On January 21, 2005, CMS released Transmittal 98 of the Program Integrity Manual, entitled "Psychotherapy Notes." CMS issued these instructions, which affect Community Mental Health Centers, Hospitals and Physicians, in order to remain consistent with the Privacy Rule in 45 CFR Â§164.501. The new policy instructs contractors not to request that a provider submit psychotherapy notes. It also states that physically integrating information excluded from the definition of psychotherapy notes and protected information into one document or record does not transform the non-protected information into protected psychotherapy notes. Finally, it indicates that the provider is responsible for extracting the information needed to support that the claim is reasonable and necessary.