Tex. R. Evid. 509

Physician–Patient Privilege

sha256 566a005b94bd23209821bb41d8915746… · retrieved 7/15/2026, 8:29:35 PM · Supreme Court of Texas official rules PDF — txcourts.gov, verbatim · verified 8/5/2026 by TXEV-1 July reconcile (artifact-proven, dual-sourced)

Rule 509. Physician–Patient Privilege
(a) Definitions. In this rule:
(1) A “patient” is a person who consults or is seen by a physician for medical care.
(2) A “physician” is a person licensed, or who the patient reasonably believes is licensed,
to practice medicine in any state or nation.
(3) A communication is “confidential” if not intended to be disclosed to third persons
other than those:
(A) present to further the patient’s interest in the consultation, examination, or
interview;
(B) reasonably necessary to transmit the communication; or
(C) participating in the diagnosis and treatment under the physician’s direction,
including members of the patient’s family.
(b) Limited Privilege in a Criminal Case. There is no physician–patient privilege in a criminal
case. But a confidential communication is not admissible in a criminal case if made:
(1) to a person involved in the treatment of or examination for alcohol or drug abuse; and
(2) by a person being treated voluntarily or being examined for admission to treatment
for alcohol or drug abuse.
(c) General Rule in a Civil Case. In a civil case, a patient has a privilege to refuse to disclose
and to prevent any other person from disclosing:
(1) a confidential communication between a physician and the patient that relates to or
was made in connection with any professional services the physician rendered the
patient; and
(2) a record of the patient’s identity, diagnosis, evaluation, or treatment created or
maintained by a physician.
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(d) Who May Claim in a Civil Case. The privilege may be claimed by:
(1) the patient; or
(2) the patient’s representative on the patient’s behalf.
The physician may claim the privilege on the patient’s behalf—and is presumed to have
authority to do so.
(e) Exceptions in a Civil Case. This privilege does not apply:
(1) Proceeding Against Physician. If the communication or record is relevant to a claim
or defense in:
(A) a proceeding the patient brings against a physician; or
(B) a license revocation proceeding in which the patient is a complaining witness.
(2) Consent. If the patient or a person authorized to act on the patient’s behalf consents
in writing to the release of any privileged information, as provided in subdivision (f).
(3) Action to Collect. In an action to collect a claim for medical services rendered to the
patient.
(4) Party Relies on Patient’s Condition. If any party relies on the patient’s physical,
mental, or emotional condition as a part of the party’s claim or defense and the
communication or record is relevant to that condition.
(5) Disciplinary Investigation or Proceeding. In a disciplinary investigation of or
proceeding against a physician under the Medical Practice Act, Tex. Occ. Code §
164.001 et seq., or a registered nurse under Tex. Occ. Code § 301.451 et seq. But the
board conducting the investigation or proceeding must protect the identity of any
patient whose medical records are examined unless:
(A) the patient’s records would be subject to disclosure under paragraph (e)(1);
or
(B) the patient has consented in writing to the release of medical records, as
provided in subdivision (f).
(6) Involuntary Civil Commitment or Similar Proceeding. In a proceeding for
involuntary civil commitment or court-ordered treatment, or a probable cause hearing
under Tex. Health & Safety Code:
(A) chapter 462 (Treatment of Persons With Chemical Dependencies);
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(B) title 7, subtitle C (Texas Mental Health Code); or
(C) title 7, subtitle D (Persons With an Intellectual Disability Act).
(7) Abuse or Neglect of “Institution” Resident. In a proceeding regarding the abuse or
neglect, or the cause of any abuse or neglect, of a resident of an “institution” as
defined in Tex. Health & Safety Code § 242.002.
(f) Consent For Release of Privileged Information.
(1) Consent for the release of privileged information must be in writing and signed by:
(A) the patient;
(B) a parent or legal guardian if the patient is a minor;
(C) a legal guardian if the patient has been adjudicated incompetent to manage
personal affairs;
(D) an attorney appointed for the patient under Tex. Health & Safety Code title
7, subtitles C and D;
(E) an attorney ad litem appointed for the patient under Tex. Estates Code title 3,
subtitle C;
(F) an attorney ad litem or guardian ad litem appointed for a minor under Tex.
Fam. Code chapter 107, subchapter B; or
(G) a personal representative if the patient is deceased.
(2) The consent must specify:
(A) the information or medical records covered by the release;
(B) the reasons or purposes for the release; and
(C) the person to whom the information is to be released.
(3) The patient, or other person authorized to consent, may withdraw consent to the
release of any information. But a withdrawal of consent does not affect any
information disclosed before the patient or authorized person gave written notice of
the withdrawal.
(4) Any person who receives information privileged under this rule may disclose the
information only to the extent consistent with the purposes specified in the consent.
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Notes and Comments
Comment to 1998 change: This comment is intended to inform the construction and application of
this rule. Prior Criminal Rules of Evidence 509 and 510 are now in subparagraph (b) of this Rule.
This rule governs disclosures of patient-physician communications only in judicial or administrative
proceedings. Whether a physician may or must disclose such communications in other circumstances
is governed by TEX. REV. CIV. STAT. ANN. art. 4495b, § 5.08. Former subparagraph (d)(6) of
the Civil Evidence Rules, regarding disclosures in a suit affecting the parent-child relationship, is
omitted, not because there should be no exception to the privilege in suits affecting the parent-child
relationship, but because the exception in such suits is properly considered under subparagraph
(d)(4), as construed in R.K. v. Ramirez, 887 S.W.2d 836 (Tex. 1994). In determining the proper
application of an exception in such suits, the trial court must ensure that the precise need for the
information is not outweighed by legitimate privacy interests protected by the privilege.
Subparagraph (d) does not except from the privilege information relating to a nonparty patient who
is or may be a consulting or testifying expert in the suit.
Comment to 2015 Restyling: The physician–patient privilege in a civil case was first enacted in
Texas in 1981 as part of the Medical Practice Act, formerly codified in Tex. Rev. Civ. Stat. art.
4495b. That statute provided that the privilege applied even if a patient had received a physician’s
services before the statute’s enactment. Because more than thirty years have now passed, it is no
longer necessary to burden the text of the rule with a statement regarding the privilege’s retroactive
application. But deleting this statement from the rule’s text is not intended as a substantive change
in the law.
The former rule’s reference to “confidentiality or” and “administrative proceedings” in subdivision
(e) [Exceptions in a Civil Case] has been deleted. First, this rule is a privilege rule only. Tex. Occ.
Code § 159.004 sets forth exceptions to a physician’s duty to maintain confidentiality of patient
information outside court and administrative proceedings. Second, by their own terms the rules of
evidence govern only proceedings in Texas courts. See Rule 101(b). To the extent the rules apply
in administrative proceedings, it is because the Administrative Procedure Act mandates their
applicability. Tex. Gov’t Code § 2001.083 provides that “[i]n a contested case, a state agency shall
give effect to the rules of privilege recognized by law.” Section 2001.091 excludes privileged
material from discovery in contested administrative cases.
Statutory references in the former rule that are no longer up-to-date have been revised. Finally,
reconciling the provisions of Rule 509 with the parts of Tex. Occ. Code ch. 159 that address a
physician-patient privilege applicable to court proceedings is beyond the scope of the restyling
project.

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