Is Stripe HIPAA Compliant? A Guide with Best Practices and Compliance Tips

Stripe's HIPAA Compliance Status

Short answer: no—Stripe is not HIPAA compliant for handling Protected Health Information (PHI). Stripe does not act as a Business Associate for its core payments platform and therefore does not provide a Business Associate Agreement (BAA) to cover PHI. Without a BAA, HIPAA-Covered Entities and their business associates cannot use Stripe to create, receive, maintain, or transmit PHI.

It’s essential to distinguish Payment Processing Compliance from HIPAA obligations. Stripe is a PCI Level 1 Service Provider—the highest certification for card security—which protects cardholder data, not medical information. HIPAA applies when PHI is involved, and PCI DSS does not substitute for HIPAA compliance.

In practice, you may still use Stripe in healthcare contexts only when you prevent PHI from entering Stripe. If PHI touches Stripe—whether in API fields, metadata, invoices, receipts, or webhooks—you step outside the permitted use and into HIPAA territory without a BAA, which is not allowed.

Payment Processing Exemption

HIPAA recognizes a narrow “payment processing” exemption for financial institutions. You may route consumer-initiated payments through a processor without a BAA so long as the processor only facilitates the transaction and does not receive PHI beyond what is strictly necessary to complete the payment.

What the exemption allows

• Accepting card or ACH payments for services using generic descriptors (for example, “clinic payment”).
• Transmitting card data and non-medical billing details required by the card networks or banks.
• Using Stripe solely to move funds, not to store clinical details.

What the exemption does not allow

• Including diagnoses, treatment details, procedure codes, test names, appointment dates, medical record numbers, or patient identifiers in any Stripe field.
• Embedding PHI in free-text fields such as description, statement_descriptor, product names, invoice line items, or metadata.
• Exposing PHI via receipts, email notifications, exports, dashboards, or downstream integrations.

If any PHI is shared with Stripe, the exemption no longer applies and a BAA would be required. Because Stripe will not sign a BAA for core payments, you must architect your flows so that PHI never enters Stripe.

Limitations on Stripe's Use

To stay within HIPAA boundaries, you must strictly limit how you use Stripe. Treat every input, log, and export as potentially discoverable and design accordingly.

High‑risk touchpoints to control

• API fields: Avoid PHI in description, metadata, customer fields, invoice items, and refund reasons.
• Invoices and receipts: Use generic billing labels; never reference conditions, visit types, or clinician names tied to treatment.
• Webhooks: Send only non-PHI identifiers (e.g., random order IDs). Do not include patient names, DOB, or clinical details in webhook payloads or URLs.
• Dashboard and exports: Keep exports free of PHI; limit access to staff with a “need to know.”
• Support tickets and screenshots: Redact any patient information before sharing with Stripe or third parties.

Practical do’s and don’ts

• Do use internal, random IDs to link Stripe charges to records stored in your EHR or another BAA-covered system.
• Do configure generic statement descriptors and product names.
• Do minimize data retention in Stripe and routinely purge unnecessary objects.
• Don’t store appointment dates, CPT/ICD codes, lab names, or clinical notes in Stripe.
• Don’t email receipts from Stripe with details that could reveal treatment context.

Stripe's Security Certifications

Stripe maintains mature security controls and certifications focused on payments. As a PCI Level 1 Service Provider, Stripe undergoes rigorous assessments, uses tokenization to limit exposure of card data, and enforces strong encryption in transit and at rest. Stripe also undergoes independent audits such as SOC examinations and maintains information security certifications (for example, ISO/IEC 27001).

These attestations demonstrate robust controls for cardholder data and operational security; they do not make Stripe a HIPAA-compliant platform for PHI. HIPAA and PCI DSS address different risks and obligations under different Data Protection Regulations.

Alternative HIPAA-Compliant Payment Processors

If your workflows require PHI to touch the payment platform, use vendors that will execute a Business Associate Agreement and support HIPAA-grade controls.

• InstaMed (healthcare payments network) — offers healthcare-specific payment tools and BAAs.
• Sphere/TrustCommerce — healthcare-focused processing with tokenization and BAAs.
• Rectangle Health — patient payments and financial tools for providers with BAAs.
• PayJunction — offers BAAs and healthcare-oriented merchant features.
• ClearGage or RevSpring — patient financial engagement tools that include BAAs.

Treat “HIPAA compliant” as shorthand for “will sign a BAA and provide technical/administrative safeguards.” Always validate scope, obtain a signed BAA, and confirm how PHI is stored, transmitted, and retained.

Stripe's Data Handling Practices

Stripe uses tokenization so raw card numbers are vaulted in Stripe’s PCI environment, not your servers. Data is encrypted in transit and at rest, and risk systems may process device and behavioral signals to detect fraud. These capabilities strengthen payment security but are not tied to HIPAA Technical Safeguards unless a BAA is in place—which Stripe does not provide for PHI.

Because Stripe stores object fields, metadata, logs, and webhook payloads, you must assume persistence beyond your immediate transaction. Keep PHI in systems covered by BAAs (such as your EHR), and let Stripe store only what card networks require. Configure minimal data sharing with downstream apps and routinely review retained fields and exports for inadvertent PHI.

Best Practices for HIPAA Compliance

Design for data minimization

• Classify all data elements; keep PHI out of Stripe entirely.
• Map data flows end to end and remove PHI from free-text fields, descriptors, metadata, and receipts.
• Use internal tokens to link payments in Stripe to PHI stored elsewhere under a BAA.

Apply HIPAA Technical Safeguards

• Unique user IDs, least-privilege access, and MFA on all admin accounts.
• Audit controls: centralize logs, monitor webhook usage, and alert on policy violations.
• Integrity and transmission security: enforce TLS, validate webhook signatures, and hash sensitive internal identifiers.

Harden operational processes

• Execute BAAs with every vendor that can access PHI, including analytics and support tools.
• Conduct a risk analysis covering payment flows and Payment Processing Compliance obligations alongside HIPAA requirements.
• Train staff to recognize PHI and avoid entering it into Stripe or support channels.
• Set retention limits; routinely purge unnecessary payment objects and attachments.
• Establish an incident response plan and test it with tabletop exercises.

Key takeaways

• Stripe is suitable for payments only when no PHI is sent to or stored in Stripe.
• The payment processing exemption is narrow—once PHI is involved, a BAA is required.
• If PHI must touch payments, choose a processor that signs BAAs and supports HIPAA controls.

FAQs

Why is Stripe not HIPAA compliant?

Stripe does not sign a Business Associate Agreement for its core payments services. Without a BAA, you cannot use Stripe to create, receive, maintain, or transmit Protected Health Information, even though Stripe meets PCI requirements for cardholder data.

Can Stripe be used for healthcare payment processing?

Yes, but only under the limited payment processing exemption and only if you prevent PHI from entering Stripe. Use generic descriptors, avoid PHI in all fields (including metadata and invoices), and keep clinical details in a BAA-covered system such as your EHR.

What are Business Associate Agreements and why are they important?

A BAA is a contract required by HIPAA when a vendor handles PHI for a covered entity or another business associate. It allocates responsibilities for safeguards, breach notification, and permissible uses, making it a cornerstone of HIPAA compliance for third-party services.

Which payment processors are HIPAA compliant?

Look for vendors that explicitly sign BAAs and support HIPAA Technical Safeguards. Examples include InstaMed, Sphere/TrustCommerce, Rectangle Health, PayJunction, and similar healthcare-focused platforms. Always verify scope and obtain a signed BAA before transmitting any PHI.