AI scribe laws by state and what they mean for PT

The operative section of Rhode Island’s new AI scribe law is one sentence long. It does not contain the word “consent,” and it does not contain the phrase “opt out.”

That is not how it has been reported. The Journal of Urgent Care Medicine told its readers in July that Rhode Island “recently became the first state with a law specifically aimed at ambient AI scribes, requiring disclosure to patients when scribes are used and provision of an opt-out process.” The first half of that is right. Here is the whole requirement, from S 2570 Substitute A as enacted:

Any and all healthcare providers and healthcare facilities that employ artificial intelligence (“AI”) to document in-person or telehealth visits shall notify patients of the use of AI for that sole purpose and review the AI-generated documentation for accuracy after the visit.

Notice, and a review for accuracy. Two duties, and neither one is consent.

What follows describes what these statutes say and where to read them. It is not legal advice. Which rule reaches your practice, and what your carrier and payer contracts already oblige you to do, is an hour with your own counsel, well spent.

What does Rhode Island’s AI scribe law actually require?

Two things, both landing on the provider instead of the vendor. Tell the patient AI is documenting the visit. Read what the AI produced, and check it, after the visit is over.

Nothing in the chapter gives a patient the right to refuse. Nothing requires a signature, a form, or a record that the notice was given. The chapter runs three sections: short title, definitions, and the sentence above. There is no penalty in it. There is no rulemaking authority either, so no agency is going to issue guidance telling you what compliance looks like. The obvious question is what happens if you ignore it, and the honest answer is nothing in particular, which is a poor reason to skip a notice that takes four seconds.

Does it reach a PT clinic? The definition of “healthcare provider” lists physicians, PAs, dentists and several nursing roles, then ends with “any other healthcare professional licensed by the director of the department of health.” Rhode Island’s board of physical therapy sits inside the Department of Health’s division of professional regulation, and PT license applications go to that department. A clinic in Providence should treat itself as covered and let counsel confirm.

The Senate passed Substitute A on June 10, the House concurred on June 11, and the governor signed it on June 22. The act takes effect upon passage. No grace period, no implementation window.

Which states have a rule that reaches a PT clinic today?

Two, plus a second Texas law that gets conflated with the first.

Of the three laws that reach a PT clinic, Louisiana’s asks the most of the disclosure itself. Act 649 enacts one subsection: a healthcare professional licensed under Title 37 “shall verbally disclose the use of any recording device, software, or service to a patient before recording any part of an appointment or treatment to be transcribed by artificial intelligence.” Two words carry it. Verbally, so a line in the intake packet is not the disclosure the statute describes. And before, so the sentence comes ahead of the tap. Violations are a licensing board matter, with immunity from civil liability absent gross negligence or willful misconduct.

Watch what happened to that bill in transit. The caption on the Louisiana Legislature’s own bill page still reads “Requires a healthcare provider to obtain a patient’s consent prior to recording a medical visit.” The consent language never made it into Act 649. Read the summary instead of the act and you get this exactly backwards, the same way the Rhode Island opt-out got loose.

Texas has two laws doing different jobs. HB 149, the Texas Responsible Artificial Intelligence Governance Act, says at § 552.051(f) that “if an artificial intelligence system is used in relation to health care service or treatment, the provider of the service or treatment shall provide the disclosure under Subsection (b)” no later than the date service is first provided. Take one wrinkle to counsel. Subsection (b), the disclosure being cross-referenced, is drafted as a duty of “a governmental agency.” How that reads against a private clinic is statutory construction, and not something to settle from a blog post. SB 1188 is separate. It requires a practitioner using AI “for diagnostic purposes” to review all records created with it and to disclose that use. A scribe drafting a SOAP note is documentation, not a recommendation on a diagnosis, so read the two sections apart.

Do the written consent rules apply to a physical therapy clinic?

No, as those statutes are written. This is the error most likely to send a PT owner down the wrong path. The consent rules are the ones getting written about, and they stop at the door of a behavioral health practice.

Colorado’s HB26-1195 bars a psychotherapy licensee from using AI to record or transcribe a therapeutic session on three conditions. The client is told in advance, in writing, that AI will be used and for what specific purpose. The client consents in writing. And refusing or revoking “shall not be used as a basis to deny psychotherapy services.” That consent is required once, for the first use, unless the purpose or manner of use materially changes. Illinois got there first, in August 2025, and defines consent tightly enough to rule out burying it in a terms-of-use agreement. Maine’s LD 2082 asks for the most in writing: not only that AI will be used and why, but “how session data collected by artificial intelligence will be stored, retained, used for training and deleted upon termination” of services.

None of that binds a physical therapist. Read it anyway. If your practice employs or contracts a mental health clinician, the scope question stops being academic the day they start using a scribe. And Maine’s disclosure list doubles as a vendor questionnaire: retention, training use, deletion. Put those on the shortlist you use to pick a scribe in any state.

What gets called an AI scribe law and is not one

California’s AB 3030 keeps turning up in this conversation. It is a different rule. The statute covers “a health facility, clinic, physician’s office, or office of a group practice” using generative AI “to generate written or verbal patient communications pertaining to patient clinical information.” Subdivision (b) then exempts anything “read and reviewed by a human licensed or certified health care provider.” A SOAP note is not a patient communication, and a note your therapist reads before signing would land in the exemption anyway.

Two-party recording consent is its own body of law, older than any of this, and it turns on the act of recording instead of on AI. Whether your state requires everyone in the room to agree before a recording starts has its own answer, which can come out differently from the AI question. We have not published a list of which states are which; the vendor blogs circulating one do not cite statutes. Whether patients have to consent is a question to ask counsel once, write down, and stop relitigating.

What do you do if your state has no rule?

Say the sentence anyway, before you press record.

The most useful document published on this subject did not come from a legislature. In June 2025 the Louisiana Physical Therapy Board published an account from a patient who had been seeing the same therapist for more than five years. “It wasn’t until recently that I discovered, on my own, that our sessions had been recorded by an AI scribe tool without my knowledge or consent. Not just clinical notes, but full audio recordings.” She never filed a complaint. She called her therapist “truly the best I’ve had.” She stopped going to physical therapy.

In the same article, Frank Meyers, deputy legal counsel of the Federation of State Medical Boards, put the standard in a form that survives every state line: “Any time a patient is being recorded they must be aware, whether it is AI or an old school tape recorder. And the patient must have the opportunity to opt out.” The awareness half of that is now law in Rhode Island, Louisiana and Texas. The opt-out half is law in none of them, and it is still what a patient will judge you by in the years before a legislature gets to it.

Which leaves the duty almost nobody is discussing. Rhode Island did not stop at notice. It also requires the provider to review the AI-generated documentation for accuracy after the visit, and Texas asks the same of practitioners using diagnostic AI. That obligation does not care whether the patient said yes, and it lands on the therapist who signs. Aurora, the scribe included in both Orion plans, drafts the note during the visit for the treating therapist to review and confirm before signing, and no scribe is accurate enough to make that review optional.

The disclosure is the part everyone is arguing about. The review is the part that shows up in an audit.