Custodian Of Medical Records Laws in Texas

Texas

Medical Records Custodian & Retention Laws

Are you planning to close your medical practice or retire?
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Is Responsible for over 15 million Patient Records
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Texas Medical Record Retention Law:
22 TAC s.163.2 (Medical Record Retention)

Adult patients: At least 7 years, or longer if other federal or state law requires it.
Patients who were minors: For a patient under 18: until the patient reaches age 21, or 7 years from the date of last treatment, whichever is LONGER.
The retention period runs from: The date of last treatment by the physician.
Rewritten and adopted effective 9 JANUARY 2025 - Chapter 165 no longer exists and Medical Records is now Chapter 163.
The duty falls on the physician OR the physician's employer, including group practices, professional associations and non-profit health organizations.
Access to the records must be maintained for the whole retention period.
Forensic medical examinations for sexual assault: retained under s.153.003 of the Act.

If you are closing, selling or relocating your practice
Texas sets out what has to happen to patient records. The points below are taken from the source above.

22 TAC s.163.4, PHYSICIAN RESPONSIBILITIES WHEN LEAVING A PRACTICE: on retirement, termination of employment, or leaving a practice, a physician must give patients reasonable notice to obtain copies or arrange transfer, BY BOTH (1) LETTER OR EMAIL TO EACH PATIENT SEEN IN THE LAST TWO YEARS, AND (2) POSTING A NOTICE IN A CONSPICUOUS LOCATION IN THE OFFICE AND ON THE PRACTICE WEBSITE AT LEAST 30 DAYS BEFORE the termination, leaving, sale or relocation.
S.163.4(b) - the notice must include the date of termination/retirement/departure; instructions on how patients may obtain or transfer records; the name and location of any new practice; and THE NAME OF ANOTHER LICENSED PHYSICIAN, PRACTICE, OR CUSTODIAN IF OWNERSHIP OF RECORDS IS CHANGING.
S.163.4(c) - if the licence is surrendered or revoked the notice must be given IMMEDIATELY. s.163.4(d) exempts locum tenens under six months, physicians who treated the patient only in a hospital, emergency room, birthing centre or ambulatory surgery centre, and physicians who provided only anesthesia, radiology or pathology. s.163.4(e) - the practice must supply the departing physician a list of patients seen in the last two years for notice purposes, and is not itself required to give the notice.
22 TAC s.163.5, APPOINTMENT OF RECORD CUSTODIAN OF A PHYSICIAN'S RECORDS. Under s.159.0061 of the Act the custodian is: on PHYSICIAN DEATH, the administrator, executor of the estate or other court-appointed individual, unless part of a group practice or pre-existing appointments or instructions are in place; on MENTAL OR PHYSICAL INCAPACITY, the individual with Power of Attorney, a court-appointed individual, or a legally appointed representative; in OTHER CIRCUMSTANCES OR ABANDONMENT OF RECORDS, determined case by case.
S.163.5(b) - A RECORDS CUSTODIAN MUST: (1) maintain the confidentiality of the medical records; (2) WITHIN 30 DAYS OF APPOINTMENT give notice of the custodianship TO THE BOARD AND TO PATIENTS by posting visible notice in the practice office if accessible, posting notice on a physician or practice website if accessible, or publishing in the NEWSPAPER OF GREATEST GENERAL CIRCULATION IN THE COUNTY where the practice was located; (3) RETAIN THE RECORDS FOR AT LEAST 90 DAYS BEFORE DESTROYING ANY, INCLUDING THE 30-DAY NOTICE PERIOD; and (4) include in the notice the NAME OF THE CUSTODIAN AND CONTACT INFORMATION, instructions for obtaining or transferring records, ALL APPLICABLE FEES INCLUDING AN ADDITIONAL $25.00 CUSTODIAL FEE AS APPLICABLE, and a statement that records may be destroyed after 90 days WITH THE DESTRUCTION DATE STATED.
Texas therefore does three things no other state does together: it names the custodian role in its own rule, it puts duties directly on the custodian rather than only on the physician, and it authorises a specific $25.00 custodial fee.

Texas closing-practice checklist
The same requirements as a checklist you can print and work through, with the retention periods, the notice each rule requires and what you may charge for copies.
Open the Texas checklist →

Cost

Paper: a maximum of $25.00 for the first 20 pages and 50 cents per page thereafter.
Electronic: a maximum of $25.00 for 500 pages or less, $50.00 for more than 500 pages.
Hybrid records may use the fee for each format. Affidavit: maximum $15.00. Narrative in lieu of records: maximum $20.00. Actual postage if mailed.
A records custodian may charge an additional $25.00 custodial fee, as applicable.
A request must be answered WITHIN 15 DAYS. A provider may NOT deny a records request because of a delinquent account or money owed, and may not require a subpoena where a proper request is made.

Reflects Chapter 163 as adopted 9 January 2025 (50 TexReg 333). Verified September 2026

Also referred to above
22 TAC s.163.3, s.163.4 and s.163.5 (requests, leaving a practice, appointment of record custodian)

This page summarises the source above and is not legal advice. Retention periods change and several states adjust their copying fees every year, so confirm the current text before you rely on a date or a figure.