If patients ask for copies of their electronic protected health information (PHI), the fees you charge must be reasonable and cost-based, according to federal and state regulations.
However, the HIPAA Privacy Rule, just like Texas Medical Board (TMB) rules, prohibit physicians from charging fees for retrieving the records, handling the records, or processing the request for access, says TMA’s newly revised white paper, “Fees for Copies of Medical Records” (2017).
Under TMB rules, the maximum fee physicians can charge for medical records provided in an electronic format is $25 for 500 pages or fewer and $50 for more than 500 pages.
Remember the keywords “reasonable and cost-based.” “Simply charging the maximum fee allowed under the rule may not be sufficient to be in compliance with the rule,” TMA reminds physicians in the white paper.
The medical board says a “reasonable” copy fee may include only the costs associated with:
- Copying and labor (including compiling, extracting, scanning, burning onto media, and distributing media);
- Cost of supplies for electronic media;
- Preparing a summary of the records (when appropriate); and
- Postage (if the requestor wants the copy or summary mailed).
Flat Fee Option
In 2016, U.S. Department of Health and Human Services Office of Civil Rights (OCR) said a flat fee not to exceed $6.50 is a permissible option for HIPAA-covered practices to charge for copies of electronic medical records.
Some people interpreted this to mean $6.50 was the maximum amount practices could charge for providing copies of electronic medical records, TMA’s white paper says. In response, OCR issued a clarification that “$6.50 is not the maximum amount that can be charged for all individual requests for a copy of PHI under the right of access. Rather, charging a flat fee not to exceed $6.50 is an option available to those entities that do not want to go through the process of calculating the actual or average costs for requests for electronic copies of PHI maintained electronically as permitted by the Privacy Rule.”
For more about medical records, visit the TMA Medical Records resource page. TMA’s publication, Managing Your Medical Records, covers the rules for consent, release, disclosure, retention, destruction, and more.
Have a question about medical records or other topics? Find answers in the TMA FAQs (TMA log-in required), or ask the TMA Knowledge Center at (800) 880-7955 or knowledge[at]texmed[dot]org.
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