What is Protected Health Information (PHI)?

The Privacy Rule protects all “individually identifiable health information” held or transmitted by a covered entity, its business associates or business associates’ subcontractors, in any form or media, whether electronic, paper, or oral.

The Privacy Rule refers to this information as "Protected Health Information (PHI).”

PHI is information, including demographic data, that relates to:

  • the individual’s past, present or future physical or mental health or condition,
  • the provision of health care to the individual, or
  • the past, present, or future payment for the provision of health care to the individual, and that identifies the individual or can be used to identify the individual.

Health care means care, services, or supplies related to the health of an individual.

Health care includes, but is not limited to, the following:

  • Preventive, diagnostic, therapeutic, rehabilitative, maintenance, or palliative care, and counseling, service, assessment, or procedure with respect to the physical or mental condition, or functional status, of an individual or that affects the structure or function of the body; and
  • Sale or dispensing of a drug, device, equipment, or other item in accordance with a prescription. 

When is Health Information NOT Protected by HIPAA?

The health information described above is NOT PHI, if:

  • the information is NOT received from a HIPAA-covered entity AND the person receiving the information is NOT workforce of a HIPAA-covered entity,
  • the information is part of the employment records that a covered entity maintains solely in its capacity as an employer (e.g. employee leave information, FMLA documents, return to work documentation, accommodation records),
  • the information is part of the education records subject to, or defined in, the Family Educational Rights and Privacy Act (FERPA),
  • the health information is about individuals who have been deceased for more than 50 years,
  • the information is de-identified, as defined by HIPAA:  

the following identifiers of the individual or of relatives, employers, or household members of the individual, are removed:

    • Names;
    • All geographic subdivisions smaller than a State, including street address, city, county, precinct, zip code, and their equivalent geocodes, except for the initial three digits of a zip code if, according to the current publicly available data from the Bureau of the Census:
      • The geographic unit formed by combining all zip codes with the same three initial digits contains more than 20,000 people; and
      • The initial three digits of a zip code for all such geographic units containing 20,000 or fewer people is changed to 000.
    • All elements of dates (except year) for dates directly related to an individual, including birth date, admission date, discharge date, date of death; and all ages over 89 and all elements of dates (including year) indicative of such age, except that such ages and elements may be aggregated into a single category of age 90 or older;
    • Telephone numbers;
    • Fax numbers;
    • Electronic mail addresses;
    • Social security numbers;
    • Medical record numbers;
    • Health plan beneficiary numbers;
    • Account numbers;
    • Certificate/license numbers;
    • Vehicle identifiers and serial numbers, including license plate numbers;
    • Device identifiers and serial numbers;
    • Web Universal Resource Locators (URLs);
    • Internet Protocol (IP) address numbers;
    • Biometric identifiers, including finger and voice prints;
    • Full face photographic images and any comparable images; and
    • Any other unique identifying number, characteristic, or code, except as permitted by the Privacy Rule;

and,

the covered entity does not have actual knowledge that the information could be used alone or in combination with other information to identify an individual who is a subject of the information.