North Carolina Medical Record Fees: The 2025-2026 Statutory Guide
In North Carolina, the fees a healthcare provider can charge for searching, handling, and copying medical records are strictly capped under G.S. 90-411. This statute applies to records requested by a patient or their “designated representative” (including attorneys).
1. Statutory Fee Schedule (2025-2026)
North Carolina utilizes a sliding scale for per-page fees. One of the most important aspects of this law is that the minimum fee must include the cost of the initial pages.
| Service Type | Maximum Allowable Fee |
|---|---|
| Minimum Fee | $10.00 (Inclusive of copying costs) |
| Pages 1–25 | $0.75 per page |
| Pages 26–100 | $0.50 per page |
| Pages 101+ | $0.25 per page |
| Electronic Records | Actual cost / HIPAA Rates (See below) |
| Narrative Summary | Reasonable professional fee |
The “$10.00 Inclusive Minimum”
Unlike states that allow a “Search Fee” on top of per-page charges, North Carolina’s $10.00 minimum fee is all-inclusive. For example, if you request a 5-page record, the provider can charge you $10.00, but they cannot charge you a $10.00 handling fee plus $3.75 for the pages.
Electronic Record Standards
While G.S. 90-411 focuses on “per page” rates, North Carolina providers are increasingly held to federal HIPAA and HITECH standards for digital delivery. If a record is stored electronically, the “reasonable fee” for a digital export (PDF) should typically not exceed the labor cost of the export. Many NC providers default to the HIPAA $6.50 flat fee for digital delivery to avoid the per-page calculations.
2. Special Exception: Workers’ Compensation
If a request for medical records is related to a Workers’ Compensation claim (Article 1 of Chapter 97), the fees in G.S. 90-411 do not apply. Instead, these fees are governed by the North Carolina Industrial Commission under G.S. 97-26.1. Currently, the Industrial Commission sets lower per-page rates for these specific claims.
3. Mandatory Free Records (Social Security)
Under G.S. 90-411, the statutory fee schedule does not apply to requests made by the DHHS Disability Determination Services on behalf of an applicant for:
- Social Security Disability (SSDI)
- Supplemental Security Income (SSI) Providers are generally required to furnish these records for free or at a significantly reduced rate set by federal/state contract.
4. Narrative Summaries
If a patient or attorney requests that a physician review the record and write a “Narrative Summary” (rather than just providing raw copies), the physician is permitted to charge a reasonable professional fee for their time. This fee is not capped by the per-page rates listed above.
Audit Tip for North Carolina Paralegals
The most frequent overcharge in North Carolina involves the “Handling Fee” vs. the “Minimum Fee.”
- The Double Dip: Watch out for invoices that list a “$15.00 Handling Fee” and then start charging $0.75 for page one.
- The Audit: Cite G.S. 90-411. The maximum base fee is $10.00, and that $10.00 must cover the copying costs of the initial pages until the per-page math exceeds $10.00.
Audit Your Invoice
If you believe a North Carolina provider is overcharging for a Workers’ Comp case or improperly adding a search fee to your bill, our auditor is configured with the G.S. 90-411 sliding scale.
Not sure if your invoice is accurate? Use our Medical Record Fee Calculator to audit your charges against these North Carolina statutes.
Please understand that the materials on this web page are for general information purposes only, and is not intended as legal advice.