HIPAA Notice of Privacy Practices for Therapists

Solo therapists, LCSWs, psychologists, and licensed counselors are HIPAA covered entities if they transmit health information electronically (most do, through billing or insurance claims). That means you need a Notice of Privacy Practices that complies with 45 CFR § 164.520 — posted on your website, provided at intake, and posted at your physical practice location.

Are you a HIPAA covered entity?

You are a covered entity if you electronically transmit any of these standard transactions: health care claims, eligibility verification, referral authorizations, claim status requests, enrollment, or payment/remittance advice. If your practice accepts insurance — even a single payer — you almost certainly transmit one of these electronically and are a covered entity.

Cash-only practices that never touch electronic claims may not be covered entities. But if you use an EHR, telehealth platform, or any third party that submits claims on your behalf, you are still covered.

Psychotherapy notes — the special case

HIPAA gives psychotherapy notes extra protection. Defined at § 164.501, psychotherapy notes are process notes kept separate from the regular medical record. Most uses and disclosures of psychotherapy notes require a separate written authorization from the patient, over and above the general NPP. The generator captures this and includes appropriate language.

What if you treat SUD clients?

If your practice is a 42 CFR Part 2 program (federally-assisted program that holds itself out as providing SUD diagnosis, treatment, or referral), you are subject to Part 2 in addition to HIPAA. The 2024 Part 2 Final Rule permits a single combined HIPAA/Part 2 notice. If you provide general therapy services with occasional SUD clients (without specializing in SUD care) you are generally not a Part 2 program.

Distribution for solo practices

• At first service: provide the NPP to each new client at intake
• Website: post on your practice website (required)
• Physical site: post in the waiting room or on a prominent sign
• Acknowledgment: make a good-faith effort to get written acknowledgment; document refusals