Voice Dictation for SimplePractice: Type Notes Without Paying $35/Month

SimplePractice offers two voice-related features. The first is standard browser-level dictation — macOS Dictation or Windows Speech Recognition typed into a SimplePractice note field like it would into any other text box. This works for short phrases but degrades on long clinical paragraphs and has no medical or psychiatric vocabulary.

The second is SimplePractice Note Taker, a paid add-on launched in 2024. Note Taker records the session, transcribes it on SimplePractice servers, and generates a draft note for the clinician to edit. It is an AI scribe layered on top of the EHR, not a voice-typing tool.

For therapists who want to speak their own notesbetween sessions — not have an AI listen to the session and write the note for them — neither option is ideal. That is the gap Sapience Med fills.

SimplePractice Note Taker is listed in SimplePractice’s own help center as a paid add-on at $35 per clinician per month, billed on top of the base SimplePractice subscription. It is an ambient AI scribe: the clinician opens it during a session, the tool records the audio, the audio is sent to a remote server, speech recognition and a language model generate a draft note, and the clinician edits and signs the result.

Because Note Taker uploads session audio and processes PHI on remote infrastructure, SimplePractice maintains it under their Business Associate Agreement — the same BAA that covers the base EHR. There is no separate BAA to sign, but the AI scribe model does require a clinician to be comfortable with session recording, audio transit to a vendor, and AI-drafted clinical content.

$35 per month is $420 per year per clinician, indefinitely. For a solo private-practice therapist, that is a material recurring cost on top of the EHR.

Sapience Med is a desktop app that runs on the clinician’s Mac or Windows laptop. After installation, the clinician opens SimplePractice in their browser like normal, navigates to a progress note, places the cursor in the SOAP or intake field, presses the Sapience Med hotkey, speaks the note in their own words, and releases the key. The dictated text appears in the SimplePractice field as if it had been typed.

There is no plug-in, no browser extension, and no integration with SimplePractice’s account. Sapience Med types into whatever text field has focus on the system — SimplePractice, TherapyNotes, Sessions, Athena, Apple Notes, email, Word, anywhere. The clinician’s workflow inside SimplePractice does not change, except that the words appear faster than they could be typed.

The speech recognition runs entirely on the laptop. The session is not recorded; the patient is not on the microphone; the audio of the clinician’s own voice is processed in memory and discarded. Sapience Systems LLP is not a HIPAA Business Associate because no PHI is ever transmitted to us. See why Sapience Med doesn’t need a BAA for the architectural rationale.

Both tools reduce documentation time, but they are different products. SimplePractice Note Taker is an AI scribe; Sapience Med is push-to-talk dictation. The table below summarizes the practical differences.

The price difference looks small monthly — $35 versus $33 — but the model differences are large. Note Taker requires recording your client; Sapience Med does not.

The HIPAA status of dictation depends entirely on where the audio and transcript go. SimplePractice’s own Note Taker is HIPAA-compliant under the BAA that already governs the EHR, because PHI stays within SimplePractice’s infrastructure. That is the appropriate model for an AI scribe.

Sapience Med dictation is HIPAA-friendly by a different mechanism: the audio of the clinician’s voice never leaves the device, so no Business Associate relationship is established with Sapience Systems LLP. The dictated text lands directly in SimplePractice, which is the EHR holding the PHI under its own BAA. Both compliance postures coexist cleanly.

Browser-level dictation (macOS or Windows defaults) varies. Apple Dictation on Apple Silicon Macs runs on-device by default and is analogous to Sapience Med in that respect, but lacks medical vocabulary. Windows Speech Recognition is also local. Cloud-based dictation tools that upload audio to third-party servers (Otter.ai, Whisper.cpp web wrappers, etc.) introduce a separate vendor and would typically require a separate BAA review.

Apple Dictation on a Mac will type into a SimplePractice note field. It runs on-device on Apple Silicon (M1 and later) and is free. For very short notes or basic transcription, it is adequate.

The practical limits show up quickly in clinical use. Apple Dictation lacks specialized vocabulary: medication names like Wellbutrin, Lamotrigine, Vraylar, or Vyvanse are frequently misheard. Clinical shorthand and abbreviations (MSE, HPI, SI/HI, GAD-7, PHQ-9) confuse it. It does not strip filler words ("uh", "um") and inserts them into the note. It also lacks the push-to-talk controlled dictation model that fits between-session documentation rhythms.

For a therapist who writes one or two short notes a day, Apple Dictation may be enough. For a clinician seeing 20+ clients a week with substantial documentation requirements, the time saved by medical-specialized dictation is meaningful. Sapience Med is built for that second case.