22 Tex. Admin. Code § 165.2

Medical record release and charges

A physician must furnish copies or a summary or narrative of medical and/or billing records requested in accordance with a patient or representative's written release of the information, within 15 business days after receiving such release. The physician may deny access to information if he or she determines that it would be harmful to the patient's physical, mental, or emotional health. The physician may withhold access to any part of the record that is confidential information about another patient or a family member of the patient who has not consented to release of the information. If the physician denies a request for records in whole or in part, the physician must notify the patient in writing within 15 days after receiving the request for access, stating the reasons for the denial and instructing the patient on how to file a complaint. A copy of this notification must be placed in the patient's medical and/or billing records as appropriate. 

A physician may charge a reasonable, cost-based fee for providing requested information that may include charges for copying, including labor and cost of supplies, postage (if the individual has requested that the information be mailed), and preparing a summary of the records when appropriate, but may not include costs associated with searching for and retrieving information. The total fee may be up to $25 for pages 1-20, and up to $0.50 per page for pages 21 and above. The physician may charge separate fees for requested medical and billing records, and may withhold the records until payment is made, unless the information is requested by a health care provider licensed in Texas or a physician licensed anywhere in the United States or Canda, or if the information is requested for purposes of emergency or acute medical care. If payment for the record is not submitted with the request for the record, the physician must notify the requesting party of the need for payment within 10 calendar days of receiving the request. A copy of this notification  must be made part of the patient's medical and/or billing record as appropriate. A physician may not withhold records because of a past due account for medical care or treatment. A physician may not charge a fee for records requested in relatoin to a benefits or assistance claim based on the patient's disability. 

If the physician transmits information in electronic form, the physician may be subject to the HIPAA rules governing access to records.