What AI clinical notes actually are
An AI clinical note tool sits between your therapy session and your EHR. During or after the session it captures audio (and sometimes video), transcribes it, and uses a language model trained on clinical documentation to draft a structured note (DAP, SOAP, BIRP, or your own template). You review, edit, and sign.
That's it. It is not an autonomous clinician. It does not replace your clinical judgment. It removes the 10–25 minutes of typing that previously sat between back-to-back sessions and your evening.
For a typical caseload of 25 sessions a week, that's roughly 4–8 hours of documentation time recovered per week, about a day. The math is why this category went from niche to mainstream inside 18 months.
What to look for in an AI scribe
Not every product called an "AI scribe" is built for therapy. A useful one for a mental health practice will have all five of the following. Be skeptical of any vendor that skips one.
1. A signed BAA, not just "HIPAA-compliant" marketing
"HIPAA-compliant" appears on every vendor's homepage. What actually matters is whether they will sign a Business Associate Agreement with your practice, and whether the BAA is included in the tier you can afford. A few vendors gate the BAA behind enterprise plans.
2. Templates tuned to therapy, not general medicine
A SOAP note written for an internist looks different from one a therapist signs. Look for vendors that ship therapy-specific templates out of the box: progress notes, treatment plans, intake summaries, group-therapy notes, EMDR-specific formats, IFS parts-work language, and so on. Generic medical scribes will produce notes you spend more time rewriting than you would have spent writing.
3. Clean integration with the EHR you already use
The best AI note in the world is useless if you have to copy-paste it into SimplePractice. The leaders in this category have first-class integrations with the major behavioral-health EHRs:
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SimplePractice
All-in-one practice management for therapists
From $49/moHIPAA-compliant -
TherapyNotes
Complete EHR for behavioral health
From $59/moHIPAA-compliant -
Jane App
Practice management for allied health
From $79/moHIPAA-compliant
If you use any of those (and you probably do), filter the comparison table above to only show tools that integrate with your EHR.
4. A clear, opt-in client consent flow
Recording a therapy session is a different ethical conversation than recording a primary care visit. You will need to:
- Disclose that the session may be recorded
- Explain how the recording is used, retained, and deleted
- Document client consent in your intake paperwork
- Offer an opt-out without penalty
Good vendors give you the language and the workflow to do all four. Mediocre vendors leave it as "your problem."
5. Transparent pricing that doesn't punish growth
Watch for "per clinician" pricing that goes from reasonable at 1 user to painful at 5. If you run a group practice, model out the year-three cost, not the month-one cost.
Common concerns therapists raise
"Will my clients feel uncomfortable being recorded?"
In our reading of dozens of practice case studies, the honest answer is: most clients are fine once you explain what it's for ("so I can be present with you instead of typing"), and a meaningful minority (often clients with trauma histories) will say no. Treat the no as a clinical signal, not a logistics problem. A good AI scribe should let you toggle recording per-session.
"What if the AI gets the note wrong?"
It will, occasionally. The published accuracy rates from the better vendors (Mentalyc, Upheal, Heidi Health and a handful of others) sit in the 90–95% range for clinically-meaningful content, but you are still the signatory. The note you sign is yours. Review every note before signing, especially in the first 30 days while you calibrate to the model's quirks.
"What happens to the audio?"
Different vendors, different answers. The strict-privacy end of the market deletes audio immediately after transcription. The convenience end retains it for 30–90 days so you can re-run summaries. Decide which trade-off your practice can defend before you pick a vendor, and write it into your privacy policy.
Five questions to ask before you sign
- Will you sign a BAA, and is it included in this pricing tier?
- Where is audio stored, for how long, and who else can access it?
- Which behavioral-health EHRs do you have native integrations with?
- Can I export all my data (notes, templates, settings) if I leave?
- What is your typical turnaround time from session end to draft note?
The leaders in this category
The comparison table above is the live, filterable view. As of this writing, the two tools that come up most often in solo and small-group practices are:
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Mentalyc
AI clinical notes for therapists
Free / from $20/moHIPAA-compliant -
Upheal
AI co-pilot for mental health professionals
Free / from $72/moHIPAA-compliant
Both ship a real BAA, both have therapy-specific templates, and both integrate with SimplePractice and TherapyNotes. Pricing is similar; the workflow differences are where you should focus your trial. Most therapists know within a week which one fits their session style.
When AI scribes aren't the right answer
A few practice profiles where the cost-benefit doesn't pencil out:
- Very low session volume (under ~8 sessions/week) where the time saved doesn't justify the monthly fee
- Highly somatic or movement-based modalities where most of the session has no spoken content to transcribe
- Solo couples or family practices where speaker separation across 3+ voices is still rough in 2026
- Anyone whose practice is in a state with two-party-consent recording laws and a client population that will not consent
If that's you, the next category to look at is Intake & Assessment tools, which can claw back documentation time at the front of the relationship instead of the middle.
The table above is updated regularly as new vendors launch and existing ones change pricing. If you spot something out of date, let us know.