Texas Medical Records Retention Requirements: How Long You Must Keep Patient Records (Adults & Minors)

Texas sets clear record preservation requirements based on provider type and whether the patient was an adult or a minor at the last treatment date. Use the last treatment date as your anchor to calculate the correct record retention period, and apply any longer period required by other laws or contracts.

This guide explains the record retention period for physicians and hospitals, the patient age threshold rules for minors, when a litigation hold pauses destruction, and the compliance notification hospitals must give before medical record disposal.

Physician Record Retention

Adults (18+)

For physicians, the minimum record retention period for adult patients is at least seven years from the last treatment date. Providers must also maintain access to those records throughout the entire retention window, and must keep them longer if another federal or state law or payer contract requires it. ([law.cornell.edu](https://www.law.cornell.edu/regulations/texas/22-Tex-Admin-Code-SS-163-2))

Practical checkpoints

• Confirm the correct “last treatment date” for each patient before starting a destruction review.
• Inventory any contracts or program rules (for example, federal payers) that may extend the preservation timeframe; follow the longest applicable period. ([law.cornell.edu](https://www.law.cornell.edu/regulations/texas/22-Tex-Admin-Code-SS-163-2))

Minor Patient Record Retention

When a patient was younger than 18 at the last treatment date, a physician must retain the record until the patient turns 21 or for seven years after the last treatment date—whichever is later. Example: If you last treated a 16-year-old on March 1, 2021, you must keep the record at least until March 1, 2028 (seven years), which is later than the 21st birthday. ([law.cornell.edu](https://www.law.cornell.edu/regulations/texas/22-Tex-Admin-Code-SS-163-2))

Hospital Record Retention

Hospitals may authorize disposal of a patient’s medical record on or after the 10th anniversary of the last treatment date. This effectively requires a 10-year preservation period for adult hospital records. ([tx.elaws.us](https://tx.elaws.us/law/hs_title4_chapter241_sec.241.103))

Special case: sexual assault forensic exam records

Hospitals have a longer preservation requirement for medical records from forensic sexual-assault examinations—those records may not be destroyed until the 20th anniversary of the record’s creation. ([regulations.justia.com](https://regulations.justia.com/states/texas/title-26/part-1/chapter-505/subchapter-c/section-505-41/?utm_source=openai))

Minor Patient Record Retention in Hospitals

For minor patients treated in a hospital, the record may be disposed of on or after the patient’s 20th birthday or the 10th anniversary of the last treatment date, whichever is later. In practice, this sets a patient age threshold of 20 for hospital records, subject to the “later of” rule. ([tx.elaws.us](https://tx.elaws.us/law/hs_title4_chapter241_sec.241.103))

Records Related to Litigation

A litigation hold pauses routine destruction. Hospitals may not destroy medical records that relate to any matter involved in litigation if the hospital knows the litigation has not been finally resolved. ([tx.elaws.us](https://tx.elaws.us/law/hs_title4_chapter241_sec.241.103))

For physicians, Texas Medical Board rules likewise state that medical records connected to a civil, criminal, or administrative proceeding may be destroyed only after the physician knows the proceeding has been finally resolved. In other words, implement a litigation hold and preserve the record until final resolution, even if the standard retention period has run. Destruction, when allowed, must protect confidentiality. ([casemine.com](https://www.casemine.com/regulation/us/641862f2a084d5318907a830))

Record Disposal Notification

Before disposing of hospital records after the applicable retention periods, hospitals must provide a written compliance notification to the patient or the patient’s legally authorized representative. This notice must be given no later than the date the patient is treated (or as soon as reasonably practicable following emergency treatment) and must state that the hospital may authorize disposal after the statutory periods. ([tx.elaws.us](https://tx.elaws.us/law/hs_title4_chapter241_sec.241.103))

When disposal is authorized, destroy records in a manner that renders protected health information unreadable and irretrievable (for example, secure shredding or incineration) to ensure continued confidentiality. ([casemine.com](https://www.casemine.com/regulation/us/641862f2a084d5318907a830))

Conclusion

In Texas, physicians keep adult records for at least seven years; hospitals keep adult records for 10 years. For minors, physicians retain records until age 21 or seven years from last treatment (whichever is later), while hospitals retain until the 20th birthday or 10 years from last treatment (whichever is later). Apply litigation holds to suspend destruction and, for hospitals, provide the required written notice before medical record disposal. ([law.cornell.edu](https://www.law.cornell.edu/regulations/texas/22-Tex-Admin-Code-SS-163-2))

FAQs

How long must physicians retain adult patient medical records in Texas?

At least seven years from the last treatment date, and longer if another law or contract requires it. Maintain access to the record throughout the retention period. ([law.cornell.edu](https://www.law.cornell.edu/regulations/texas/22-Tex-Admin-Code-SS-163-2))

What is the retention period for minor patient records in Texas hospitals?

Hospitals may dispose of a minor’s record on or after the patient’s 20th birthday or the 10th anniversary of the last treatment date, whichever occurs later. ([tx.elaws.us](https://tx.elaws.us/law/hs_title4_chapter241_sec.241.103))

Are there special rules for retaining records related to litigation?

Yes. Hospitals may not destroy records related to any matter in litigation until the litigation is finally resolved, and physicians may destroy records tied to a civil, criminal, or administrative proceeding only after they know the proceeding has been finally resolved. Maintain a litigation hold until final resolution. ([tx.elaws.us](https://tx.elaws.us/law/hs_title4_chapter241_sec.241.103))

What notification is required before hospitals dispose of patient records?

Hospitals must give patients (or their legally authorized representatives) written notice—no later than the date of treatment, or as soon as practicable after an emergency—that the hospital may authorize disposal after the statutory retention periods. ([tx.elaws.us](https://tx.elaws.us/law/hs_title4_chapter241_sec.241.103))