How We Compare these mental health EHRs
How vendors are included and scored: the evidence-packet policy and the status of existing guide orders.
EHR & Practice Software evaluation framework v1.0 (behavioral-health cut). The published EHR framework v1.0 weights are set before any vendor is assessed; this behavioral-health cut applies them to the sub-criteria that actually differentiate mental health software -- progress/psychotherapy note quality and DSM-5-TR support, HIPAA-compliant telehealth, behavioral-health insurance billing (CPT 90791/90834/90837/90847), client portal, group-practice scalability, and psychiatry features (EPCS, medication management). Scores are editorial judgments against these published criteria. Where a vendor quotes only, that is recorded and labeled, not estimated as an own-site price. See the full How We Evaluate standards and the sourced EHR pricing transparency finding. Last updated July 2026.
Providers compared
Placement on this page cannot be bought. See our methodology.
Best for: IOP/PHP, residential and SUD treatment, and complex behavioral health with 42 CFR Part 2 documentation needs.
Best for: Growth-focused private practices and integrated medical/behavioral health that want EHR, billing, and practice marketing in one vendor.
Best for: Interventional psychiatry -- ketamine-assisted therapy, TMS, Spravato (esketamine), and psychedelic-assisted therapy practices.
Best for: Solo therapists and small groups (up to ~10 clinicians) that want the best interface and client portal; cash-pay and mixed cash/insurance practices.
Best for: Budget-conscious solo therapists and small groups, particularly in the first 12-18 months of practice.
Best for: Solo and group practices that bill insurance heavily and want the strongest billing performance and documentation quality without Valant pricing.
Best for: Mid-to-large behavioral health organizations and psychiatry -- managed care contracts, outcome measurement (MBC), EPCS, and medication management.
Sponsored and featured slots are always labeled and sit outside the comparison -- they never change a vendor's editorial position.
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GetPracticeHelp is an independent comparison platform. The comparison above is a criteria-based editorial judgment against our published EHR framework, made before any commercial conversation. No vendor on this page holds a paid or affiliate placement that moves its placement; where a partner link is ever added it is labeled and carries rel=sponsored, and partner status never moves a vendor's position. Where a vendor quotes only, its price is shown as a labeled quote-based estimate, not an own-site list price. Verify current pricing with the vendor.
Comparison table
Prices are vendor-published where the vendor lists them, or a labeled quote-based estimate where the vendor quotes only. Full EHR pricing sourcing: EHR pricing transparency.
| System | Price / clinician / mo | Insurance billing | Telehealth | EPCS | Group scale | Best for |
|---|---|---|---|---|---|---|
| ICANotes | $35-$213/provider/mo by plan (Notes Only, Non-Prescribing or Prescribing; part-time or full-time) | Good | Add-on ($20 per user/mo) | Yes | Any (incl. inpatient/IOP) | IOP/PHP, residential and SUD treatment, and complex behavioral health with 42 CFR Part 2 documentation needs. |
| Kareo for Mental Health (now Tebra) | Not published: quote-only; per-provider subscription by module | Excellent | Included | Add-on | Practices with 1-10 providers (solo and group practices) | Growth-focused private practices and integrated medical/behavioral health that want EHR, billing, and practice marketing in one vendor. |
| Osmind | Quote-based; typically $150+/provider/mo | Good | Included | Yes | 1-20 clinicians | Interventional psychiatry -- ketamine-assisted therapy, TMS, Spravato (esketamine), and psychedelic-assisted therapy practices. |
| SimplePractice | $49 / $79 / $99 per clinician/mo (Starter / Essential / Plus) | Good | Excellent (built-in) | Add-on | 1-10 clinicians | Solo therapists and small groups (up to ~10 clinicians) that want the best interface and client portal; cash-pay and mixed cash/insurance practices. |
| TheraNest | $29 / $59 / $89 per therapist/mo (Essentials / Advanced / Premier) | Good | Telehealth: optional add-on on Essentials; unlimited on Advanced and Premier | Add-on | 1-20 clinicians | Budget-conscious solo therapists and small groups, particularly in the first 12-18 months of practice. |
| TherapyNotes | $69 solo; $79 first clinician + $50/additional clinician/mo | Excellent | Included | Add-on | 1-30+ clinicians | Solo and group practices that bill insurance heavily and want the strongest billing performance and documentation quality without Valant pricing. |
| Valant | Not published: quote-only | Excellent | Included | Yes | 15+ clinicians | Mid-to-large behavioral health organizations and psychiatry -- managed care contracts, outcome measurement (MBC), EPCS, and medication management. |
The 7 Systems in Depth
Compare each system by your practice type and workflow.
SimplePractice -- Best for solo and small group
SimplePractice is the default choice for new solo therapists and the benchmark for user experience in mental health software. The interface is clean, the client portal is strong, and onboarding is fast. Built-in HIPAA-compliant telehealth launches with a single click from the calendar.
Strengths: Leading interface and client portal (intake paperwork, secure messaging, card-on-file, self-scheduling). Reliable built-in telehealth. Good documentation templates with DSM-5-TR diagnosis pickers. Strong mobile app and live support.
Weaknesses: Insurance billing is functional but shallower than TherapyNotes or Valant. Supervisor-review and detailed clinician reporting lag the specialty systems. Add-ons stack up at higher tiers.
Pricing: Starter $49, Essential $79, Plus $99 per clinician per month; Insurance Essentials (claims, coverage checks) included in all plans with per-claim fees; Insurance Navigator billing assistance add-on (listed coming soon). Group plans add a per-additional-clinician fee. Best for solo therapists and small groups up to about 10 clinicians, cash-pay and mixed cash/insurance.
TherapyNotes -- best billing depth and documentation quality
TherapyNotes is the clinically-rigorous alternative to SimplePractice, built by clinicians. It shows in the depth of documentation templates, treatment planning, and the insurance billing module. Where billing performance matters, TherapyNotes consistently outperforms on clean-claim rate and days in A/R.
Strengths: Deep insurance billing with claim scrubbing, ERA posting, and denial management. Strong progress-note and psychotherapy-note templates. Treatment plans linked to diagnoses and goals. Scales to 30-plus clinicians. Telehealth included. Transparent flat-rate pricing.
Weaknesses: Interface is functional but less polished than SimplePractice. Client portal is adequate rather than elegant. Slightly steeper learning curve.
Pricing: $69 for a solo clinician; groups pay $79 for the first clinician and $50 per additional clinician per month. The client portal and basic telehealth are included; electronic claims ($0.14 each), Premium Telehealth and card processing are paid add-ons. Best for solo and group practices that bill insurance heavily.
TheraNest -- budget-friendly for solo and small groups
TheraNest (Therapy Brands) is the cost leader among established mental health EHRs. It covers scheduling, progress notes, insurance billing, and telehealth at a lower monthly rate, with three per-therapist plan tiers.
Strengths: Lowest entry price of the established systems. Covers all core workflows: scheduling, notes, billing, telehealth, client portal. Workable group features for small teams.
Weaknesses: Interface lags SimplePractice and TherapyNotes. The tier you pick sets what is included: telehealth is an optional add-on on Essentials, and eRx, card payments and claims beyond 50 a month are charged per use. Support quality is mixed in user reviews.
Pricing: $29 (Essentials), $59 (Advanced) and $89 (Premier) per therapist per month, billed monthly. Best for solo therapists and small groups prioritizing cost, especially in the first 12 to 18 months.
ICANotes -- best for complex behavioral health and inpatient
ICANotes is the longtime specialist for complex behavioral health: inpatient psychiatric settings, intensive outpatient (IOP), residential treatment, and substance use disorder treatment. Its button-driven engine generates narrative notes from structured clinical selections, which is very different from template-based systems.
Strengths: Deep documentation for complex behavioral health. Supports inpatient, IOP, PHP, and SUD settings that other mental health EHRs do not. Strong coverage of 42 CFR Part 2 substance-use requirements. E-prescribing with EPCS.
Weaknesses: The button-driven engine is polarizing -- clinicians either adapt to it quickly or never do. Interface feels dated. Not a strong fit for pure outpatient private practice.
Pricing: $35 to $213 per provider per month depending on clinician type (part-time or full-time) and plan (Notes Only, Non-Prescribing or Prescribing). Best for IOP/PHP programs, residential treatment, SUD treatment centers, and complex behavioral health organizations.
Osmind -- best for interventional psychiatry
Osmind is the category leader for interventional psychiatry: ketamine-assisted therapy, TMS, esketamine (Spravato), and psychedelic-assisted therapy. It is built for the specific clinical and billing workflows of these modalities and integrates the outcome-tracking tools most interventional practices need.
Strengths: The only mental health EHR built for interventional psychiatry. Outcome measurement integrated into the clinical workflow. EPCS and medication management. A growing set of interventional-psychiatry integrations and research partnerships.
Weaknesses: Too specialized for traditional talk-therapy practices. A younger platform than SimplePractice or TherapyNotes, though maturing quickly.
Pricing: Quote-based; expect $150 or more per provider per month. Best for ketamine clinics, TMS practices, Spravato providers, and psychiatric practices with significant interventional volume.
Kareo for Mental Health (now Tebra) -- best EHR, billing, and marketing bundle
Kareo, now part of Tebra, offers a mental health configuration of its medical EHR with behavioral-health templates, scheduling, and billing. Its distinctive value is bundling the EHR with practice-marketing tools -- website, review management, and patient acquisition -- for practices actively growing.
Strengths: Integrated EHR, billing, and practice marketing in one vendor. Good insurance billing carried over from the medical side. Works for practices that also offer medical services (integrated primary care and behavioral health).
Weaknesses: Less purpose-built for behavioral health than SimplePractice or TherapyNotes. Group features are adequate rather than deep. Pricing is less transparent.
Pricing: Not published: quote-only; Tebra prices a per-provider subscription by module, plus per-transaction fees. Best for growth-focused private practices and integrated medical and behavioral health.
Valant -- best for behavioral health organizations and psychiatry
Valant is built for behavioral health organizations: medium-to-large group practices, multi-site clinics, and psychiatry-heavy practices. It handles complexity smaller systems cannot, including managed care contracts, Measurement-Based Care workflows, and psychiatric medication management with EPCS.
Strengths: Purpose-built for mid-to-large behavioral health organizations. Strong psychiatric features including EPCS and medication management. Built-in outcome measurement (PHQ-9, GAD-7, ongoing symptom tracking). Group and organization reporting. Handles managed care and complex authorization workflows.
Weaknesses: Too much system, and too costly, for a solo therapist. Steeper learning curve. Pricing is quote-only; Valant does not publish it.
Pricing: Not published: quote-only; request a quote from Valant. Best for group practices of roughly 15 or more clinicians, psychiatric practices, and multi-site behavioral health organizations.
Best EHR by Practice Type
Solo therapy practice (LCSW, LPC, PhD, PsyD)
Pick SimplePractice if you value interface and onboarding speed above all else and are mostly cash-pay or do modest insurance billing. Pick TherapyNotes if you bill insurance heavily, or plan to, and want the best billing performance without Valant's price point. Pick TheraNest if cost is the primary constraint and you accept a less polished interface.
Group therapy practice (5 to 30 clinicians)
TherapyNotes is the default. It handles multi-clinician scheduling, supervisor review, and group billing cleanly at a price that stays reasonable at scale. SimplePractice works for smaller groups but becomes expensive and loses some group functionality past 10 to 15 clinicians.
Behavioral health organization (30-plus clinicians, multi-site, managed care)
Valant for traditional behavioral health organizations. ICANotes if you operate IOP/PHP, residential treatment, or SUD programs. Both are designed for the operational complexity and compliance these settings demand.
Psychiatry practice (controlled substances, medication management)
Valant is the default for traditional psychiatry. Osmind for interventional psychiatry (ketamine, TMS, Spravato). TherapyNotes with the EPCS add-on can work for psychiatrists in smaller private-practice settings.
Integrated primary care and behavioral health
Tebra (Kareo) or a general-purpose medical EHR with strong behavioral-health templates. Most dedicated mental health EHRs do not handle primary care workflows well.
HIPAA Compliance and Security Notes
Every system here is HIPAA compliant and will sign a Business Associate Agreement (BAA). HIPAA compliance is table stakes, not a differentiator. What matters for mental health practices specifically:
- 42 CFR Part 2 support if you treat substance use disorder -- extra protections apply beyond HIPAA. ICANotes and Valant handle this well; most other systems need workflow workarounds. The rule changed recently and the change is a consent-workflow question, not a checkbox: HHS published Confidentiality of Substance Use Disorder (SUD) Patient Records (89 FR 12472, published February 16, 2024, effective April 16, 2024) implementing section 3221 of the CARES Act and aligning Part 2 more closely with the HIPAA Privacy Rule. Ask any vendor you shortlist how its consent model handles a single Part 2 consent covering future treatment, payment and health care operations, and how it segregates SUD counseling notes -- a system that treats Part 2 as "HIPAA plus a warning banner" will push that work onto your staff.
- Psychotherapy-note protections under HIPAA -- your EHR should separate psychotherapy notes from progress notes and apply the right access controls. SimplePractice, TherapyNotes, and Valant handle this well.
- Telehealth HIPAA compliance -- every system here offers HIPAA-compliant video. Do not use consumer tools like standard Zoom or FaceTime; use the built-in telehealth from your EHR, or a HIPAA-compliant telehealth platform with a BAA. If the built-in video is a deciding factor, compare it against standalone options in the telehealth platform comparison before you let it drive the EHR choice, and check which practice vendors require a BAA so the agreement coverage is complete rather than assumed.
- Intake-form HIPAA compliance -- every digital intake touchpoint before a patient signs must also be HIPAA compliant. See the intake-forms section below.
Common Mistakes When Choosing a Mental Health EHR
- Picking based on a single demo. Demos show happy paths. Insist on a 14-day trial and test your real documentation workflow, not the vendor's scripted scenario.
- Underestimating insurance billing. Even cash-pay practices usually end up billing out-of-network for superbills. If you plan to scale, pick a system whose billing is strong from day one.
- Choosing group features too late. Migrating from a solo-optimized system to a group-capable one mid-growth is painful. If you realistically plan to hire within 24 months, choose a group-capable system now.
- Ignoring the client portal. The portal is your patient's main touchpoint outside sessions. A clunky portal drives no-shows, billing disputes, and low satisfaction. Test it as a patient, not just as a clinician.
- Not factoring add-on costs. Base pricing often excludes premium telehealth, e-prescribing, EPCS, and custom documentation. Get a total all-in quote including every add-on you will realistically use.
- Assuming the system will exchange records with anyone. Behavioral health is the weakest interoperability segment in US health IT, and the gap is measured. ONC's data brief Electronic Health Record Adoption and Exchange Capabilities Among Substance Use and Mental Health Treatment Facilities, 2024 (ONC Data Brief No. 82, April 2026, from the 2024 N-SUMHSS survey) found that only 19% of substance use and mental health treatment facilities participated in a health information exchange, and 67% reported no knowledge or awareness of one in their service area, while 56% at least sometimes searched electronically for patient health information. Ask the vendor what it actually connects to in your state, and treat "interoperable" as a claim to be tested rather than a feature to be assumed.
The same brief is a useful reality check on where the segment sits overall: 68% of these facilities used an EHR only, and another 25% ran an EHR alongside paper charts as of 2024. A quarter of the segment is still hybrid, so if you are moving off paper, the migration and dual-running period is a normal cost to plan for rather than a sign that you chose badly. If your practice bills insurance, sequence the EHR decision against credentialing for a mental health practice -- panel enrollment timelines, not software, are usually what gate revenue in the first year.
HIPAA-Compliant Intake Forms
Every mental health EHR here has a client portal for intake paperwork. For many solo therapists, the built-in forms are adequate. For group practices, specialty clinics, and organizations with custom intake flows -- sliding-scale screening, specialized consent, multi-step clinical assessments, insurance card and ID capture -- a dedicated HIPAA-compliant form platform is often better than the EHR's built-in tool.
HIPAAtizer provides HIPAA-compliant digital forms for healthcare practices, with e-signature, insurance-card capture, secure file upload, conditional logic for screening workflows, and BAA-compliant hosting. It works alongside your EHR rather than replacing it -- useful when you need intake flexibility your EHR does not provide. Pricing starts around $20 to $40 per month for solo-practice plans.
Frequently Asked Questions
What is the best EHR for a solo therapist in 2026?
SimplePractice and TherapyNotes are the two clear leaders for solo therapists. SimplePractice wins on user interface, client portal, and ease of onboarding -- most therapists can go from signup to seeing clients in under a week. TherapyNotes wins on insurance billing depth and documentation quality; if you bill insurance heavily, it typically outperforms on clean-claim rate. If ease of use is the first priority, SimplePractice is the better fit. Most solo therapists are well-served by either.
How much does a mental health EHR cost per provider per month?
Mental health EHRs typically run about $29 to $69 per provider per month for solo and small group practices at the entry tier. Group plans add a per-additional-clinician fee. Expect premium telehealth, e-prescribing, EPCS, and advanced reporting to add more per month. Enterprise behavioral health systems run higher and are usually quote-based -- Osmind, for example, starts around $150 per provider at scale.
Which mental health EHR is best for group practices?
TherapyNotes and Valant are the strongest choices for group mental health practices. TherapyNotes scales cleanly to about 30 clinicians and handles supervisor-review and multi-clinician billing at a reasonable price. Valant is built for behavioral health organizations and handles larger groups, managed care contracts, psychiatric medication management, and outcome measurement better than any alternative. For groups under 10, SimplePractice is also workable.
Are SimplePractice and TherapyNotes HIPAA compliant?
Yes. Both are HIPAA compliant and will sign a Business Associate Agreement (BAA), including encrypted data at rest and in transit, audit logging, access controls, and HIPAA-compliant built-in telehealth. Every legitimate mental health EHR offers HIPAA compliance and a BAA -- it is a requirement, not a differentiator between systems.
What is the best EHR for psychiatrists who prescribe controlled substances?
You need an EHR with EPCS (Electronic Prescribing of Controlled Substances) certification and DEA compliance. Valant, Osmind, and TherapyNotes (with the EPCS add-on) all support EPCS. Valant is the most feature-complete for traditional psychiatry, including medication management, managed care, and outcome measurement. Osmind is built for interventional psychiatry -- ketamine, TMS, Spravato, and psychedelic-assisted therapy. TherapyNotes with EPCS works for smaller psychiatric private practices.
Does my mental health EHR need to handle insurance billing?
If you are in-network with any payer, yes -- insurance billing is a core workflow, not an optional add-on. SimplePractice, TherapyNotes, TheraNest, Valant, ICANotes, and Kareo for Mental Health all include insurance billing. Cash-pay-only practices can run on a simpler system, though even they often generate superbills for clients' out-of-network reimbursement. If there is any chance you will accept insurance within 24 months, choose a system with strong billing now rather than migrating later.
How do vendors get included?
Placement on this page cannot be bought. Vendors are included using our published methodology and the information and evidence available for each vendor. You can submit corrections or supporting evidence for review. Providers are listed alphabetically. Paid placement is labeled separately.