Tennessee Medical Record Fees: The 2026 Statutory Guide
Effective July 1, 2025, Tennessee significantly reformed its medical record fee structure via Public Chapter 339 (HB 495). While early drafts suggested a per-page tiered model for digital files, the final enacted law established a mandatory flat fee for most electronic requests.
1. Statutory Fee Schedule (2026)
Tennessee law distinguishes between traditional paper copies and modern electronic delivery. Note that Workers’ Compensation remains a separate category with its own specific fee schedule.
| Service Type | Paper Records | Electronic Records | Workers’ Comp (Special) |
|---|---|---|---|
| Search & Retrieval | $0.00 (Prohibited) | $0.00 (Prohibited) | $0.00 |
| Base / Flat Fee | $25.00 (First 5 pages) | $90.00 Flat Fee | No Base Fee |
| Per Page Rate | $0.50 (Page 6+) | $0.00 (Included) | $0.50 (Page 1+) |
| Certification Fee | $20.00 | $20.00 | $20.00 |
| Maximum Total | No Statutory Cap | $90.00 Total | No Statutory Cap |
2. The $90.00 Electronic “Flat Fee” Mandate
Under the 2026 update to T.C.A. § 63-2-102, for all requesters other than the patient (including law firms and insurance companies), the fee for electronic medical records provided via portal, email, or USB must be a flat fee of $90.00.
- Final Amendment Note: Although early versions of HB 495 included a per-page rate for electronic files, Amendment HA0180 simplified this to a $90 flat fee for all digital requests.
- Large Files: A 5,000-page PDF costs exactly $90.00.
- Small Files: A 2-page PDF also costs exactly $90.00.
3. Workers’ Compensation Exception
The $90.00 flat fee and standard paper caps do not apply to Workers’ Comp cases. Per T.C.A. § 50-6-204, these fees follow the TN Department of Labor schedule:
- Rate: $0.50 per page from page one.
- No Cap: There is no maximum limit for WC records; a large file can cost hundreds of dollars.
4. Specialized Media (Imaging)
Tennessee limits the fees for radiology images (X-ray, MRI, CT) provided electronically:
- Portable Media (USB/CD): Max $25.00 per request.
- Portal/Email Delivery: Max $15.00 per request.
- Hard Copy (Film): $20.00 per printed film.
5. Mandatory Flat Fees for SSDI/SSI
If the records are for a Social Security Disability claim or appeal and are provided electronically, the fee is restricted to a flat $20.00 total under T.C.A. § 68-11-304.
Audit Tip for Tennessee Paralegals
- Check for “Legacy Billing”: Some vendors are still using the old “presumed reasonable” rates from 2024. If you see a $18 base fee or $0.85 per page, the invoice is outdated and likely an overcharge.
- Prepayment Rights: Providers are legally allowed to require payment prior to the release of records for all non-patient requests.
- Electronic Delivery: Providers must provide records in electronic form if they maintain them that way.
Audit Your Invoice
Our auditor is updated with the final 2026 Tennessee logic to catch vendors attempting to bypass the $90 flat fee.
Not sure if your invoice is accurate? Use our Medical Record Fee Calculator to audit your charges.
Please understand that the materials on this web page are for general information purposes only, and is not intended as legal advice.