AI scribe for psychiatrists: an honest comparison for prescribers

By Selam Koch, PMHNP-BC, founder of OneStep Scribe and practicing psychiatric nurse practitioner. Published July 2026.

Full disclosure before anything else: OneStep Scribe is my product. I founded it because none of the tools I tried were designed around a prescriber's E/M-plus-add-on note. A team of talented engineers and providers builds it, and every release is proven in daily use at my own psychiatric practice in Cranford, New Jersey, before any other clinician sees it. So this comparison is written by a vendor, and you should weigh it that way. What I can promise is this: every claim about a competitor below comes from that vendor's own public website as of July 2026, with no editorializing about quality, and I will tell you plainly where another tool may fit your practice better than mine.

Why prescriber notes are different

A therapist's progress note and a psychiatric prescriber's note are different documents with different audit exposure. When you prescribe, your note has to support an E/M level selected on medical decision making: the diagnoses you managed, the data you reviewed, the risk of the medications you touched. It has to capture medication decisions and the risk-benefit conversation behind them. On many visits it also has to carry a separately documented psychotherapy add-on, most commonly 90833, with its own time statement and its own recognizably therapeutic content. Add standardized scales like the PHQ-9 and GAD-7, and DSM-5-TR criteria supporting the diagnosis, and you have a document that a SOAP or DAP template was never designed to produce.

An AI scribe built around talk-therapy note formats will transcribe your visit accurately. That is not the hard part. The hard part is whether the draft comes out shaped like a prescriber's note: E/M portion standing on MDM, add-on section separated with a minute count, therapy content that reads as therapy rather than medication counseling. I wrote up exactly what that structure looks like, field by field, in the annotated 90833 note example. If you bill add-on codes, read that before you evaluate any scribe, including mine.

What to demand from any AI scribe, including ours

• Prescriber-shaped note structure. A full E/M note plus a clearly separated psychotherapy add-on section when you provided one. If the vendor cannot show you a sample, generate one in a trial and look at it.
• Session-specific language. The draft should quote your patient's actual words, not produce interchangeable paragraphs. Cloned therapy language across visits is a records-request magnet.
• A BAA. You are sending PHI to a vendor. A Business Associate Agreement is not optional, and you should know which plan tier includes it before you upload a single recording.
• Review-and-sign workflow. The AI drafts, you edit and sign, and the vendor is clear that the final note is yours. Any tool that blurs that line is a problem regardless of specialty.
• Transparent limits and pricing. Note caps, session length limits, and the real monthly cost should be published, not discovered on an invoice.

The comparison

OneStep Scribe (our product)

OneStep Scribe is the tool my team built around my own visits, so I will state its focus directly: it is built for mental health, and it is built prescriber-first. The prescriber's note is the hardest case in this specialty, E/M documentation plus, when you provided psychotherapy, a separated, audit-ready 90833 section with an explicit time statement and the patient's own quoted words. A tool that handles that also serves therapists, psychologists, and other mental health clinicians who want the same documentation depth without the E/M layer. It includes standardized scales, a DSM-5-TR criteria reference, and custom templates. Every account is NPI-verified, because the product assumes a licensed clinician is on the other end.

Pricing is $59 per month for Basic and $79 for Pro, with a 14-day trial that does not ask for a card. The honest tradeoff: OneStep is a scribe, not a full practice-management EHR. If you want scheduling, billing, and a client portal all in one product, several tools below are aimed squarely at that work.

Mentalyc

Mentalyc describes itself as "the AI platform and tools for therapists, counselors, and mental health professionals," and its audience per its own site is primarily therapists, counselors, psychologists, and social workers. Its homepage does also state that "psychiatrists and PMHNPs use Mentalyc as AI for psychiatrists, with medication management notes, psychiatric evaluations, and structured MSE documentation," and its pricing page lists psychiatry as a modality on the Pro plan and up, with auto-computed CPT codes on Pro. E/M codes and psychotherapy add-on codes such as 90833 are not published as product features on its homepage or pricing page.

Pricing is published and starts low: plans from $14.99 per month billed annually, with the Pro tier that includes the psychiatry modality at $69.99 monthly or $59.99 billed annually for 160 notes per month. Its site claims HIPAA compliance and SOC 2 Type II certification, and says a signed BAA can be downloaded from account settings. It also claims 30,000+ mental health professionals, named integrations with SimplePractice, TherapyNotes, and Jane App, and a works-with-every-EHR claim. If you run a mixed practice or supervise therapists, that breadth may be exactly the fit.

Upheal

Upheal calls itself "the most loved AI notes for therapists" and an "AI-native EHR built specifically for therapists," and its homepage framing is therapist-exclusive: solo providers, group practices, and virtual care, with a claim of 70,000+ providers. It is more than a scribe by its own description, offering AI treatment plans, a compliance checker, scheduling, telehealth, a client portal, and messaging. There is no prescriber- or psychiatrist-targeted messaging on its homepage or pricing page, though its support center lists psychiatric intake and psychiatric medication management templates, including a "Psychiatric Medication Management + Therapy" template. Specific E/M codes or the 90833 add-on are not published on its product or template pages.

Pricing is unusually simple: $1 per session, capped at $69 per month on the individual plan, with a 30-day trial and no card required. The site states a BAA is provided for every account and claims HIPAA compliance and SOC 2 Type II certification. If you want an all-in-one therapy practice platform rather than a scribe that feeds your existing EHR, Upheal's own positioning says that is the product it is building.

Freed

Freed positions itself as "the AI scribe and Front Desk giving time back to independent clinics," serving clinicians across 30+ specialties, from family medicine to OB/GYN. It is a deliberately broad, multi-specialty tool by its own framing. It does maintain a dedicated psychiatry page that calls Freed "Psychiatry's #1 AI Scribe," describing chart-ready SOAP notes and the ability to upload your own templates. Freed also advertises a general Coding Assistant with "optimized ICD-10, CPT, and E/M codes," available on its Premier plan, but the psychiatry page itself does not mention E/M levels, add-on codes like 90833, or medication management workflows; those specifics are not published for psychiatry.

Published pricing: Starter at $39 per month with a 40-note cap, Core at $79 with unlimited notes, and Premier at $104 to $119 with EHR push and coding. There is a 7-day trial with no card. The site claims HIPAA compliance and SOC 2 certification, states Freed does not store patient recordings, and says an organization-wide BAA is available for group plans; individual-plan BAA terms are not published on the pages I reviewed. If your clinic spans multiple specialties, a generalist scribe like this may be the practical choice.

Heidi Health

Heidi describes itself as "your AI care partner for modern clinical practice" and serves a similarly broad audience by its own account: primary care, specialists, nurses, allied health, dentists, and veterinarians. Its mental health solutions page does name psychiatrists explicitly, says Heidi is "trained on the language, context, and clinical complexity of behavioral health," and lists psychiatric intake, progress note, and risk assessment templates. Its homepage mentions coding and CDI capabilities, and its Practice tier lists a coding feature, but nothing specific about E/M levels, psychotherapy add-on codes, or medication management visit workflows is published.

Heidi's pricing page lists Free, Clinician, and Practice tiers with 14-day trials on the paid tiers, but current per-tier US dollar prices are not published in the page content I could review. The site claims HIPAA compliance with a dedicated safeguards page, SOC 2 Type 2 and ISO 27001 certifications, and a public trust center; a BAA section exists on the HIPAA page, though which accounts receive one is not published there. For a clinician who works across settings and languages, Heidi's breadth is its stated strength.

Twofold Health

Twofold is the competitor whose public site speaks most directly to prescribers. It positions itself as a multi-specialty AI scribe with heavy mental health emphasis, and its psychiatry page, headlined "Best AI Medical Scribe for Psychiatry," claims over 4,600 psychiatric prescribers use it. That page explicitly references E/M codes 99213 to 99215, add-on codes 90833, 90836, and 90838, and evaluation codes 90791 and 90792, plus visit-over-visit tracking of PHQ-9, GAD-7, AIMS, and PCL-5, and documentation of PDMP review for controlled substances. Credit where due: that is genuine prescriber-facing depth stated on their own site.

Published pricing: a free tier with a 7-day full-access trial, and a Personal plan at $69 monthly or $49 billed annually, with custom group pricing. The site states HIPAA compliance with a BAA on every plan including the free tier, no raw audio storage, and no PHI used for model training. The fit difference with OneStep is focus: Twofold's site describes a broad multi-specialty platform, from pediatrics to veterinary medicine, with psychiatry as one specialty page among many, where OneStep is a mental-health-only tool designed prescriber-first from the first line of code, built and iterated inside a working psychiatric clinic.

Side by side

Frequently asked questions

Do general medical AI scribes work for psychiatry?

They transcribe psychiatric visits fine; transcription is a solved problem. The question is structure. Generalist vendors do not publish psychiatry-specific claims about separating psychotherapy add-on time from E/M work, quoting the patient in the therapy section, or framing the assessment against DSM-5-TR criteria, as of July 2026. So before you count on the time savings, generate a few drafts in a trial and check whether they do those things, because restructuring a draft by hand is the time you were trying to buy back.

What should psychiatric NPs specifically look for?

Everything in the checklist above, plus two PMHNP-specific items: does the vendor verify you are a licensed clinician (OneStep verifies NPI at signup), and does the drafted add-on section survive the audit tests in the 90833 guide: separate minute count, named modality, interventions that read as therapy, and the patient's response.

Does OneStep Scribe offer a BAA?

Yes. A BAA is available where applicable, and because accounts are NPI-verified, we know a licensed prescriber is on the other end of every account before PHI moves.

How do I switch scribes without losing my workflow?

Do not switch cold. Run the new scribe alongside your current one on a handful of visits during the trial, then compare the notes you actually signed: which draft needed less restructuring, which add-on section you would defend in an audit, which one quoted your patient. The signed note is the product; judge it there.

This article is educational only and is not legal, billing, or payer-specific advice; it does not guarantee reimbursement. CPT is a registered trademark of the American Medical Association. The comparison is based on each vendor's public website as of July 2026; features and pricing change, so verify current details with each vendor directly. All trademarks and product names are the property of their respective owners. No vendor named here endorsed, reviewed, or is affiliated with this article. OneStep Scribe is the author's product; weigh this comparison accordingly.