As Introduced

136th General Assembly

Regular Session H. B. No. 525

2025-2026

To enact section 4743.21 of the Revised Code regarding the use of artificial intelligence in therapy services.

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:

Section 1. That section 4743.21 of the Revised Code be enacted to read as follows:

Sec. 4743.21. (A) As used in this section:

(1) "Administrative support" means tasks performed to assist a licensed therapy professional in the delivery of therapy or psychotherapy services that do not involve communication. "Administrative support" includes managing appointment scheduling and reminders, processing billing and insurance claims, and drafting general communications related to therapy logistics that do not include therapeutic advice.

(2) "Artificial intelligence" means a machine-based system that, for explicit or implicit objectives, infers, from the input it receives, how to generate outputs such as predictions, content, recommendations, or decisions that can influence physical or virtual environments. "Artificial intelligence" includes generative artificial intelligence.

(3) "Generative artificial intelligence" means an artificial intelligence technology system that satisfies all of the following:

(a) The system is trained on data.

(b) The system is designed to simulate human conversation with a consumer through text, audio, or visual communication.

(4) "Licensed therapy professional" means all of the following:

(a) A psychologist, independent school psychologist, or school psychologist licensed under Chapter 4732. of the Revised Code;

(b) A professional clinical counselor, independent social worker, independent marriage and family therapist, art therapist, or music therapist licensed under Chapter 4757. of the Revised Code;

(d) A certified mental health assistant licensed under Chapter 4772. of the Revised Code;

(e) A certified Ohio behavior analyst certified under Chapter 4783. of the Revised Code;

(f) Any other professional authorized to provide therapy or psychotherapy services.

(5) "Peer support" means services provided by individuals with lived experience of mental health conditions or recovery from substance use that are intended to offer encouragement, understanding, and guidance without clinical intervention.

(6) "Religious counseling" means counseling provided by clergy members, pastoral counselors, or other religious leaders acting within the scope of their religious duties if the services are explicitly faith-based and are not represented as clinical mental health services or therapy or psychotherapy services.

(7) "Supplementary support" means tasks performed to assist a licensed therapy professional in the delivery of therapy or psychotherapy services that do not involve therapeutic communication and are not administrative support. "Supplementary support" includes preparing and maintaining client records and therapy notes, analyzing anonymized data to track client progress or identify trends, and identifying and organizing external resources or referrals for client use.

(8) "Therapeutic communication" means any verbal, nonverbal, or written interaction conducted in a clinical or professional setting that is intended to diagnose, treat, or address an individual's mental, emotional, or behavioral health concerns. "Therapeutic communication" includes all of the following:

(a) Direct interactions with clients for the purpose of understanding or reflecting their thoughts, emotions, or experiences;

(b) Providing guidance, therapeutic strategies, or interventions designed to achieve mental health outcomes;

(d) Collaborating with clients to develop or modify therapeutic goals or treatment plans;

(e) Offering behavioral feedback intended to promote psychological growth or address mental health conditions.

(9) "Therapy or psychotherapy services" means services provided to diagnose, treat, or improve an individual's mental health or behavioral health. "Therapy or psychotherapy services" does not include religious counseling or peer support.

(10) "Therapy professional licensing board" means all of the following:

(a) The state board of psychology;

(b) The counselor, social worker, and marriage and family therapist board;

(d) The state medical board;

(e) Any other professional licensing board in this state that licenses or certifies a professional authorized to provide therapy or psychotherapy services.

(B)(1) Subject to divisions (B)(2) and (C) of this section, a licensed therapy professional may use artificial intelligence to assist in providing supplementary support in therapy or psychotherapy services while engaging in therapeutic communication with a client.

(2) Before utilizing artificial intelligence in accordance with division (B)(1) of this section, a licensed therapy professional shall do both of the following:

(a) Obtain the written informed consent of the patient or patient's authorized representative indicating that the patient or the patient's authorized representative has been informed that artificial intelligence will be used and for what specific purpose the artificial intelligence will be used;

(b) Enter into all necessary business associate agreements to ensure compliance with the "Health Insurance Portability and Accountability Act of 1996," 42 U.S.C. 1320d et seq.

(1) Make independent therapeutic decisions, including diagnosing a client;

(2) Directly interact with clients in any form of therapeutic communication;

(3) Generate therapeutic recommendations or treatment plans without review and approval by the licensed therapy professional;

(4) Detect emotions or mental states.

(D) All records kept by a licensed therapy professional and all communications between an individual seeking therapy or psychotherapy services and a licensed therapy professional shall be confidential and shall not be disclosed except as required by section 5119.28 of the Revised Code.

(E) A licensed therapy professional who violates this section may be fined by the appropriate therapy professional licensing board an amount not to exceed ten thousand dollars per violation.