Getting a copy of your medical records typically costs between $0 and $6.50 for electronic copies, though paper copies can run much higher depending on your state and the size of your file. The exact amount depends on whether you’re requesting your own records, how many pages are involved, and whether you want them on paper or in a digital format.
The $6.50 Electronic Copy Option
Federal guidance from HHS gives healthcare providers a simple shortcut: they can charge a flat fee of up to $6.50 for an electronic copy of your records instead of calculating their actual costs. This option exists specifically so providers don’t have to itemize labor and supply expenses for every request. Many providers use it because it’s easy.
That $6.50 figure is not a cap on all medical record fees. It only applies when a provider chooses this flat-rate approach for electronic copies of records already stored electronically. If a provider wants to charge more, they can, but they have to justify it by calculating their actual labor costs for preparing the copy. They cannot, however, include the cost of searching for and retrieving your records in that calculation. Retrieval fees are explicitly prohibited under federal law, even if a state law says otherwise.
Paper Copies Cost Significantly More
Paper records are where costs climb. States set their own fee schedules for paper copies, and rates vary widely. Pennsylvania’s schedule offers a useful example of a typical structure:
- Pages 1 through 20: up to $2.00 per page
- Pages 21 through 60: up to $1.48 per page
- Pages 61 and beyond: up to $0.52 per page
- Microfilm copies: up to $2.95 per page
For a medical file that runs 100 pages on paper, you could be looking at roughly $80 to $100 in a state with a similar fee structure. Other states set their own maximums, and some are higher, some lower. A few states cap fees at a flat rate regardless of page count, while others use a sliding scale like Pennsylvania’s.
One important distinction: if you’re requesting your own records, many states prohibit charging a search and retrieval fee on top of the per-page cost. Pennsylvania, for example, allows a $29.61 search and retrieval fee only when someone other than the patient is requesting the records. If you’re the patient, that fee should not appear on your bill.
What Providers Cannot Charge You For
Federal law is clear about what counts as a reasonable fee and what doesn’t. Providers can only charge you for the labor involved in copying and preparing the records, the cost of paper or a CD/USB drive if you request physical media, and postage if you want the records mailed. That’s it.
They cannot charge you for the time spent searching through their system, pulling your file from storage, verifying that the records belong to the right person, or reviewing your request. A GAO investigation found cases where hospitals and their record-processing vendors charged patients retrieval fees anyway. HHS has stated since 2013 that retrieval costs are not permitted, and any charge for them violates federal privacy rules regardless of what state law allows.
If you see a line item for “retrieval,” “search,” or “processing” on a bill for your own records, you have grounds to dispute it.
How to Keep Your Costs Low
The simplest way to minimize what you pay is to request electronic copies. If your provider maintains records in an electronic health record system (and most do at this point), you have a legal right to receive your records in electronic format. The fee for electronic records can only reflect the labor cost of preparing the copy, not the search time, and many providers default to the $6.50 flat rate or less.
Accessing records through a patient portal is often free. Most hospitals and large health systems now offer portal access where you can view and download lab results, visit notes, and other records at no cost. This won’t always give you the complete file (imaging studies and older records may not be available), but it covers the most commonly needed information.
If you only need records sent to another provider for continuity of care, the transfer sometimes happens at no charge, especially between providers within the same health system. It’s worth asking before filing a formal records request.
Imaging Records Have Different Rules
X-rays, MRIs, CT scans, and other imaging files don’t follow the same per-page fee schedules as text-based records. Pennsylvania’s fee guidelines, for instance, explicitly exclude “X-ray film or any other portion of a medical record which is not susceptible to photostatic reproduction.” These files are typically provided on a CD or through a secure digital transfer, and the cost varies by facility. Expect to pay anywhere from $10 to $50 for imaging on disc, though some facilities charge more for multiple studies.
If the imaging was stored digitally (which is standard practice now), you still have the right to request it in electronic format, and the fee should reflect only the labor and media costs.
How Long It Takes to Get Your Records
Providers have 30 calendar days from the date they receive your request to either provide your records or deny access. That 30 days is a maximum, not a target. HHS expects many requests to be fulfilled well before the deadline.
If a provider can’t meet the 30-day window (for example, if records are stored in an offsite archive), they can extend the deadline by an additional 30 days. To do this, they must notify you in writing within the first 30 days, explain the reason for the delay, and give you a specific date by which you’ll receive the records. Only one extension is allowed per request.
These timelines apply even when a provider uses a third-party company to handle records requests. The clock starts the day the provider (or their vendor) receives your request. If a provider routes your request to a vendor and that handoff takes a week, that week counts against their 30 days.
If your situation is time-sensitive and the provider anticipates a delay, HHS encourages them to send records in batches as they become available, assuming you’re willing to receive them that way. It’s worth mentioning urgency in your initial request.
What to Do if You’re Overcharged
If a provider charges you fees that seem unreasonable or includes prohibited line items like retrieval or search fees, you can file a complaint with the HHS Office for Civil Rights. This is the federal agency responsible for enforcing the privacy rules that govern medical records access. Complaints can be filed online through the HHS website. You can also contact your state’s health department or attorney general’s office, since many states have their own enforcement mechanisms for medical records fee violations.