What a mental health practice needs from its software
A mental health practice runs on recurring appointments, long narrative notes and a lot of video. Software built for primary care handles none of that well. These are the requirements that matter most for therapy, counseling, psychology and psychiatry practices.
- Behavioral health note types. Intake assessments, progress notes in SOAP, DAP or BIRP format, treatment plans with review dates, and discharge summaries. Insurers audit treatment plans, so the EHR should remind you when one is due.
- A place for psychotherapy notes. HIPAA gives psychotherapy notes extra protection only when they are kept separate from the rest of the record. Your EHR needs a separate, access-limited note type for them. It must also keep them out of anything you release with the chart.
- Group, couples and family sessions. Group practices need one appointment with several clients, a group note that copies shared content into each client's chart, and a claim per attendee. TherapyNotes added a Group Progress Note Wizard in 2026. SimplePractice puts group appointments and group telehealth on its Plus plan.
- Telehealth inside the chart. Many clients are seen by video, and Medicare allows behavioral telehealth from the client's home and audio-only visits on a permanent basis. Video that launches from the appointment saves a login and keeps the visit record in one place.
- A client portal for the paperwork. Online intake, consent forms, outcome measures, booking and card payments. Self-pay and out-of-network clients also need a Good Faith Estimate under the No Surprises Act, so templates for it help.
- Insurance billing for high claim volume. Therapy claims are high volume and low dollar. Look at per-claim and per-ERA fees as closely as the subscription, because they add up over a month of weekly sessions.
- Prescriber tools for psychiatry. Psychiatrists and psychiatric nurse practitioners need e-prescribing with EPCS for controlled substances, state PDMP checks inside the workflow, and lab ordering. Therapy-first systems usually sell this as an add-on.
- Substance use treatment and 42 CFR Part 2. If your practice is a federally assisted SUD program, Part 2 applies on top of HIPAA. You need consent capture and tracking, and you need SUD counseling notes kept separately. Programs with several levels of care usually outgrow a therapy EHR (see below).
All-in-one or separate tools?
For most practices, one system is enough. TherapyNotes and SimplePractice both bundle scheduling, notes, billing, a client portal and video on every plan. Both also sell an AI note tool as an add-on: TherapyFuel for TherapyNotes, and Note Taker or Care Aide for SimplePractice. A solo therapist or a group of five therapists can run the whole practice from either one. TherapyNotes gives non-clinical staff free logins, which helps once you hire a biller or front desk person.
Psychiatry and mixed practices. If some clinicians prescribe, compare prescriber pricing before anything else. ICANotes publishes a separate Prescribing plan with e-prescribing and lab ordering, so a practice can pay prescriber rates only for prescribers. Valant lists ePrescribing, PDMP access, group therapy tools, IOP and PHP workflows and revenue cycle services, and prices by the number and type of provider licenses. It quotes rather than publishing prices. TherapyNotes and SimplePractice both offer ePrescribe as an add-on, which works for a group with one or two prescribers.
When to add a standalone AI scribe. Use your EHR's built-in scribe first, because the draft lands in the chart. A standalone scribe such as Freed or Heidi Health makes sense if your EHR has no scribe, or if a clinician prefers a different note style. You then copy or push the note into the EHR. Get client consent to recording either way.
When to add a separate video or phone tool. EHR video covers most one-to-one sessions. Doxy.me has a free plan and a paid plan with group calls and a waiting room. It suits clinicians whose EHR has no video, or who need a backup. Spruce Health is a practice phone line with texting, fax and video under a BAA. It helps when clinicians currently text clients from personal phones.
When to add compliance software. A solo clinician can usually manage HIPAA with the vendor BAAs, a written risk analysis and annual training. Once you have staff, a program like Accountable or Compliancy Group keeps policies, training records, the risk assessment and BAAs in one place.
When you need an addiction treatment EHR instead. Outpatient counselors who treat some SUD clients can stay on a therapy EHR if it handles Part 2 consents. Programs running detox, residential, PHP or IOP levels of care, or medication-assisted treatment, need a platform built for that, such as Kipu Health or Benji. Our behavioral health and addiction EHR shortlist compares them on Part 2 support, MAT and group notes.
What mental health software costs
These figures use list prices from the vendors' own pricing pages as of November 2026. They exclude per-claim fees, card processing and taxes. Try your own numbers in the software cost calculator.
EHR subscription. TherapyNotes Solo is $69 a month. Its pricing page now lists Group at $89 for the first clinician plus $60 for each additional clinician. TherapyNotes announced that the old Group rate of $79 plus $50 changes with billing cycles starting December 1, 2026. Electronic claims go to 25 cents each and ERAs drop to 9 cents. SimplePractice Essential is $79 a month for one clinician, and Plus is $99 with additional clinicians starting at $74 each. ICANotes charges per clinician: $75 a month for Non-Prescribing and $213 for Prescribing (with a $99 activation fee), with the first non-clinical user free.
Add-ons. E-prescribing is $65 per prescriber per month on TherapyNotes and $49 a month plus an $89 setup fee on SimplePractice. AI notes cost $40 per clinician a month for TherapyFuel and $35 a month for SimplePractice Note Taker. Standalone, Freed Core is $79 per clinician and Heidi Clinician is $110 billed annually. Doxy.me Premium is $29 per user per month billed annually, and Spruce starts at $24 per user. Accountable Basic HIPAA is $169 a month billed annually ($2,028 a year), or $199 month to month.
Typical totals before claim fees:
- Solo therapist: about $70 to $80 a month for the EHR alone, or $110 to $160 with an AI scribe. That is roughly $830 to $1,900 a year.
- 3-clinician therapy group: about $210 to $250 a month for the EHR. Add AI notes for everyone and a compliance program and the total is about $500 to $650 a month, or $6,000 to $7,800 a year.
- 10-clinician practice: about $630 to $770 a month for the EHR. With AI notes and compliance, plan for $1,200 to $1,700 a month, or $14,000 to $21,000 a year. E-prescribing adds $49 to $140 a month per prescriber, depending on the EHR.
SimplePractice offers custom pricing to groups with six or more clinicians, and Valant quotes every deal, so get written quotes at the 10-clinician size.
Compliance checklist for mental health practices
- Sign a BAA with every vendor that touches client data. That includes the EHR, scribe, video, phone and texting, email and backup tools.
- Keep psychotherapy notes separate. HIPAA's extra protection applies only to process notes kept apart from the record. With few exceptions, disclosing them needs the client's written authorization, even to another treating provider.
- Know your duty-to-warn and mandatory reporting rules. HHS notes that disclosures required by other law, such as abuse reporting, are an exception to the authorization rule. State laws vary on whether a warning is mandatory or permitted.
- Check whether 42 CFR Part 2 applies. Federally assisted SUD programs had to comply with the 2024 Part 2 final rule by February 16, 2026. The rule allows a single consent for treatment, payment and operations. It adds HIPAA-style breach notification and penalties, and it protects SUD counseling notes much like psychotherapy notes.
- Track the DEA telemedicine deadline. DEA's flexibilities for prescribing controlled substances by telemedicine, without a prior in-person visit, are extended through December 31, 2026. Psychiatry practices should watch for the rule that replaces them.
- Follow Medicare telehealth rules. Medicare's in-person visit requirement for behavioral telehealth is waived through December 31, 2027. Home and audio-only behavioral telehealth are permanent.
- Give Good Faith Estimates to self-pay clients. Clients not using insurance are generally entitled to a Good Faith Estimate when they request one or schedule at least three business days ahead.
- Keep a current security risk analysis. Update it when you add systems or staff, train staff, and keep records of both.
Questions to ask in a demo
- How do you store psychotherapy notes separately from progress notes, and who can see them?
- Can one group session create a note and a claim for each attendee?
- Which note formats come built in (SOAP, DAP, BIRP), and can we edit the templates?
- What do e-prescribing, EPCS and PDMP checks cost per prescriber, and is there a setup fee?
- What are the per-claim, per-ERA and per-eligibility-check fees, and when did they last change?
- Is telehealth included, and does it support group sessions and clients joining without an app?
- Does the AI scribe store session audio, and how do we capture and record client consent?
- How do you support 42 CFR Part 2 consents and SUD counseling notes?
- Can clients complete intake, consents, outcome measures and Good Faith Estimates in the portal?
- Do non-clinical staff logins cost extra?
- How do you handle minors, guardians and personal representatives in the portal?
- What does it cost to export all our data if we leave?