Why do doctors still use fax?

In our reading, doctors still use fax because electronic exchange still misses many offices they deal with, and HHS allows faxing patient information for treatment. In 2025, 40% of U.S. non-federal general acute care hospitals often sent summary of care records to outside providers by mail or fax, ASTP/ONC reports. As of November 2026, CMS's electronic prior authorization API requirement for many health plans isn't in effect yet. CMS gives payers until "primarily January 1, 2027" to meet its API requirements.

How much U.S. healthcare still uses fax

The most useful government numbers we found come from HHS's health IT office, ASTP/ONC, which funds the American Hospital Association's IT survey. ASTP/ONC describes the question as how often hospitals use each method for "a summary of care record" when a patient moves to or from outside care.

The years are ASTP/ONC's labels. Its 2018 figures come from a survey fielded from January to May 2019. Its 2021 figures come from the 2020 survey, fielded from April to September 2021.

Adding ASTP/ONC's "often" and "sometimes" rows gives about 74% of hospitals sending records by mail or fax often or sometimes in 2025. For receiving, the sum is about 81%. Both are our sums of two rounded figures.

Two limits apply if you quote these figures. The survey asks about mail and fax together, so it can't show fax alone. The AHA's 2025 survey form also words the question differently. It asks about sending or receiving "patient health information in a structured format" when a patient moves to or from outside care.

For doctors' offices, the newest federal figure we found is from 2019. That year, 35% of office-based physicians used only fax, mail or e-fax to share patient information with providers outside their organization. Only 10% sent, received, found and integrated records electronically, the four parts ONC counts as interoperability. The source is ONC Data Brief No. 59, published in 2022 from a CDC survey.

We found no government or standards-body figure for the share of all healthcare communication that goes by fax, so we don't give one. ONC's briefs also leave e-fax out of electronic exchange. Its 2023 hospital data brief counts records as sent electronically only if they didn't go by eFax. The AHA's 2025 form also lists "eFax using EHR" and "Mail or fax" as separate methods. In our reading, the 2025 mail-or-fax figures above may therefore leave out faxes sent from a hospital's records system.

Why healthcare still uses fax

In an August 2018 speech, then-CMS Administrator Seema Verma described "a technological Tower of Babel" in which systems "speak different languages" and records aren't interoperable. She said doctors "are still faxing patient records." She challenged the developers in the room to make "every doctor's office in America a fax free zone by 2020."

ONC's 2023 hospital data brief shows where the gaps are. Fewer than 1 in 5 hospitals sent summary of care records to most or all of their long-term and post-acute care providers, ONC reports. The same held for behavioral health providers. ONC said this likely reflects, in part, those providers' "limited exchange capabilities." Small, rural, critical access and independent hospitals also exchanged records electronically less often.

Federal rules also allow fax. HHS's HIPAA guidance lets providers share patient information for treatment by fax, with reasonable safeguards. Our medical cover sheet page sums up what HHS says about faxing health information. CMS's fact sheet on its 2024 prior authorization rule lists fax among the ways payers may communicate denials. Our history guide covers that under where U.S. agencies still list fax.

In our reading, there are practical reasons too. Many offices have a fax number, and a fax needs no shared records system between the two sides. It also arrives as a page, which suits offices that still run on paper. Our guide to how a fax machine works explains the shared standard behind that.

The federal rules moving healthcare off fax

None of the federal rules we read bans fax. In our reading, they work by requiring an electronic route next to it, with the main deadlines in 2026 and 2027.

Who the 2024 CMS rule covers

CMS-0057-F covers Medicare Advantage organizations, state Medicaid and CHIP programs and their managed care plans, and Qualified Health Plan issuers on the federal Marketplace.

This page explains public federal guidance and data. It isn't legal advice.

Need to fax a form or a letter yourself? You can upload PDFs or photos on this website, and you don't need an account. As of November 2026, a fax of up to 40 pages costs $2.49 here, to any fax number in the US or Canada. For paper pages, the FaxFair iPhone app scans them with the camera.

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