HIPAA regulations grant special status to psychotherapy notes, placing greater restrictions on their use and disclosure versus other information in a patient's record. Regulations specifically prohibit health plans from requiring the disclosure of psychotherapy notes in their consideration of health claims. However, this issue is surrounded by much confusion. If the information in psychotherapy notes is found only in the psychotherapy notes, it is protected under this provision. However, information that rightfully belongs in the more accessible part of the record is not considered part of psychotherapy notes. In addition, there are certain circumstances in which a provider may be required to disclose psychotherapy notes. This article discusses the definition of psychotherapy notes under HIPAA, comments on the relevance of psychotherapist-patient privilege, and provides important information for the case manager when managing psychiatric patients.