Texas Medical Record Retrieval, Statutory Copying Fee Caps & Subpoena Rules (Tex. Health & Safety Code § 241.154 (Hospitals) & 22 TAC § 165.2 (Physicians))
Complete guide to Texas medical record retrieval, comparing the Federal HIPAA Patient Rate (45 CFR § 164.524) against Texas's third-party copying fee caps under Tex. Health & Safety Code § 241.154 (Hospitals) & 22 TAC § 165.2 (Physicians) (post-Ciox Health v. Azar), mandatory 15 business days after receipt of request and fee under Tex. Health & Safety Code § 241.154(b)! response deadlines, and Tex. R. Evid. 902(10) Business Records Affidavit & Tex. Civ. Prac. & Rem. Code § 18.001 (Billing Cost & Necessity Affidavit) & TRCP Rule 200 DWQ trial authentication.
Texas (TX) Medical Record Laws at a Glance
- Governing Fee Statute
- Tex. Health & Safety Code § 241.154 (Hospitals) & 22 TAC § 165.2 (Physicians)
- Mandatory Response Deadline
- 15 business days after receipt of request and fee under Tex. Health & Safety Code § 241.154(b)!
- State Statutory Third-Party Copying Fee Schedule (Post-Ciox v. Azar)
- Hospitals (THSC § 241.154): CPI-adjusted basic retrieval fee (~$52.12+ for pgs 1–10) + tiered per-page rates (11–60, 61–400, 401+) for paper; EHR records capped at 1–25 pgs flat rate + $1.00/pg thereafter. $0.00 FREE copy for disability benefit applications/appeals under THSC § 161.202!
- Custodian Affidavit & Evidence Rule
- Tex. R. Evid. 902(10) Business Records Affidavit & Tex. Civ. Prac. & Rem. Code § 18.001 (Billing Cost & Necessity Affidavit) & TRCP Rule 200 DWQ
- Minimum Record Retention Rule
- 10 years adult hospital retention; minor until age 20 (THSC § 241.103)
Texas Medical Record Fee Comparison: Patient Direct vs. Third-Party Law Firm
Under Ciox Health, LLC v. Azar, 435 F. Supp. 3d 30 (D.D.C. 2020), the federal HIPAA “Patient Rate” applies strictly to direct-to-patient requests, while third-party attorney and insurance requests in Texas are governed by Tex. Health & Safety Code § 241.154 (Hospitals) & 22 TAC § 165.2 (Physicians):
| Requirement | Patient Direct (45 CFR § 164.524) | Texas Third-Party Attorney (Tex. Health & Safety Code § 241.154 (Hospitals) & 22 TAC § 165.2 (Physicians)) | Texas Civil Subpoena & Affidavit |
|---|---|---|---|
| Maximum Copying & Search Fee | Reasonable cost-based labor only when delivered directly to patient ($0 search fee) | Hospitals (THSC § 241.154): CPI-adjusted basic retrieval fee (~$52.12+ for pgs 1–10) + tiered per-page rates (11–60, 61–400, 401+) for paper; EHR records capped at 1–25 pgs flat rate + $1.00/pg thereafter. $0.00 FREE copy for disability benefit applications/appeals under THSC § 161.202! | Statutory subpoena clerical & per-page limits under Tex. Health & Safety Code § 241.154 (Hospitals) & 22 TAC § 165.2 (Physicians) |
| Mandatory Turnaround Window | 15 business days after receipt of request and fee under Tex. Health & Safety Code § 241.154(b)! (or 30 days federal ceiling, whichever is shorter) | 15 business days after receipt of request and fee under Tex. Health & Safety Code § 241.154(b)! | Subpoena return date + mandatory consumer notice window |
| Self-Authentication in Court | Uncertified unless Custodian Affidavit is requested | Certified Custodian Declaration under Tex. R. Evid. 902(10) Business Records Affidavit & Tex. Civ. Prac. & Rem. Code § 18.001 (Billing Cost & Necessity Affidavit) & TRCP Rule 200 DWQ | Mandatory Custodian Affidavit or Certificate of No Records (Tex. R. Evid. 902(10) Business Records Affidavit & Tex. Civ. Prac. & Rem. Code § 18.001 (Billing Cost & Necessity Affidavit) & TRCP Rule 200 DWQ) |
Texas County Subpoena Venues, Coroner Autopsy & EMS Run Sheet Hubs
Autopsy and forensic toxicology reports, 911 paramedic Prehospital Care Reports (PCRs), and trial court civil subpoenas in Texas are governed at the county/district level. Select a county below to view its trial court subpoena venue, Medical Examiner office, and 911 EMS agency:
Harris County
Court: Harris County District Courts & Civil Courts at Law (Houston — TRCP Rule 200 DWQ & TCPRC § 18.001)
Coroner/ME: Harris County Institute of Forensic Sciences (Medical Examiner — Texas Medical Center)
Dallas County
Court: Dallas County District Courts (George L. Allen, Sr. Courts Building)
Coroner/ME: Dallas County Southwestern Institute of Forensic Sciences (SWIFS — Medical Examiner)
Bexar County
Court: Bexar County District Courts (San Antonio)
Coroner/ME: Bexar County Medical Examiner's Office (San Antonio)
Travis County
Court: Travis County District Courts (Austin)
Coroner/ME: Travis County Medical Examiner's Office (Austin)
Tarrant County
Court: Tarrant County District Courts (Fort Worth)
Coroner/ME: Tarrant County Medical Examiner's Office (Fort Worth)
Major Texas Medical Center Cities (HIM, Billing & PACS Routing)
Select a major medical center city in Texas to view its Level I/II trauma centers, acute-care hospitals, VA Medical Centers, and 3-department ROI vendor routing:
Houston, TX Medical Record Retrieval
Memorial Hermann-Texas Medical Center (Red Duke Trauma Institute — Level I Trauma) • Ben Taub Hospital (Harris Health System — Level I Trauma) • Houston Methodist Hospital (Texas Medical Center)
Dallas, TX Medical Record Retrieval
Parkland Memorial Hospital (Dallas County — Level I Trauma & Regional Burn Center) • Baylor University Medical Center at Dallas (BSW Health — Level I Trauma) • Methodist Dallas Medical Center (Level I Trauma)
San Antonio, TX Medical Record Retrieval
University Hospital (University Health — South Texas Level I Trauma & Pediatric Trauma) • Brooke Army Medical Center (BAMC / SAMMC — DoD Level I Trauma & Burn Center) • Methodist Hospital (HCA / Methodist Healthcare San Antonio)
Austin, TX Medical Record Retrieval
Dell Seton Medical Center at The University of Texas (Ascension Seton — Central TX Level I Trauma) • St. David's South Austin Medical Center (HCA — Level II Trauma) & St. David's Medical Center • Baylor Scott & White Medical Center – Round Rock & Austin
Fort Worth, TX Medical Record Retrieval
JPS Health Network (John Peter Smith Hospital — Level I Trauma) • Texas Health Harris Methodist Hospital Fort Worth (Level I Trauma) • Baylor Scott & White All Saints Medical Center
Major Texas Hospital Systems & Retrieval Hubs
We retrieve complete inpatient and outpatient clinical charts, UB-04 / CMS-1500 itemized billing ledgers, and DICOM radiology studies from all healthcare systems in Texas, including HCA Houston / Medical City / St. David's, Baylor Scott & White Health, Memorial Hermann Health System, Houston Methodist, UT Southwestern / Parkland, CHRISTUS Health, Texas Health Resources, and regional clinics.