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BILLING QUESTION

George Posted Fri 10th of February, 2017 12:22:04 PM
What can we charge for a copy of radiology films? Theses would include mammogram films, ultrasound films or xray films. Is there a standard cost for these or a maximum cost?
SuperCoder Answered Mon 13th of February, 2017 04:32:19 AM

This query is under discussion. We will get back to you soon. Thank you.

SuperCoder Answered Mon 13th of February, 2017 04:32:19 AM
This query is under discussion. We will get back to you soon. Thank you.
SuperCoder Answered Mon 13th of February, 2017 08:14:29 AM

Thanks for your question.  Medical record fees and limitations are based on individual state statutes.  The Department of Health and Human Services takes the following stance on medical records fees: The Privacy Rule permits a covered entity to impose a reasonable, cost-based fee if the individual requests a copy of the PHI (or agrees to receive a summary or explanation of the information).  The fee may include only the cost of: (1) labor for copying the PHI requested by the individual, whether in paper or electronic form; (2) supplies for creating the paper copy or electronic media (e.g., CD or USB drive) if the individual requests that the electronic copy be provided on portable media; (3) postage, when the individual requests that the copy, or the summary or explanation, be mailed; and (4) preparation of an explanation or summary of the PHI, if agreed to by the individual.  See 45 CFR 164.524(c)(4).  The fee may not include costs associated with verification; documentation; searching for and retrieving the PHI; maintaining systems; recouping capital for data access, storage, or infrastructure; or other costs not listed above even if such costs are authorized by State law. Below is a link to this resource.

https://www.hhs.gov/hipaa/for-professionals/privacy/guidance/access/index.html#maximumflatfee

There are a few legal sites that publish individual state statutes.  We were unable to find 2017 statutes for all states, but several of the states have 2016 fees and limitations.  Please see the links below:

https://medicopy.net/who-we-are/blog/guide-of-state-statutes-for-copies-of-medical-records

http://www.lamblawoffice.com/medical-records-copying-charges/

https://www.nosscr.org/state-medical-records-payment-rates

Thanks again for your question and we hope this information helps.

SuperCoder Answered Mon 13th of February, 2017 08:14:29 AM
This query is under discussion. We will get back to you soon. Thank you.

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