Updated February 2026

The best AI therapy note generator for 2026.

Ranked by HIPAA compliance architecture, input method, note format support, and clinical accuracy. Because "AI-powered" and "HIPAA-compliant" do not mean the same thing.

BAA verification 6 note formats compared Written by a Registered Psychotherapist

Direct answer

For text-input, privacy-first workflows: Reframe Practice ranks first. It has a signed Business Associate Agreement with Google Vertex AI, zero-retention processing architecture, and 10 free notes per month with no account required. For recording-based workflows, Quill or Mentalyc are the strongest compliant options. AutoNotes is not recommended for clinical documentation: it has no BAA and its terms of service prohibit uploading PHI.

At a glance

ToolBAAInputFree tierPriceFormats
Reframe Practice #1Text10/mo$0 / $296
QuillTextNone$204+
MentalycRecordingNone$293+
UphealVideoNoneHigher2+
AutoNotes ⚠TextTrial$196

⚠ AutoNotes has no BAA and prohibits PHI in its ToS. Not recommended for clinical documentation.

Detailed rankings

Each tool evaluated on HIPAA compliance architecture, input method, note format coverage, pricing, and clinical usefulness.

#1

Reframe Practice

Best for: text-input, HIPAA by architecture, free tier

BAA availableFree (10/mo) + $29/mo

Strengths

  • Signed BAA with Google Vertex AI
  • Zero-retention — data never stored on servers
  • 10 free notes/month, no account required
  • All 6 note formats included
  • Built by a Registered Psychotherapist
  • Includes worksheets, session prep, thinking partner

Limitations

  • –Text-input only — no recording option
  • –Pro features require subscription

Verdict: Strongest for therapists who want true HIPAA compliance without a monthly bill to start.

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#2

Quill

Best for: text-input with full HIPAA compliance

BAA available$20/mo

Strengths

  • BAA available
  • Clean text-input workflow
  • Competitive $20/month pricing
  • Reliable note quality

Limitations

  • –No free tier
  • –Fewer note formats than Reframe
  • –No worksheet or session prep tools

Verdict: Solid text-input alternative. Good if you want a dedicated note tool without extras.

Full comparison
#3

Mentalyc

Best for: session recording with structured output

BAA available$29/mo

Strengths

  • BAA available
  • Audio recording with clean transcript
  • Good format support for recording-based workflow

Limitations

  • –Recording required — no text-input option
  • –Privacy exposure inherent in recording
  • –$29/month no free tier

Verdict: Good choice if your workflow is recording-based and you want a purpose-built note tool.

Full comparison
#4

Upheal

Best for: live video sessions with note generation

BAA availableHigher tier

Strengths

  • BAA available
  • Integrates with live video sessions
  • Session insights alongside notes

Limitations

  • –Higher price point
  • –Designed around video — requires platform adoption
  • –Overkill for text-input users

Verdict: Best if you already use their video platform. Not worth switching for notes alone.

Full comparison
#5

AutoNotes

Not recommended for clinical PHI

No BAA$19/mo

Strengths

  • Affordable at $19/month
  • Multiple format support
  • Text-input workflow

Limitations

  • –No Business Associate Agreement
  • –ToS prohibits uploading PHI without stripping identifiers
  • –Not legally usable for standard clinical records

Warning: Cannot recommend for standard therapy documentation. No BAA = HIPAA violation risk.

Full comparison

"HIPAA-compliant" is not a feature. It is an architecture.

The difference between tools is not whether they claim HIPAA compliance. It is whether the architecture makes data exposure structurally impossible.

Business Associate Agreement

A BAA is a legal contract between you and the AI vendor. Without one, you cannot legally share PHI with that service. A privacy policy is not a BAA.

Zero-retention processing

Session data processed in-memory and never written to storage means a breach cannot expose your clients' records. Architecture, not just policy.

AI subprocessor BAAs

If a tool uses OpenAI, Google, or Anthropic to process your data, those vendors also need BAAs. Ask which models process your session data.

Recording vs text-input: which should you choose?

Both approaches can be compliant. The right choice depends on your workflow and your clients.

Text-input

You type a brief session summary after the appointment. You control exactly what information enters the system.

Best for

  • Private practice therapists
  • Clients sensitive to recording
  • Trauma-informed care
  • Therapists who write notes after sessions

Tools: Reframe Practice, Quill, AutoNotes (no BAA)

Audio recording

You record a dictation or the session audio after the fact. Requires explicit client consent and recording disclosures.

Best for

  • Therapists with high note volume
  • Practices with consent protocols
  • Dictation-style documentation

Tools: Mentalyc, some Quill tiers

Live session recording

The tool records the live session video or audio and generates notes automatically. Highest consent and disclosure requirements.

Best for

  • Telehealth-first practices
  • Practices with robust consent infrastructure
  • Training programs and supervision

Tools: Upheal

Note formats: which one is right for your practice?

Reframe Practice supports all six major therapy note formats. Each has a dedicated generator with clinical examples, FAQ, and format-specific guidance.

SOAP Notes

Subjective, Objective, Assessment, Plan. Standard across healthcare.

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DAP Notes

Data, Assessment, Plan. Common in outpatient mental health.

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BIRP Notes

Behavior, Intervention, Response, Plan. Session-focused for CBT/DBT.

Try free

GIRP Notes

Goal, Intervention, Response, Plan. Goal-oriented and EHR-friendly.

Try free

PIRP Notes

Problem, Intervention, Response, Plan. Preferred in substance abuse settings.

Try free

Narrative Notes

Unstructured prose. Common in psychodynamic and relational approaches.

Try free

Frequently asked questions

What is the best free AI therapy note generator?

Reframe Practice offers the strongest free tier for HIPAA-compliant therapy note generation: 10 progress notes per month with no account required, and no credit card. It supports SOAP, DAP, BIRP, GIRP, PIRP, and Narrative formats. The architecture uses zero-retention processing with a signed Business Associate Agreement with Google Vertex AI, meaning session data is never stored on servers.

Which AI note generators do not require session recording?

Text-input note generators include Reframe Practice (free + $29/mo, BAA signed) and Quill ($20/mo, BAA available). These work by having the therapist type a brief session summary after the appointment ends. No microphone, no recording, no transcript. AutoNotes also uses text-input but does not have a BAA and is not recommended for PHI.

Which therapy note generators have a Business Associate Agreement?

Reframe Practice, Quill, Mentalyc, and Upheal all offer Business Associate Agreements. AutoNotes does not offer a BAA and explicitly prohibits uploading PHI in their terms of service. Always request and sign the BAA before using any tool with real client information.

Is it safe to use AI to write therapy notes?

AI therapy note generators with a signed BAA and zero-retention architecture can be used safely under HIPAA. Tools without a BAA cannot legally receive PHI. Text-input workflows carry less inherent risk than recording-based tools because the therapist controls exactly what information is entered. The clinician remains responsible for reviewing and signing all AI-generated notes.

What note formats do AI therapy note generators support?

Most tools support SOAP and DAP at minimum. Reframe Practice supports all six major formats: SOAP, DAP, BIRP, GIRP, PIRP, and Narrative. The right format depends on your setting and clinical approach. SOAP is standard in integrated care; BIRP and GIRP suit structured CBT/DBT sessions; PIRP is preferred in substance abuse programs; Narrative is common in psychodynamic and relational approaches.

How much do AI therapy note generators cost?

Reframe Practice: free (10 notes/month) or $29/month for unlimited. Quill: $20/month. AutoNotes: $19/month (no BAA, not recommended). Mentalyc: $29/month. Upheal: higher tier pricing. The key cost factor beyond subscription is HIPAA liability: tools without BAAs create legal risk that outweighs subscription savings.

Can I use ChatGPT to write therapy notes?

ChatGPT's consumer version does not have a Business Associate Agreement and is not HIPAA compliant. Using it with client PHI violates HIPAA. AI therapy note generators like Reframe Practice are purpose-built for clinical documentation with compliance architecture already in place.

Do AI therapy note generators use my session data to train their AI?

This varies by tool. Reframe Practice uses zero-retention architecture: session data is processed in-memory and never stored. The system does not retain session content and does not use it for training. Check each vendor's BAA and privacy policy carefully. Ask specifically: 'Does your BAA prohibit using my clients' data to train your models?'

Compare by tool

vs Quillvs Mentalycvs Uphealvs AutoNotesvs SimplePracticevs ChatGPTvs Therapist-Aid

Built by a Registered Psychotherapist

Start with 10 free notes. No account required.

SOAP, DAP, BIRP, GIRP, PIRP, or Narrative. Type a session summary. Get a clinical note in seconds. No recording, no signup, no credit card.

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Zero data retention. Signed BAA. Built by a Registered Psychotherapist.