall be automatically adjusted as set forth in Section 8-2006. The physician or other practitioner may, however, charge for the reasonable cost of all duplication of record material or information that cannot routinely be copied or duplicated on a standard commercial photocopy machine such as x- ray films or pictures.
- $1 per page for the first 10 pages
- $.50 for pages 11-50
- $.25 for pages 51 and higher
- Labor fee not to exceed $20. If the provider or medical records company collects a labor fee, the provider or medical records company may not charge for making and providing copies of the first ten (10) pages of a medical record.
- Actual cost of mailing the records
- Additional $10 if the request is for copies to be provided within two working days
- $20 for certifying a patient's medical record
45 CFR (Code of Federal Regulations) 164.524(c)(4)
If the individual requests a copy of the PHI [protected health information] or agrees to a summary or explanation of such information, the covered entity may impose a reasonable, cost-based fee, provided that the fee includes only the cost of:
- Copying, including the cost of supplies for and labor of copying, the PHI requested by the individual;
- Postage, when the individual has requested the copy, or the summary or explanation be mailed; and
- Preparing an explanation or summary of the PHI, if agreed to by the individual as required by paragraph (c)(2)(ii) of this section.
- $17.50 fee for labor
- $.58 per page for first 250
- $.41 per page for additional pages
For copies of records that cannot be duplicated on a standard photocopy machine: “reasonable cost.”
Upon a patient's written request, a hospital licensed under KRS Chapter 216B or a
health care provider shall provide, without charge to the patient, a copy of the
patient's medical record. A copying fee, not to exceed one dollar ($1) per page, may
be charged by the health care provider for furnishing a second copy of the patient's
medical record upon request either by the patient or the patient's attorney or the
patient's authorized representative.
For records, a reasonable charge not to exceed:
- $1.00 per page for first 25 pages
- $0.50 per page for pages 26-500
- $0.25 per page thereafter
- Plus handling charge of $25.00
- Plus actual postage
For x-rays, microfilm, electronic, and imaging media:
- Reasonable reproduction costs
- Plus handling charge of $20.00 for hospitals, $10.00 for other health care providers
- $10 for the first page
- $.35 for additional pages
- Health care provider may charge a fee for copying and mailing not exceeding 50 cents for each page of the medical record. In addition to the fee charged under subparagraph (i) of this paragraph, a hospital or a health care provider may charge:
- A preparation fee not to exceed $15 for medical record retrieval and preparation
- The actual cost for postage and handling of the medical record
- This law, originally established in 1994, states that these fees may be adjusted annually for inflation in accordance with the Consumer Price Index
- A fee for copying in excess of $.25/page or a fee for clerical work in excess of $20.00/hour is presumptively unreasonable.
- Charges for copies of x-rays and similar documents not reproducible by ordinary photocopying shall be at the licensee's actual cost, plus reasonable clerical fees not in excess of $20.00/hour.
MEDICAL RECORD COPYING FEE: 2011 UPDATE
- Initial fee of $20.00 per request for a copy of the record
- Paper copies:
- One dollar per page for the first 20 pages
- Fifty cents per page for pages 21 through 50
- Twenty cents for pages 51 and over
- For mediums other than paper, the actual cost of copying
- Postage or shipping costs
- Actual costs incurred for records older than seven years
When a provider or its representative makes copies of patient records upon a patient's request under this section, the provider or its representative may charge the patient or the patient's representative no more than:
- 75 cents per page, plus $10 for time spent retrieving and copying the records, unless
other law or a rule or contract provide for a lower maximum
- This limitation does not apply to x-rays
- The provider may charge a patient no more than the actual cost of reproducing x-rays
- Plus no more than $10 for the time spent retrieving and copying the x-rays
- The respective maximum charges of 75 cents per page and $10 for time provided in this subdivision are in effect for calendar year 1992 and may be adjusted annually each calendar
year as provided in this subdivision
- Maximum copying charge is $20.00 for up to 20 pages
- $1.00 per page for the next 80 pages
- $.50 per page for all pages thereafter
- 10 percent of the total charge may be added for postage and handling
- $15.00 may be recovered by the medical provider or hospital or nursing home for retrieving medical records in archives at a location off the premises where the facility is located
- Actual cost of reproducing x-rays or other special records
- A handling fee of $17.05
- Plus a fee of $.40 per page for copies of documents made on a standard photocopy
- Providers may charge for the reasonable cost of all duplications of medical record material or information which cannot routinely be copied or duplicated on a standard copy machine.
Provides that effective February 1st of each year, the handling fee and per page fee will be increased or decreased based on the annual percentage change in the unadjusted, U.S. city average, annual average inflation rate of the medical care component of the Consumer Price Index for all urban consumers (CPI-U).
- A reasonable fee for providing health care information may not exceed 50 cents for each page for a paper copy or photocopy
- A reasonable fee may include an administrative fee that may not exceed $15 for searching and handling recorded health care information
- A provider may charge no more than twenty dollars as a handling fee
- No more than fifty cents per page as a copying fee.
- A provider may charge for the reasonable cost of all duplications of medical records which cannot routinely be copied or duplicated on a standard photocopy machine.
- A provider may charge an amount necessary to cover the cost of labor and materials for furnishing a copy of an X-ray or similar special medical record. If the provider does not have the ability to reproduce X-rays or other records requested, the person making the request may arrange, at his or her expense, for the reproduction of such records.
Source: Laws 1999, LB 17, § 4. Effective date August 28, 1999.
- Actual cost of postage
- Costs of making the copy, not to exceed 60 cents per page for photocopies and a reasonable cost for copies of x-ray photographs and other health care records produced by similar processes
- No administrative fee or additional service fee of any kind may be charged for furnishing a copy
- The charge for the copying of a patient's medical records shall not exceed $15 for the first 30 pages or $.50 per page, whichever is greater
- Copies of filmed records such as radiograms, x-rays, and sonograms shall be copied at a reasonable cost.
New Jersey Administrative Code §8:43G-15.3(d)
- $1.00 per page for first 100 pages
- $.25 per page thereafter to a maximum charge of $200.00 for the entire record
New Jersey Administrative Code §13:35-6.5(c)(4)
- $1.00 per page or $100.00 for the whole record, whichever is less
- $30.00 for the first 15 pages
- $.25 per page thereafter
- The actual cost of reproduction for electronic records and record formats other than paper, such as x-rays
The cost can be no more than Seventy-Five cents ($.75) per page for paper copies and a reasonable charge for diagnostic images, plus postage.
Inclusive of searching, handling, copying, and mailing costs:
- $.75 for first 25 pages
- $.50 for pages 26-100
- $.25 for pages over 100
- Minimum fee of $10.00 permitted
Upon the request for medical records with the signed authorization of the patient, the health care provider shall provide medical records at a charge of no more than:
- $20 for the first 25 pages
- $.75 per page after 25
- This charge includes any administration fee, retrieval fee, and postage expense.
Except as provided in divisions (C) and (E) of this section, a health care provider or medical records
company that receives a request for a copy of a patient's medical record from the patient or patient's personal representative may charge not more than the amounts set forth in this section. Total costs for copies and all services related to those copies shall not exceed the sum of the following:
- $2.50 per page for the first ten pages
- $.50 per page for pages eleven through fifty
- $.20 per page for pages fifty-one and higher
- With respect to data recorded other than on paper, $1.70 per page
- The actual cost of any related postage incurred by the health care provider or medical records
Any person who is or has been a patient of a doctor, hospital, or other medical institution shall be entitled, upon request, to obtain access to the information contained in the patient’s medical records, including any x-ray or other photograph or image.
- The cost of each copy, not including any x-ray or other photograph or image, shall not exceed One Dollar ($1.00) for the first page and fifty cents ($.50) for each subsequent page.
- May produce the records in digital form at a cost not to exceed twelve cents ($0.12) per digital page.
- The cost of each x-ray or other photograph or image shall not exceed Five Dollars ($5.00) or the actual cost of reproduction, whichever is less.
- The physician, hospital, or other medical professionals and institutions may charge a patient for the actual cost of mailing the patient’s requested medical records, but may not charge a fee for searching, retrieving, reviewing, and preparing medical records of the person.
A health care provider or state health plan that receives an authorization to disclose protected health information may charge:
- No more than $30 for copying 10 or fewer pages of written material and no more than $.50 per page for pages 11 through 50 and no more than $.25 for each additional page
- Bonus charge of $5 if request for records is processed and records are mailed by first class mail to the requester within seven business days after the date of the request.
- Postage costs to mail copies of protected health information or an explanation or summary of protected health information, if requested by an individual or a personal representative of the individual
- Actual costs of preparing an explanation or summary of protected health information, if requested by an individual or a personal representative of the individual
Act 26 sets the maximum fees that can be charged for medical records. These fees are updated yearly through the Department of Health. With a few exceptions, the maximum fees for a record request from a patient or attorney for 2007 are as follows:
- searching and retrieving the record - $19.80
- pages 1 through 20 - $1.33 per page
- pages 21 through 60 - $.99 per page
- pages 61 and after - $.33 per page
- actual mailing or delivery fees
- Not more than $0.25 per page for the first 100 pages
- After 100 pages, not more than $0.10 per page
- Maximum fee of $15.00 for retrieval regardless of time spent retrieving
- Special handling fee of an additional $10.00 if records must be delivered within 48 hours of request
- Copying of x-rays or other documents not reproducible by photocopy at physician's actual cost plus clerical fees not to exceed $15.00
A physician or other owner of medical records may charge a fee for the search and duplication of a medical record, but the fee may not exceed:
- Sixty-five cents per page for the first thirty pages
- Fifty cents per page for all other pages
- A clerical fee for searching and handling not to exceed fifteen dollars per request
- Plus actual postage and applicable sales tax
- The physician may charge no more than the actual cost of reproduction of an x-ray
- $.65 per page for the first 30 pages
- $.50 per page for all other pages
- Clerical fee not to exceed $15.00
- Plus actual postage
Reimbursement for copies. The maximum reimbursement for copies of provider records is ten dollars for the first ten pages, and thirty-three cents for each additional page.
- For other than records involving workers' compensation cases, such reasonable costs shall not exceed twenty dollars ($20.00) for medical records forty (40) pages or less in length
- twenty-five cents ($.25) per page for each page copied after the first
forty (40) pages
- the actual cost of mailing
Fees that hospitals can charge patients, their lawyers, or their authorized representatives for hospital records.
- Generally, a hospital may require a "reasonable charge" for copying. The law interprets "reasonable" not to exceed a $18 retrieval fee for the first 5 pages of the record.
- $.85 for pages 6-50.
- $.60 for pages 51-250.
- $.35 for page 251 and thereafter.
MAXIMUM FEES ALLOWED FOR PROVIDNG HEALTH CARE INFORMATION
EFFECTIVE SEPTEMBER 2012:
A basic retrieval or processing fee not to exceed $44.35 for first 10 pages of records; then,
- $1.49 per page for pages 11-60
- $.74 per page for pages 61-400
- $.39 per page for any remaining pages
- Plus actual cost of mailing or shipping
If the requested records are stored on any microform or other electronic medium, a retrieval or processing fee, which must include the fee for providing the first 10 pages of the copies and which may not exceed $67.57, and:
- $1.49 per page thereafter
- Actual cost of mailing, shipping, or otherwise delivering the provided copies
If the requested records are provided on a digital or other electronic medium and the requesting party requests delivery in a digital or electronic medium, including electronic mail:
- a retrieval or processing fee, which may not exceed $80.36; and
- the actual cost of mailing, shipping, or otherwise delivering the provided copies.
No more than $25.00 for the first 20 pages; then,
- $.50 per page for every copy thereafter
- In addition, actual cost of mailing or shipping
- Also, a reasonable fee not to exceed $15.00 for executing affidavit.
22 Texas Administrative Code §165.3
- Maximum charge for x-rays and diagnostic imaging studies $8.00 per copy
Title 78B,Chapter 5, Section 618: Patient access to medical records.
- A health care provider who provides a copy of a patient's records to the patient or the patient's personal representative may charge a reasonable fee to cover the health care provider's costs.
18 V.S.A. § 9419. Charges for access to medical records
- A custodian may impose a charge that is no more than a flat $5.00 fee or no more than $0.50 per page, whichever is greater, for providing copies of an individual's health care record
- A custodian may charge an individual a fee, reasonably related to the associated costs, for providing copies of x-rays, films, models, disks, tapes, or other health care record information maintained in other formats
If an individual or his agent / attorney requests a copy of his own medical records, the health care entity may impose a reasonable cost-based fee, which shall include the cost of supplies for and labor of copying the requested information, as well as postage where applicable.
NOTE: As to what may be regarded as "reasonable" in connection with the above staute, see:
A reasonable charge may be made for the service of maintaining, retrieving, reviewing and preparing such copies. Except for copies of X-ray photographs, however, such charges shall not exceed:
- fifty cents per page for up to fifty pages
- twenty-five cents a page thereafter for copies from paper or other hard copy generated from computerized or other electronic storage, or other photographic, mechanical, electronic, imaging or chemical storage process
- one dollar per page for copies from microfilm or other micrographic process plus all postage and shipping costs and a search and handling fee not to exceed ten dollars.
- Copies of hospital, nursing facility, physician's, or other health care provider's records or papers shall be furnished within fifteen days of such request.
- No more than ninety-six cents per page for the first thirty pages
- No more than seventy-three cents per page for all other pages
- The provider can charge a twenty-two dollar clerical fee for searching and handling records
- If the provider personally edits confidential information from the record, as required by statute, the provider can charge the usual fee for a basic office visit
- $10.00 maximum search fee plus “reasonable expenses” provided
that the cost may not exceed $.75 per page for copying of records already
reduced to written form
If a patient or if the personal representative of the patient requests copies of the patient's health care records, the health care provider may charge no more than the following fees:
1. For paper copies: $1 per page for the first 25 pages; 75 cents per page for pages 26 to 50; 50 cents per page for pages 51 to 100; and 30 cents per page for pages 101 and above.
2. For microfiche or microfilm copies, $1.50 per page.
3. For a print of an X-ray, $10 per image.
4. If the requester is not the patient or a person authorized by the patient, for certification of copies, a single $8 charge.
5. If the requester is not the patient or a person authorized by the patient, a single retrieval fee of $20 for all copies requested.
6. Actual shipping costs and any applicable taxes.
The hospital may charge a reasonable fee, not to exceed the hospital's actual cost, for providing the health care information and is not required to permit examination or copying until the fee is paid.