Medical Record Fee Must Equal Actual Costs

Q. Can we charge patients a search fee when we have to go into our off-site storage to fulfill a records request?

A. No. Texas Medical Board (TMB) rules specifically prohibit charging a fee for searching for and retrieving the requested information. Practices may charge a reasonable, cost-based fee for medical records that covers the cost of copying (including labor and supplies), postage, and/or preparing a summary of records when appropriate. The U.S. Office of Civil Rights rules are the same.

TMB rules dictate that a reasonable fee shall be no more than $25 for the first 20 pages and 50 cents per page for every copy thereafter. Thus, you may charge a maximum fee of $27.50 for a 25-page chart. For diagnostic imaging studies, such as x-rays, the reasonable fee is no more than $8 per film. Additionally, if an affidavit is requested, you may charge a reasonable fee of up to $15 for executing the affidavit.

Note that merely staying below the maximum allowable charge may not be sufficient to meet the TMB’s mandate that your fees be “cost based.” To make sure the fee you charge is reflective of your actual costs, annually calculate the average hourly cost for wages and benefits of staff responsible for forwarding records requests, along with the per-page expense of making photocopies.

Remember also: You cannot deny a copy of records to a patient because he or she has a past-due account with your practice.

Questions regarding medical records are among the most asked in the TMA Knowledge Center. Now, TMA’s new publication, Managing Your Medical Records, has all the answers in one place, updated for HIPAA compliance. Or, contact the TMA Knowledge Center with your questions at (800) 880-7955 or

Published Nov. 29, 2012 

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