Skip to main content
Patient Protect circular logo mark in purple and white used for site navigationPatient Protect

HIPAA compliance for therapy practices in Colorado

Colorado keeps obligations of its own alongside HIPAA, with different recipients and triggers from the federal rules. Beyond that, Colorado has 7 recorded rules that apply to therapy practices differently from other businesses in the state — set out below with their conditions and sources.

Colorado jurisdiction record verified against primary state authority August 2026. General reference, not legal advice.

Does this reach your practice?

Two questions have to be settled before any state rule matters: whether HIPAA reaches a practice like yours, and whether Colorado's own law reaches a practice that HIPAA already covers.

Federal — is this practice a covered entity

A therapy practice is a HIPAA covered entity when it or a service acting for it electronically conducts an HHS-adopted standard transaction, such as a claim or eligibility inquiry. Cash-pay status alone does not answer the question. Covered practices must complete every duty below; non-covered practices may still be governed by state mental-health privacy, professional, and contractual requirements.

State — how Colorado law interacts with HIPAA

Colorado substitutes federal notice for part of its scheme but keeps a residual state duty of its own. Therapy practices operating here should expect both a federal and a state obligation, with different recipients and triggers.

Colorado Attorney General guidance under § 6-1-716 provides that an entity regulated under HIPAA or another applicable state or federal regime may generally comply with § 6-1-716 by following its primary regulator's notification procedures, subject to two express exceptions: (a) Colorado AG notice under § 6-1-716 is still required when the breach affects 500 or more Colorado residents, and (b) where federal and state notice periods differ, the shorter period applies. The Colorado AG has specifically noted that HIPAA's potential 60-day individual-notice window does not override Colorado's 30-day outer bound — a HIPAA-regulated entity must therefore notify Colorado residents within 30 days even if HIPAA alone would allow up to 60. Colorado also maintains the Colorado Privacy Act (CPA, C.R.S. §§ 6-1-1301 et seq.) which imposes independent obligations on controllers of personal data.

What Colorado adds for therapy practices specifically

Rules that exist because of the combination — not federal HIPAA, which applies the same way everywhere, and not Colorado's general breach law, which applies the same way to every business in the state.

Minor consent to treatment

Minor may consent

A mental health professional may provide psychotherapy services to a minor who is twelve years of age or older without parental consent, where the professional determines that the minor is knowingly and voluntarily seeking the services and that provision of them is clinically indicated and necessary to the minor's well-being. A minor may not refuse psychotherapy services where the professional and the parent or guardian agree the services are in the minor's best interest.

Provider class
a mental health professional as defined in § 12-245-203.5(1), including licensed professionals and candidates
Service
outpatient psychotherapy services as defined in § 12-245-202(14)(a)
Patient population
minors aged 12 and older
Setting
outpatient only — the section excludes inpatient psychotherapy services

More than one provision may apply

The interaction arises for one fact pattern: a minor aged fifteen or older receiving OUTPATIENT PSYCHOTHERAPY. Below fifteen, only § 12-245-203.5 reaches them; for mental health services that are not outpatient psychotherapy, only § 27-65-104 does. Where both are facially in play the two parental-disclosure provisions differ materially — a conditional ladder with a documentation duty against an unconditional permission. Both sections open with notwithstanding language and neither states which governs, so for that population both should be evaluated rather than one assumed to displace the other.

What this means operationally

The consent runs one way only. A twelve-year-old can start therapy without a parent, and cannot stop it once the professional and the parent agree it is in their interest — so the record has to distinguish which of those two situations it is in. The definition of mental health professional is also unusually wide here, reaching candidates and school social workers, so eligibility to rely on the section is broader than a license check would suggest.

Applies when

  • The minor is 12 or older
  • The service is outpatient psychotherapy
  • The professional determines the minor is knowingly and voluntarily seeking the services
  • The professional determines the services are clinically indicated and necessary to the minor's well-being

Exceptions

  • Does not extend to inpatient psychotherapy services
  • A minor may not refuse services the professional and the parent agree are in the minor's best interest
State statuteColo. Rev. Stat. § 12-245-203.5(1)–(2), (6)Minors aged 12 and olderVerified 2026-08-29

Minor may consent

A minor who is fifteen years of age or older may consent to receive mental health services, with or without the consent of a parent or legal guardian, rendered by a facility, a professional person, or a mental health professional licensed under parts 3, 4, 5, 6 or 8 of article 245 of title 12, in any practice setting. Such consent is not subject to disaffirmance because of minority.

Provider class
a facility, a professional person, or a mental health professional licensed under parts 3, 4, 5, 6 or 8 of article 245 of title 12
Service
mental health services
Patient population
minors aged 15 and older

More than one provision may apply

The interaction arises for one fact pattern: a minor aged fifteen or older receiving OUTPATIENT PSYCHOTHERAPY. Below fifteen, only § 12-245-203.5 reaches them; for mental health services that are not outpatient psychotherapy, only § 27-65-104 does. Where both are facially in play the two parental-disclosure provisions differ materially — a conditional ladder with a documentation duty against an unconditional permission. Both sections open with notwithstanding language and neither states which governs, so for that population both should be evaluated rather than one assumed to displace the other.

What this means operationally

Fifteen here, twelve for outpatient psychotherapy under § 12-245-203.5. The two provisions set different ages against differently described services, so a practice offering both has more than one age threshold to hold in mind rather than a single Colorado number. The phrase 'in any practice setting' is also doing work: unlike the psychotherapy provision, this one is deliberately not narrowed by setting.

Applies when

  • The minor is 15 or older
  • The services are mental health services rendered by a qualifying facility or professional
State statuteColo. Rev. Stat. § 27-65-104(1)Minors aged 15 and olderVerified 2026-08-29

Provider disclosure to a parent

Provider may disclose, subject to a test

Where a minor seeks psychotherapy on their own behalf, the professional may notify the parent or guardian of the services given or needed with the minor's consent, unless notification would be inappropriate or detrimental to the minor's care, and may notify the parent without the minor's consent where, in the professional's opinion, the minor is unable to manage their own care or treatment.

Provider class
a mental health professional as defined in § 12-245-203.5(1)
Service
psychotherapy services a minor sought on their own behalf
Patient population
minors aged 12 and older

More than one provision may apply

The interaction arises for one fact pattern: a minor aged fifteen or older receiving OUTPATIENT PSYCHOTHERAPY. Below fifteen, only § 12-245-203.5 reaches them; for mental health services that are not outpatient psychotherapy, only § 27-65-104 does. Where both are facially in play the two parental-disclosure provisions differ materially — a conditional ladder with a documentation duty against an unconditional permission. Both sections open with notwithstanding language and neither states which governs, so for that population both should be evaluated rather than one assumed to displace the other.

What this means operationally

Two permissions, not one: notification WITH the minor's consent is the ordinary route and is itself defeasible where notifying would be inappropriate or detrimental, while notification WITHOUT consent turns on a clinical judgment that the minor cannot manage their own care. Neither is a duty. The affirmative duty in this section — to discuss and encourage involvement — is recorded separately, because conflating a permission with an obligation is precisely what leads staff to notify when they only may.

Applies when

  • The minor sought psychotherapy on their own behalf under § 12-245-203.5(2)(a)

Exceptions

  • Notification with the minor's consent is withheld where it would be inappropriate or detrimental to care
  • Notification without the minor's consent is available only where the minor is unable to manage their own care
  • A serious threat of imminent physical violence triggers the separate notification provisions of § 13-21-117(2)
State statuteColo. Rev. Stat. § 12-245-203.5(3), (7)Minors aged 12 and older receiving psychotherapy on their own consentVerified 2026-08-29

Provider may disclose

The professional person or licensed mental health professional rendering mental health services to a minor may, with or without the consent of the minor, advise the minor's parent or legal guardian of the services given or needed.

Provider class
the professional person or licensed mental health professional rendering the services
Service
mental health services under § 27-65-104
Patient population
minors aged 15 and older

More than one provision may apply

The interaction arises for one fact pattern: a minor aged fifteen or older receiving OUTPATIENT PSYCHOTHERAPY. Below fifteen, only § 12-245-203.5 reaches them; for mental health services that are not outpatient psychotherapy, only § 27-65-104 does. Where both are facially in play the two parental-disclosure provisions differ materially — a conditional ladder with a documentation duty against an unconditional permission. Both sections open with notwithstanding language and neither states which governs, so for that population both should be evaluated rather than one assumed to displace the other.

What this means operationally

No test attaches to this permission — the Texas rule rather than the Maryland one. It sits in the same state as the heavily conditioned psychotherapy notification rule under § 12-245-203.5, which reads very differently. Both sections open with notwithstanding language, and an older minor receiving outpatient psychotherapy can face them both, so a Colorado practice should expect to evaluate more than one provision rather than assume a single parental-disclosure rule applies.

Applies when

  • The minor is receiving mental health services under § 27-65-104
State statuteColo. Rev. Stat. § 27-65-104(1)Minors aged 15 and older receiving mental health servicesVerified 2026-08-29

Provider must disclose

The professional shall engage the minor in a discussion about the importance of involving and notifying the minor's parent or guardian, and shall encourage such notification.

Provider class
a mental health professional as defined in § 12-245-203.5(1)
Service
psychotherapy services a minor sought on their own behalf
Patient population
minors aged 12 and older

More than one provision may apply

The interaction arises for one fact pattern: a minor aged fifteen or older receiving OUTPATIENT PSYCHOTHERAPY. Below fifteen, only § 12-245-203.5 reaches them; for mental health services that are not outpatient psychotherapy, only § 27-65-104 does. Where both are facially in play, this duty to discuss and encourage parental involvement has no counterpart in § 27-65-104, which states an unconditional disclosure permission instead. Neither section says which governs and both open with notwithstanding language, so for that population both should be evaluated rather than one assumed to displace the other.

What this means operationally

The one unconditional obligation in the Colorado provision, and it runs toward the MINOR rather than toward the parent. It is satisfied by a conversation, not by a disclosure — so a practice can meet it in full while still telling the parent nothing. Staff who read the section as a single block tend to collapse this into the notification permissions beside it and conclude they are expected to contact the parent, which the statute does not say.

Applies when

  • The minor sought psychotherapy on their own behalf under § 12-245-203.5(2)(a)
State statuteColo. Rev. Stat. § 12-245-203.5(3)(b)Minors aged 12 and older in self-sought psychotherapyVerified 2026-08-29

Provider must disclose

A mental health professional shall fully document when they attempt to contact or notify the minor's parent or legal guardian and whether the attempt was successful or unsuccessful, or the reason why in their opinion it would be inappropriate to contact or notify the parent. Where the minor sought psychotherapy on their own behalf, that documentation must be included in the minor's clinical record ALONG WITH A WRITTEN STATEMENT SIGNED BY THE MINOR indicating that the minor is voluntarily seeking psychotherapy services.

Provider class
a mental health professional as defined in § 12-245-203.5(1)
Service
psychotherapy services a minor sought on their own behalf

More than one provision may apply

The interaction arises for one fact pattern: a minor aged fifteen or older receiving OUTPATIENT PSYCHOTHERAPY. Below fifteen only § 12-245-203.5 reaches them; for mental health services that are not outpatient psychotherapy only § 27-65-104 does. Where both are facially in play the unresolved question is which SECTION governs the episode, and every rule derived from § 12-245-203.5 travels with that question — including this one, which § 27-65-104 has no counterpart to. Both sections open with notwithstanding language and neither states which governs, so for that population both should be evaluated rather than one assumed to displace the other.

What this means operationally

The signed statement is the part a practice is most likely to miss, because nothing about the clinical encounter produces it. Colorado does not merely require the professional to record a judgment that the minor is knowingly and voluntarily seeking services — it requires the MINOR's own signed statement to that effect in the chart. Without it, the consent basis for the whole episode is undocumented no matter how well the reasoning was written up.

Applies when

  • The minor sought psychotherapy services on their own behalf under § 12-245-203.5(2)(a)
State statuteColo. Rev. Stat. § 12-245-203.5(4)Minors aged 12 and older in self-sought psychotherapyVerified 2026-08-29

Provider must disclose

If a minor receiving psychotherapy services under § 12-245-203.5 communicates a serious threat of imminent physical violence against a specific person or persons — including a person identifiable by their association with a specific location or entity — the mental health professional is subject to the notification provisions of § 13-21-117(2) AND shall notify the minor's parent or legal guardian, unless notifying the parent or legal guardian would be inappropriate or detrimental to the minor's care and treatment.

Provider class
a mental health professional as defined in § 12-245-203.5(1)
Service
psychotherapy services under § 12-245-203.5

More than one provision may apply

The interaction arises for one fact pattern: a minor aged fifteen or older receiving OUTPATIENT PSYCHOTHERAPY. Below fifteen only § 12-245-203.5 reaches them; for mental health services that are not outpatient psychotherapy only § 27-65-104 does. Where both are facially in play the unresolved question is which SECTION governs the episode, and every rule derived from § 12-245-203.5 travels with that question — including this one, which § 27-65-104 has no counterpart to. Both sections open with notwithstanding language and neither states which governs, so for that population both should be evaluated rather than one assumed to displace the other.

What this means operationally

Two distinct notifications arise from one event and they are owed to different people: the § 13-21-117(2) duty runs toward the person threatened, and this one runs toward the parent. Only the second is defeasible. It is worth stating precisely because the Legislative Council's own issue brief describes this provision as triggered by a minor communicating an intent to commit SUICIDE; the statute is about a threat of violence against a specific other person, and a practice policy written from the brief would fire on the wrong event and miss the right one.

Applies when

  • The minor communicates a serious threat of imminent physical violence against a specific person

Exceptions

  • Parental notification is excused where it would be inappropriate or detrimental to the minor's care and treatment
State statuteColo. Rev. Stat. § 12-245-203.5(7)Minors receiving psychotherapy under § 12-245-203.5Verified 2026-08-29

Each rule above was read against the cited source on the date shown. General reference for compliance planning, not legal advice — confirm current text before relying on it.

Colorado breach obligations

These apply to businesses generally rather than to therapy practices in particular, and they are shown after applicability because whether they reach you depends on the answer above.

Coloradobreach data →

Individual notice deadline

In the most expedient time possible, without unreasonable delay, and within 30 days after the date of determination that a security breach has occurred, subject to the specified law-enforcement delay.

The outer bound of 30 days is materially shorter than HIPAA's 60-day individual-notice window. Federal and state duties apply independently.

State regulator notice

Required at 500+ residents

If a security breach is reasonably believed to have affected 500 or more Colorado residents, the covered entity must provide notice to the Colorado Attorney General using the Data Breach Reporting Form.

Source: Colo. Rev. Stat. § 6-1-716 (material 30-day breach regime enacted by HB18-1128, effective September 1, 2018; further amended by HB26-1426, effective August 12, 2026 — see notes for currency detail)

Statewide rules that also reach therapy practices

Minor may consent

A minor eighteen years of age or older, or a minor fifteen years of age or older who is living separate and apart from a parent or legal guardian — with or without their consent — and is managing their own financial affairs regardless of the source of income, or any minor who has contracted a lawful marriage, may consent to organ or tissue donation or to the furnishing of hospital, medical, dental, emergency health and surgical care to themselves. The consent is not subject to disaffirmance because of minority, and the minor has the same rights, powers and obligations as if they had attained majority. Parental consent is not necessary, and no hospital, physician, surgeon, dentist, trained emergency health-care provider or their agent or employee who in good faith relies on such a minor's consent is liable for civil damages for failure to secure the parent's consent.

What this means operationally

The Colorado route that reaches beyond behavioral health — it names dental and surgical care expressly and is not tied to a service list. Fifteen is a lower age floor than the equivalent status routes in Texas, Virginia and Washington, all of which use sixteen. The good-faith reliance protection names dentists and trained emergency health-care providers among those covered, so it is not confined to physicians.

Applies when

  • The minor is 15 or older, living separate and apart from a parent, and managing their own financial affairs
  • Or the minor has contracted a lawful marriage

Exceptions

  • Except as otherwise provided in §§ 15-19-204, 18-1.3-407(4.5) and 25-4-409
StatewideColo. Rev. Stat. § 13-22-103(1), (2)Minors 15 and older living apart and self-supporting, and married minorsVerified 2026-08-29

Payment liability

The parent, parents or legal guardian of a minor described in § 13-22-103(1) shall not be liable to pay the charges for care provided to the minor on that minor's consent, unless the parent, parents or legal guardian agrees to be so liable.

What this means operationally

Colorado uses an AGREEMENT test rather than California's or Maryland's participation test, which puts it alongside Massachusetts at the stricter end: a parent who drives the minor to the appointment, or who is the insurance subscriber, has not agreed to pay. The agreement has to be obtained, which makes it a front-desk step and not an inference from the demographic record.

Applies when

  • Care was provided on the consent of a minor described in § 13-22-103(1)

Exceptions

  • A parent or guardian who agrees to be liable is liable
StatewideColo. Rev. Stat. § 13-22-103(2), payment clauseMinors who consented under § 13-22-103(1)Verified 2026-08-29

Duty to keep an accurate record

For the purposes of § 25-1-802, MEDICAL INFORMATION TRANSMITTED DURING THE DELIVERY OF HEALTH CARE VIA TELEMEDICINE, as defined in § 12-240-104(10), IS PART OF THE PATIENT'S MEDICAL RECORD maintained by a health-care provider.

What this means operationally

This closes the gap a practice would otherwise argue: material generated in a telehealth encounter is not ancillary correspondence, it is the medical record, and every access, copying, format, timing and inspection-logging duty in the section reaches it. The practical consequence is about systems rather than policy — where a telemedicine platform holds session data outside the EHR, that data is still the record and must be retrievable and producible on the same clocks. A practice that cannot export from its telehealth vendor has a records problem, not a vendor problem.

Applies when

  • Health care is delivered via telemedicine as defined in § 12-240-104(10)
StatewideColo. Rev. Stat. § 25-1-802(5)Patients, personal representatives and authorized third-party requestersVerified 2026-08-30

Parental right of access

Every patient record in the custody of an enumerated licensed provider, EXCEPT records withheld in accordance with 45 C.F.R. 164.524(a), MUST BE AVAILABLE to the patient or the patient's personal representative UPON SUBMISSION OF A VALID AUTHORIZATION FOR INSPECTION OF RECORDS, DATED AND SIGNED BY THE PATIENT, at reasonable times and upon reasonable notice. A SUMMARY of records pertaining to a patient's MENTAL HEALTH PROBLEMS may, upon written request accompanied by a signed and dated authorization, be made available to the patient or personal representative FOLLOWING TERMINATION OF THE TREATMENT PROGRAM.

What this means operationally

Colorado requires a signed, dated authorization even for the patient inspecting their OWN record, which is unusual and is a real workflow difference from states where a patient's own request needs no form. Practices should hold a compliant inspection-authorization form rather than treating a verbal or emailed ask as sufficient. The mental-health limb is narrower than it looks twice over: what is available is a SUMMARY rather than the record, and it is available only AFTER the treatment program has terminated, so a patient in active treatment has no route to it under this section.

Applies when

  • A patient or personal representative submits a signed, dated authorization to inspect records held by an enumerated provider

Exceptions

  • Records withheld in accordance with 45 C.F.R. § 164.524(a)
  • Mental health records yield only a summary, and only after the treatment program terminates
StatewideColo. Rev. Stat. § 25-1-802(1)(a)Patients and patients' personal representativesVerified 2026-08-30

Duty to keep an accurate record

ALL REQUESTS by a patient or the patient's personal representative for inspection of their medical records SHALL BE NOTED WITH THE TIME AND DATE OF THE REQUEST AND THE TIME AND DATE OF INSPECTION by the health-care provider or the provider's designated representative. The patient or personal representative SHALL ACKNOWLEDGE THE INSPECTION BY DATING AND SIGNING THE RECORD FILE. A health-care provider SHALL NOT CHARGE A FEE FOR THE INSPECTION of medical records.

What this means operationally

This creates a record ABOUT the record, and it is the duty Colorado practices most often have no system for. Four data points must be captured — request time, request date, inspection time, inspection date — and the patient must physically sign the file to acknowledge having seen it. An electronic portal that logs a view but collects no signature does not satisfy the acknowledgment limb. Note the fee rule: inspection is free, which is distinct from copying, so a practice that charges a records-handling fee merely to let someone look at their chart is charging for something the statute forbids.

Applies when

  • A patient or personal representative requests inspection of their medical records
StatewideColo. Rev. Stat. § 25-1-802(4)Patients and patients' personal representativesVerified 2026-08-30

Parental right of access

A COPY of the records, INCLUDING RADIOGRAPHIC STUDIES, must be made available to the patient or personal representative upon request and payment of the fee A COVERED ENTITY MAY IMPOSE IN ACCORDANCE WITH HIPAA, or to a THIRD PERSON who requests the records upon submission of a HIPAA-compliant authorization, a valid subpoena, or a court order, and payment of reasonable fees. FOR A REQUEST NOT EXCEEDING SIX HUNDRED SIXTY-FOUR PAGES, the fees charged to a third person SHALL NOT EXCEED THE REASONABLE FEES.

What this means operationally

Colorado does not write its own per-page schedule for patient requests — it adopts the HIPAA covered-entity fee by reference, so the federal cost-based limit is the operative constraint and a practice tracking only state law will look in the wrong place. The six-hundred-and-sixty-four-page threshold is the hinge for third-party requests: at or below it, reasonable fees; above it, the separate attorney cap applies. That specific number is worth building into the billing workflow, because it is where the rule changes character.

Applies when

  • A patient, personal representative or authorized third person requests copies of records

Exceptions

  • Nothing requires disclosure of information privileged, confidential or protected from discovery or admission under state or federal law, including under §§ 12-30-204 and 25-3-109 or 42 U.S.C. § 1320c
StatewideColo. Rev. Stat. § 25-1-802(1)(b)(I)(A), (1)(e)Patients and patients' personal representativesVerified 2026-08-30

Deadline to respond to an access request

An INVOICE for all records provided in response to a request for medical records MUST BE PROVIDED TO THE REQUESTOR WITHIN THIRTY DAYS of receiving a valid request, and the records must be provided UPON PAYMENT of the invoice. If a health-care provider is UNABLE to provide access within thirty days, the provider MAY EXTEND the time frame by AN ADDITIONAL THIRTY DAYS, and MUST NOTIFY THE REQUESTOR IN WRITING of the extension WITHIN THE INITIAL THIRTY-DAY PERIOD. A RECORD NOT PROVIDED WITHIN THIRTY DAYS, OR WITHOUT WRITTEN NOTIFICATION OF A THIRTY-DAY EXTENSION, MUST BE PROVIDED TO THE REQUESTOR AT NO COST, absent an independent intervening FORCE MAJEURE that renders the requested records inaccessible, irretrievable or undeliverable within the required time frame. Where a force majeure event prevents compliance, the provider shall give WRITTEN NOTICE as soon as reasonably practicable but NOT LATER THAN FIVE BUSINESS DAYS after becoming aware of the event; the thirty-day period recommences upon RESOLUTION of the event; the provider shall notify the requestor within five business days after resolution; and all notices must be DELIVERED IN THE SAME FORMAT IN WHICH THE REQUEST WAS RECEIVED. Force majeure means a factor outside the parties' control that makes performance impossible or impracticable as a result of an event the parties could not have anticipated or controlled.

What this means operationally

The sanction is the point: miss thirty days without a written extension notice and the records become FREE. That converts a records backlog from an administrative annoyance into direct revenue loss, and it is self-executing rather than requiring a complaint. Two traps follow. The extension notice must go out INSIDE the first thirty days — a notice on day thirty-one preserves nothing — and it must be written. The force majeure route is real but tightly policed: notice within five business days of becoming aware, a fresh thirty days only from RESOLUTION, a second notice within five business days of resolution, and every notice delivered in the same format the request arrived in, so an emailed request cannot be answered by post.

Applies when

  • A valid request for medical records is received

Exceptions

  • An independent intervening force majeure event, with written notice within five business days of the provider becoming aware of it
StatewideColo. Rev. Stat. § 25-1-802(1)(d)(II), (III), (IV)Patients, personal representatives and authorized third-party requestersVerified 2026-08-30

Parental right of access

As used in § 25-1-802, PATIENT RECORD DOES NOT INCLUDE A DOCTOR'S OFFICE NOTES.

What this means operationally

A single sentence that removes a whole class of material from every access, copying, format and timing duty in the section. It is narrower than the federal psychotherapy-notes exclusion and differently drawn — it turns on the material being office notes rather than on a separately maintained psychotherapy record — and Colorado does not define the term further, so the boundary between a clinical entry and an office note is left to the practice. That ambiguity cuts both ways and should not be leaned on: a practice that classifies substantive clinical content as office notes to avoid disclosure is making a judgement no authority in this section supports.

Applies when

  • A request under § 25-1-802 would otherwise reach a doctor’s office notes
StatewideColo. Rev. Stat. § 25-1-802(3)Patients, personal representatives and authorized third-party requestersVerified 2026-08-30

Limit on copy fees, format or delivery

The health-care provider MUST provide the medical records IN ELECTRONIC FORMAT if the person requests electronic format, the ORIGINAL medical records ARE STORED IN ELECTRONIC FORMAT, and the medical records ARE READILY PRODUCIBLE in electronic format. The provider SHALL DELIVER the medical records in electronic format, upon request and payment of the fees, where those three conditions are met.

What this means operationally

Three conditions, all of which must hold, and the middle one is the one practices misread: the ORIGINAL must be stored electronically. A paper chart later scanned to satisfy a request is not an original stored in electronic format, so a practice with paper originals owes paper. Conversely a fully electronic practice cannot insist on printing. Readily producible refers to the system's actual capability, so a format the EHR genuinely cannot export is outside the duty — but inconvenience is not incapability.

Applies when

  • A requester asks for electronic format, the originals are stored electronically, and the records are readily producible in that format
StatewideColo. Rev. Stat. § 25-1-802(1)(b)(I)(B), (1)(d)(I)Patients and patients' personal representativesVerified 2026-08-30

Limit on copy fees, format or delivery

If a licensed health-care professional determines that a COPY of a radiographic study, including an X ray, mammogram, CT scan, MRI or other film, IS NOT SUFFICIENT for diagnostic or other treatment purposes, the enumerated practitioner SHALL MAKE THE ORIGINAL of any radiographic study AVAILABLE to the patient, the personal representative, a person authorized by the patient, or another health-care professional or facility as specifically directed, pursuant to a HIPAA-compliant authorization and upon payment of the reasonable fees. If a practitioner releases an original radiographic study, THE PRACTITIONER IS NOT RESPONSIBLE for any loss, damage or other consequences as a result of the release. Any original radiographic study made available MUST BE RETURNED UPON REQUEST TO THE LENDING PRACTITIONER WITHIN THIRTY DAYS.

What this means operationally

The trigger is a clinical judgement by a licensed professional that a copy will not do, which means the practice cannot be compelled to surrender originals on request alone. Two protections follow that are worth relying on: releasing the original carries no liability for loss or damage, and the original is RETURNABLE within thirty days of a request to return it. A practice lending films should log the loan and the return date, because the thirty-day clock is the only lever it has to get a diagnostic original back into a record it must still retain.

Applies when

  • A licensed health-care professional determines a copy of a radiographic study is insufficient for diagnostic or treatment purposes
StatewideColo. Rev. Stat. § 25-1-802(1)(b)(II)Patients and patients' personal representativesVerified 2026-08-30

Limit on copy fees, format or delivery

The TOTAL SUM of fees that a health-care provider may charge and collect for a record request made by AN ATTORNEY WHO REPRESENTS THE PATIENT, or the attorney of the patient's personal representative, pursuant to a HIPAA-compliant authorization, a valid subpoena or a valid court order, IF THE REQUESTED RECORD EXCEEDS SIX HUNDRED SIXTY-FOUR PAGES, MUST NOT EXCEED FOUR HUNDRED DOLLARS. That cap DOES NOT APPLY if a health-care provider is REQUIRED TO SEGREGATE, WITHHOLD OR REDACT protected health information from the requested record to comply with applicable law.

This changes on 2028-01-01

The figure in this proposition changes on 1 January 2028 and biennially after. The four-hundred-dollar amount is a floor as well as the current cap, so the rule never moves downward, but any published guidance quoting four hundred dollars will be stale from that date and the operative number will be the one the Secretary of State publishes rather than one stated in statute.

What this means operationally

A hard dollar ceiling, not a per-page rate, and it bites exactly where large-volume litigation requests do. Two boundaries decide whether it applies at all: the requester must be the patient's own attorney rather than any third party, and the record must exceed 664 pages — at or below that threshold the ordinary reasonable-fee rule governs instead. The redaction carve-out is the practical escape and it is narrower than it reads: it applies where segregation or redaction is REQUIRED by law, not where the practice chooses to review the file, so a routine privilege check does not lift the cap.

Applies when

  • An attorney representing the patient or the personal representative requests a record exceeding 664 pages under a HIPAA authorization, subpoena or court order

Exceptions

  • Does not apply where the provider is required by law to segregate, withhold or redact protected health information from the requested record
  • Does not apply to requests at or below 664 pages, which are governed by the reasonable-fee rule
StatewideColo. Rev. Stat. § 25-1-802(1)(b)(III), (1)(c)Patients, personal representatives and authorized third-party requestersVerified 2026-08-30

What applies to therapy practices everywhere

Behavioral health practices hold information whose exposure can affect a patient's employment, family relationships, safety, custody matters, reputation, and willingness to continue treatment. The SRA must reflect the sensitivity and the actual way therapy is delivered.

The EHR or practice-management system and the access available to clinicians, supervisors, billing personnel, and administrative staff
Telehealth platforms, clinician home offices, personal or practice-issued devices, local networks, waiting rooms, chat logs, and recordings
Patient portals, scheduling tools, intake forms, email, text messaging, and after-hours communication
The creation, separation, storage, access, and disclosure of psychotherapy notes when the practice maintains them
Supervision, peer consultation, case-review, and group-therapy documentation workflows
Billing services, payment systems, cloud storage, backup, transcription, and other vendors that handle PHI on the practice's behalf
Full therapistscompliance guide →

Knowing the Colorado rule is not the same as meeting it.

The risk assessment asks what your practice actually does — which systems hold records, who reaches them, which vendors touch them — and reports against the obligations that apply to you, including the Colorado rules on this page.

Start the risk assessment