Under the Health Insurance Portability and Accountability Act (HIPAA),
psychotherapy notes that are kept separate from the rest of the patient's
medical record are held to a higher level of confidentiality and cannot be
released to insurers, including Medicare, without written patient
Psychotherapy notes are defined by law as not including the
following information (which are considered to be part of the patient's
These bulleted items can be released without a separate written
authorization from the patient.