Kentucky Medical Record Fees: The 2025-2026 Statutory Guide
Kentucky’s medical record laws are among the most patient-friendly in the nation. Under KRS 422.317, the burden of cost is shifted away from the patient for their initial request, ensuring that financial barriers do not prevent individuals from accessing their own healthcare history.
1. The “First Copy Free” Rule
Under KRS 422.317(1), all hospitals and healthcare providers licensed in Kentucky are required to provide a patient with one copy of their medical record free of charge upon written request.
- Who qualifies: This applies to the patient and, importantly, includes requests made by the patient’s attorney or authorized representative on their behalf.
- Legal Precedent: Kentucky courts have explicitly ruled that “one free copy” means exactly that—one copy without any charges, even when requested by legal counsel (see Eriksen vs. Gruner & Sims).
- Scope: The “first copy” refers to the entire medical record held by that specific provider.
2. Statutory Fee Schedule (Second Copies & Third Parties)
If a patient has already received their free copy, or if a second set is requested, the provider may charge a fee. Kentucky law sets a strict “hard cap” on these charges to prevent price gouging.
| Service Type | Paper Format Fee | Electronic Format Fee |
|---|---|---|
| First Copy (Patient/Attorney) | $0.00 (Mandatory Free) | $0.00 (Mandatory Free) |
| Second Copy (Patient/Rep) | $1.00 per page (Maximum) | $1.00 per page (Maximum) |
| Search & Retrieval Fees | $0.00 (Prohibited) | $0.00 (Prohibited) |
| Certification Fee | Included in Max Cap | Included in Max Cap |
The “All-Inclusive” Cap
Kentucky law is unique in that the $1.00 per page limit is an all-inclusive maximum. Providers are prohibited from charging additional “Nomenclature Fees”—such as administrative, retrieval, or certification fees—if the total invoice exceeds the $1.00 per page threshold.
3. Workers’ Compensation Exception
If the records are requested specifically for a Workers’ Compensation claim under KRS Chapter 342, a separate administrative fee applies. Under 803 KAR 25:160, these rates are currently:
- Per Page Fee: $0.50 per page (plus actual postage).
- Certification Fee: $10.00 maximum (if requested).
4. The Patient Rate (HIPAA Protection)
Even for second copies, federal HIPAA law provides a secondary layer of protection for patients.
- Reasonable, Cost-Based Fee: For personal-use requests, providers should ideally only charge for the actual labor and supplies used.
- Format Choice: Patients have the right to receive their records in the format they request (e.g., PDF via email) if it is “readily producible” in that format.
Audit Tip for Kentucky Paralegals
The “First Copy Free” rule is frequently ignored by third-party vendors who send automated invoices.
- The Attorney Loophole: Some providers try to claim the free copy only applies if the patient walks in personally. This is false. Cite the Eriksen decision to remind them that an attorney’s request for the first copy must also be free.
- Total Charge Audit: If you are on your second copy and the invoice is for $50.00 but the record is only 20 pages, they are overcharging. The total bill cannot exceed $20.00 ($1.00 x 20 pages), regardless of any “Administrative” or “Search” fees they list.
Audit Your Invoice
If you believe a Kentucky provider or their vendor (like Ciox) is overcharging you for a record that should be free, our auditor can generate a dispute letter based on KRS 422.317.
Not sure if your invoice is accurate? Use our Medical Record Fee Calculator to audit your charges against these Kentucky statutes.
Please understand that the materials on this web page are for general information purposes only, and is not intended as legal advice.