Arkansas Code Annotated [A.C.A.] Sec. 16-46-106

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.

A.R.S. 12-2295

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.

Arkansas Code Annotated [A.C.A.] Sec. 16-46-106

Medical Clinics and Doctors' Offices

• May charge no more than $5.00 for the first five (5) pages
• No more than $0.25 per page thereafter for existing records
• Cost of each photocopy, excluding x-rays, shall not exceed one dollar ($1.00) per page for the first five (5) pages and twenty-five cents ($0.25) for each additional page, except that the minimum charge shall be five dollars ($5.00).

Hospitals and Ambulance Providers

• May charge a "reasonable amount" for records retrieval and re-storage, in addition to the photocopy charges.

UPDATE: 2007, including labor charge

California Evidence Code Section 1560-1567

• 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

Evidence Code Section 1158

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

UPDATE: California Health & Safety Code Section 123100

6 C.C.R. 1011-1, Chapter 2, Part 5.2.3.4

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

Title 20 §20-7c(b)

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:

• Forty-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.

Section 19a-490b

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, Section 30.0

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.

No information available.

Florida Statutes 395.3025

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

Florida Statutes 395.301, Itemized Patient Bill

• 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.

Rule 64B8-10.003, Florida Administrative Code

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."

Georgia General Assembly Unannotated Code §31-33-3

• 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.

UPDATE: July 2011

Hawaii Revised Statute Section 622-57(g)

• Reasonable costs incurred by a health care provider in making copies of medical records shall be borne by the requesting person.

No information available.

IL ST CH 735 §5/8-2006

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.

UPDATE: 2011 Annual Adjustment

760 IAC 1-71-3

• $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.

UPDATE: Charges associated with litigation and Worker's Compensation, July 2008

K.S.A. 65-4971(b)

• $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.”

UPDATE: 2011 Annual Adjustment

KRS 422.317

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.

OAG 09-009: Opinion of the Kentucky Attorney General construing KRS 422.317 (12/11/09)

Louisiana Revised Statutes 40:1299.96

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

Title 22 Section 1711

• $10 for the first page
• $.35 for additional pages

Health-General Article Section 4-304(c)(3)

• 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

UPDATE: 2011 Annual Adjustment

243 CMR 2.07(13)(c)

• 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: 2009 UPDATE

Chapter 111: Section 70 Records of hospitals or clinics; custody; inspection; copies; fees

Medical Records Access Act 47 of 2004 333.26269 Section 9 Fee:

• 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

UPDATE: 2012

Minnesota Statute 144.335, Subdivision 5

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 charge
• 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

UPDATE: 2011 Annual Adjustment

Section 11-1-52, Mississippi Code of 1972

• Maximum copying charge is $20.00 for up to 20 pages
• $1.00 per page for the next 80 or more 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

Missouri Revised Statutes §191.227

• A handling fee of $17.05
• Plus a fee of $.40 per page for copies of documents made on a standard photocopy machine
• 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).

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).

UPDATE: 2011 Annual Adjustment

Montana Code Annotated 50-16-540

• 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

71-8404

• 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.

NRS 629.061

• 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

Title XXX Occupations and Professions Chapter 332-I Medical Records

• 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

2004 Update

2005 Readoption from NJ Dept. of Health and Senior Services

New Jersey Administrative Code §13:35-6.5(c)(4)

• $1.00 per page or $100.00 for the whole record, whichever is less

UPDATE: 2008 Copying Charges

16.10.7 NMAC

• $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

UPDATE: 2009 Adjustment

Sections 17 and 18 of Public Health Law (PHL), Laws of 1991, Chapter 165, sections 48 and 49.

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.

North Carolina General Statutes §90-411

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

N.D. Cent. Code Section 23-12-14

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.

[§ 3701.74.1] § 3701.741.

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 company

Method to Determine % Change for Ohio Revised Code Section 3701.742

UPDATE: 2009 Adjustment

76 Okla. Stat. Sec. 19

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.
• 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.

UPDATE: Most Recent Statute Change

ORS 192.521 Health care provider and state health plan charges

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

UPDATE: 2011 Adjustment

Rules and Regulations for Medical Copying 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

SC ST SEC 44-115-80

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

Sec. 44-7-325 for Health Care Facilities

• $.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

South Dakota Administrative Rules

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.

Tennessee Code/Title 63 Professions Of The Healing Arts/Chapter 2 Medical Records/63-2-102.

• 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

Tennessee Code Annotated 68-11-304

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.

UPDATE: 2010

Texas Health and Safety Code §241.154:

A basic retrieval or processing fee not to exceed $30.00 for first 10 pages of records; then,

• $1.00 per page for pages 11-60
• $.50 per page for pages 61-400
• $.25 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 $45.00, and:
  • $1.00 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 $75; and
• he actual cost of mailing, shipping, or otherwise delivering the provided copies.

Title 22 Part 9 Chapter 165 Rule 165.2

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

Utah Code
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

Va. Code Section 8.01-413 (2003)

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.

VA Code § 32.1-127.1:03. Health Records

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.

WAC 246-08-400

• 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

UPDATE: July 2011 through June 2013

West Virginia Code §16-29-2(a)

• $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

Section 146.83

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.

Wyoming Statutes Title 35, Chapter 2, Article 6, Section 35-2-611(b)

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.