North Carolina medical records laws

How North Carolina differs from federal HIPAA

• Sets explicit tiered per-page caps ($0.75 / $0.50 / $0.25) and a minimum fee up to $10; HIPAA's cost-based limit and ban on search/retrieval fees still apply to patients' own requests.
• No state response deadline; HIPAA's 30 days applies.
• Hospitals must keep adult records 11 years and minors' records until age 30 — longer than many states.

How long a provider has to respond

North Carolina law sets no deadline for giving patients their records (the Medical Board asks for release 'in a timely manner'), so HIPAA applies: 30 days, with one 30-day extension if the provider explains the delay in writing.(NC Medical Board Position Statement 3.2.1 (Compendium, July 2026), 45 CFR 164.524)

Under 45 CFR § 164.524, a provider may take one 30-day extension only if it tells you in writing, within the first 30 days, why and when you will get the records.

What a provider can charge

G.S. 90-411 caps copy fees at 75 cents per page for the first 25 pages, 50 cents per page for pages 26–100 and 25 cents per page after that, with a minimum fee of up to $10 that includes copying. For a patient's own access request, federal HIPAA also limits fees to reasonable cost-based charges and does not allow search or retrieval fees.(N.C. Gen. Stat. § 90-411 (last amended 2019), 45 CFR 164.524)

Paper copies

$0.75/page for pages 1–25, $0.50/page for pages 26–100, $0.25/page over 100; minimum fee up to $10

minimum fee (inclusive of copying costs), max

Up to $10.00

Electronic copies

No separate state rate for electronic copies found; HIPAA's reasonable cost-based fee rules apply to patient access requests

A provider cannot refuse to give you your records because you owe money for treatment. Compare every state on the medical records fees by state page.

How long records must be kept

• Hospitals: 11 years after discharge for records made while the patient was an adult; records made while the patient was a minor until the patient's 30th birthday; on closure, stored for 11 years (or the minor rule)(10A NCAC 13B .3903 (readopted eff. Aug. 1, 2023))

Minors and sensitive records

• Minors: Hospitals must keep records made while a patient was a minor until the patient's 30th birthday. For mental health, developmental disability and substance abuse records, a minor's legally responsible person (usually a parent) has access subject to G.S. 90-21.4(b) and the same harm-based limits that apply to clients.(10A NCAC 13B .3903 (readopted eff. Aug. 1, 2023), N.C. Gen. Stat. § 122C-53(c), (d))
• mental health: Clients of mental health, developmental disability and substance abuse facilities have a right to their records on request, except information the attending physician (or facility director) determines would be injurious to the client's physical or mental well-being; withheld information can be sent to a physician or psychologist of the client's choice.(N.C. Gen. Stat. § 122C-53(c), (d))
• substance use: Substance abuse treatment records are covered by the same G.S. 122C-53 access rule; federally assisted programs are also subject to 42 CFR Part 2.(N.C. Gen. Stat. § 122C-53(c), (d))

If a provider doesn't comply

• North Carolina Medical Board

  physicians and other Board licensees · 1-800-253-9653 (ext. 501)

• HHS Office for Civil Rights

  HIPAA violations by any covered entity, within 180 days

How to request your records in North Carolina

1. Ask the provider's medical records (health information) department for its request form, or write your own request with your name, date of birth, dates of care, the records you want, and the format (paper or electronic).
2. Keep a copy and note the date — the 30 days (HIPAA) clock runs from when the provider receives it.
3. If the deadline passes or the bill exceeds the rules above, use the complaint routes on this page.

Templates and step-by-step help are on the records-access hub. Find a North Carolina hospital's records office, or browse hospitals in North Carolina.

Common questions about North Carolina medical records