Charting: HIPAA Progress Note

Charting is an important process, and this article reviews the HIPAA progress note chart template.

new_releases Recent changes to this template

We've added some new fields for insurance requirements, saving you time & making your job easier!

description Looking for general charting instead? Click here!

Using a HIPAA Chart Note

When you begin charting, you'll be presented with this screen:

At the top we include:

  • CPT code units and cost
  • Service modifiers
  • Start and end time
  • POS Code

Beneath that, the chart:

  • This template 'remembers' and pulls forward everything from the previous HIPAA chart note if one exists
  • All fields included:
Click to see a larger version

Did you leave any fields blank?

If you did, don't worry, we won't include that item in your completed note.

Then comes the diagnosis codes and chart note:



Note Editor options:

  • Text sizes → from heading 1-6 and normal text
  • Formatting → bold, italic, underline, and small text
    • Additionally → bullet points, numbered bullet points, and paragraph indentations

Want to pull forward your last note's narrative section?

Easy! Click the beneath the notes section above.
  • Make any edits you need and continue on

Treatment Plan & Psychotherapy Notes

  • Below you can include a treatment plan (optional)
  • You can also include a Psychotherapy Note
    • Psychotherapy notes are not included when printing a chart note by default unless specifiied


  • We also auto-save a draft every 30 seconds - just in case!
  • When done, click the button (bottom right) to review your note.

Review, Finalize & Lock

To sign your chart note after reviewing, click (bottom right).

Want to save a draft instead?

Click the button, then (bottom left of next screen)

check_circle Congratulations! You've successfully locked your chart note for this client's appointment!