Texas Release of Medical Records Laws: Fees, Deadlines, and Denials

Under Texas medical records release laws, you have the right to copies of your own health records, and the provider has to deliver them within a set window at a capped price. Hospitals must produce records within 15 days of receiving a valid written authorization and any required payment.¹ Physician offices operate under a different, generally cheaper fee schedule set by the Texas Medical Board. Both federal HIPAA rules and the Texas Medical Records Privacy Act back your access, and there are real penalties when a provider ignores a request.²

What a Provider Can Charge

Texas sets separate caps for hospitals and physician offices, and the gap between them is large. Which schedule applies depends on where you were treated, not on what kind of record you want.

Hospital Fees

Hospitals follow Texas Health and Safety Code Section 241.154, and the maximums are adjusted each year for inflation. As of September 1, 2025, a hospital may charge up to $61.79 for the first 10 paper pages (this includes retrieval and processing), $2.09 per page for pages 11 through 60, $1.02 per page for pages 61 through 400, and $0.56 per page after that.³ For electronic delivery, the retrieval or processing fee is capped at $111.94, plus actual mailing or shipping. A hospital can also charge up to $11.86 for a written response to questions about the records.¹ These figures change annually, so check the Texas Health and Human Services Commission’s current schedule before you commit.

Physician Office Fees

At a doctor’s office, the Texas Medical Board’s rules control. Paper copies run up to $25 for the first 20 pages, then $0.50 per page after that. Electronic copies are capped at $25 for 500 pages or fewer, or $50 for more than 500 pages. If you want an affidavit certifying the records, that costs up to $15.

Physician offices, unlike hospitals, cannot charge you for searching for or retrieving your file. The fee covers copying, compiling, scanning, media, and mailing only. Diagnostic imaging like X-rays follows its own separate rules.

When Records Must Be Free

You pay nothing to examine your own records in person at the hospital; the fees only apply when you request copies.¹ Hospitals also cannot charge for records tied to a workers’ compensation claim, and they must provide itemized billing statements at no cost.

Federal law puts a ceiling on top of the state caps. HIPAA limits any covered entity to a “reasonable, cost-based fee” that covers only labor for copying, supplies, and postage.⁴ A charge above the Texas maximum, or one that bills for anything beyond labor, supplies, and postage, likely violates both state and federal law.

How Fast the Provider Has to Deliver

Hospitals must make records available no later than the 15th day after receiving a valid written authorization and any required payment.¹ The statute uses calendar days, not business days.

For electronic health records, a separate rule applies to all healthcare providers. Texas Health and Safety Code Section 181.102 requires any provider using an EHR system to deliver requested records within 15 business days of receiving a written request.⁵ Business days exclude weekends and state holidays.

HIPAA gives providers up to 30 days to respond, with one 30-day extension available if the provider notifies you in writing of the reason for the delay.⁶ Because the Texas deadlines are shorter, they usually control.

The clock starts only when the provider has a complete, valid authorization and any required payment in hand. An incomplete form is the most common reason for delay. If a required field is missing, the provider sends it back and the countdown does not begin until they receive a corrected version.

How to Submit the Request So the Clock Starts

The Texas Attorney General publishes a standard authorization form under the Texas Medical Records Privacy Act.⁷ You can download it from the AG’s website, though providers may use their own forms if they meet HIPAA and Texas Medical Privacy Act requirements.⁸

A valid authorization needs:

Your full legal name and date of birth so the provider can match you to the correct file.
A description of the records you want, such as lab results, radiology reports, progress notes, or the complete chart. The standard form lists common categories.⁹
The reason for disclosure, whether personal use, treatment, insurance, legal, or another purpose.
An expiration date or event.
Your signature and the date, or your legal representative’s signature.

Specify how you want the records delivered on the same form. Paper copies by mail, electronic records by email, a USB drive, or patient portal access are all fair options, and if you request electronic delivery and the provider’s system supports it, they must accommodate that format.⁵

Send the request in a way that creates proof of receipt. Certified mail with a return receipt gives you a documented start date for the deadline. A secure patient portal typically generates a timestamped confirmation. If you hand-deliver, ask for a date-stamped copy. If the provider requires payment before processing, paying upfront prevents a second delay.

Who Else Can Request Records

A “legally authorized representative” can request records on your behalf. Under federal HIPAA rules and the Texas Health and Safety Code, that includes:

Parents or legal guardians of minors, though exceptions apply for sensitive treatments the minor consented to on their own.
A person you have designated through a medical power of attorney, for decisions they are authorized to make.¹⁰
An executor or administrator of a deceased patient’s estate.

Whoever requests the records has to prove their authority. A guardian brings the guardianship order, a POA holder brings the signed document, an executor brings letters testamentary.

Texas Family Code Section 32.003 lets a minor consent independently to treatment for reportable infectious diseases, pregnancy-related care other than abortion, and drug or chemical addiction.¹¹ Releasing those specific records to a parent requires the minor’s separate written authorization.⁹ HIPAA also allows a provider to withhold records from a personal representative if the provider reasonably believes the patient has been or could be subjected to abuse, neglect, or domestic violence by that person.

When a Provider Can Legitimately Deny Access

Denials are narrow. HIPAA permits a provider to deny access without any review in three situations:⁶

Psychotherapy notes kept separate from the main chart.
Information compiled in anticipation of a lawsuit or administrative proceeding.
Records obtained under a promise of confidentiality, where disclosure would reveal the source.

A provider may also deny access with a right of appeal if a licensed professional determines that release would endanger your life or physical safety, or would harm someone else referenced in the record. In a reviewable denial, a different licensed professional who was not involved in the first decision reviews the case.

Texas Section 181.102 incorporates these federal exceptions by reference.⁵ Any denial must be in writing, must explain the reason, and must tell you how to file a complaint.

Correcting Errors in Your File

If you spot a wrong diagnosis, an incorrect medication, or a procedure attributed to the wrong date, HIPAA gives you the right to request an amendment. Put the request in writing, identify the specific entry, explain what is wrong, and attach any supporting documentation.

The provider must respond within 60 days, with one 30-day extension possible if they notify you in writing. If they agree, they amend the record and notify anyone you identify who received the incorrect information. If they deny the request, they must explain in writing, and you may submit a written statement of disagreement that becomes part of the permanent file.⁶

Providers do not delete clinical notes. Amendments add corrections alongside the original entries, and the treating clinician makes the final call.

If You Are Denied, Ignored, or Overcharged

You have enforcement options at both levels. The U.S. Department of Health and Human Services Office for Civil Rights investigates HIPAA violations, including failures to provide timely access, and you can file through the OCR Complaint Portal.¹² OCR has actively enforced patient access rights since launching its Right of Access Initiative in 2019, with penalties in settled cases ranging from $15,000 up to a $200,000 penalty imposed in 2025.¹³

At the state level, complaints go to the Texas Medical Board when the provider is a physician, or to the Texas Attorney General’s office for broader Texas Medical Records Privacy Act violations. The 21st Century Cures Act separately prohibits “information blocking,” meaning practices by providers or health IT companies that unreasonably interfere with access to electronic health information, and knowing violators can face investigation by the HHS Office of Inspector General.¹⁴

How Long the Records Will Still Exist

Texas requires physicians to keep records for at least seven years from the date of the last treatment.¹⁵ Other laws may require longer retention for particular record types. Once the retention period ends, the provider has no obligation to keep the file, so old records should be requested sooner rather than later.

Pediatric records work differently. Because a minor cannot enforce their own rights until adulthood, records from childhood treatment should generally be retained at least until the patient turns 18 plus the standard retention period. Before paying fees or filling out an authorization for very old pediatric records, confirm with the provider that the file still exists.

1
State of Texas. Texas Health and Safety Code 241.154 – Request
2
Texas State Law Library. Medical Records – Privacy and Personal Information
3
Texas Health and Human Services Commission. Maximum Fees Allowed for Providing Health Care Information
4
U.S. Department of Health and Human Services. How Can Covered Entities Calculate the Limited Fee
5
State of Texas. Texas Health and Safety Code 181.102 – Consumer Access to Electronic Health Records
6
eCFR. 45 CFR 164.524 – Access of Individuals to Protected Health Information
7
State of Texas. Texas Health and Safety Code 181.154 – Notice and Authorization Required to Disclose
8
Office of the Attorney General of Texas. Patient Privacy
9
Office of the Attorney General of Texas. Authorization to Disclose Protected Health Information
10
U.S. Department of Health and Human Services. Can a Health Care Power of Attorney Obtain Access to Medical Records
11
State of Texas. Texas Family Code 32.003 – Consent to Treatment by Child
12
U.S. Department of Health and Human Services. Filing a Health Information Privacy Complaint
13
U.S. Department of Health and Human Services. Resolution Agreements
14
Assistant Secretary for Technology Policy. Information Blocking
15
Legal Information Institute. 22 Texas Administrative Code 163.2 – Medical Record Retention