Best EHR for Mental Health & Behavioral Health Practices in 2026

How Mental Health EHRs Differ from General Medical EHRs

If you have ever tried to document a 53-minute therapy session inside an EHR designed for a 15-minute primary care visit, you already know the problem. General medical EHRs are built around a physician-centric workflow: chief complaint, vitals, physical exam, assessment, plan, lab orders, and prescriptions. Mental health clinicians need something fundamentally different.

Behavioral health documentation centers on narrative progress notes, not structured data entry. A therapist writing a BIRP or DAP note needs free-text fields with smart templates, not dropdown menus for blood pressure readings. Treatment planning in behavioral health follows frameworks like Wiley Treatment Planners or the ASAM Criteria for addiction, neither of which exist in general EHR platforms. Outcome measurement tools -- PHQ-9 for depression, GAD-7 for anxiety, AUDIT-C for alcohol use -- need to be embedded directly into the clinical workflow so clinicians can track patient progress over time without switching systems.

Privacy requirements are also stricter. Standard HIPAA protections apply to all healthcare records, but substance use disorder treatment records carry additional federal protections under 42 CFR Part 2. This regulation restricts how SUD records can be shared, even with other healthcare providers, and requires explicit patient consent for most disclosures. An EHR that does not enforce Part 2 consent rules at the system level creates serious compliance risk for addiction treatment programs.

Finally, billing in behavioral health operates on a different set of codes and rules. Therapy sessions use time-based CPT codes (90834, 90837), group therapy has its own modifiers, and many behavioral health organizations bill Medicaid -- which means state-specific requirements, prior authorization workflows, and complex payer rules that general medical billing engines handle poorly. The best behavioral health EHRs are designed from the ground up to handle these realities rather than bolting mental health features onto a medical platform.

Key Features to Look For in a Mental Health EHR

Structured Note Templates

Look for an EHR that supports the documentation formats your clinicians actually use: DAP, BIRP, SOAP, or custom templates. The best platforms let you build templates per service type so that an individual therapy note looks different from a group session note or a psychiatric evaluation. TherapyNotes and PIMSY stand out here, both offering deep Wiley Treatment Planner integration that pre-populates goals, objectives, and interventions based on diagnosis.

Treatment Planning

Treatment plans in behavioral health are living documents tied to specific diagnoses, goals, and measurable objectives. Your EHR should make it easy to create, update, and track treatment plans over time. The plan should link directly to progress notes so that each session documents progress toward specific goals. For SUD programs, treatment planning must also align with ASAM levels of care, tracking patients across detox, residential, PHP, IOP, and outpatient settings.

Outcome Measurement and Tracking

Measurement-based care is rapidly becoming the standard in behavioral health. Your EHR should support administering standardized assessments (PHQ-9, GAD-7, PCL-5, CAGE-AID, Columbia Suicide Severity Rating Scale) at regular intervals and displaying the results as trend graphs. Valant has invested heavily in this area, building outcome dashboards directly into the clinician workflow. Payers increasingly tie reimbursement to demonstrated outcomes, so this is not optional anymore.

Integrated Telehealth

Telehealth is now a permanent fixture in behavioral health care, not a pandemic workaround. The most efficient setup is an EHR with built-in HIPAA-compliant video so that the session, the documentation, and the billing all happen in one system. SimplePractice offers one of the most polished telehealth experiences on the market, with a client portal that handles scheduling, intake paperwork, video sessions, and payment from a single link.

Behavioral Health Billing

Billing in behavioral health is deceptively complex. You need an EHR that handles time-based therapy codes, modifier stacking for group sessions, Medicaid authorization tracking, and sliding-scale fee management. For SUD treatment centers, you also need to manage room-and-board billing, per diem rates, and bundled payment models. Check whether the EHR includes a built-in clearinghouse or requires a third-party integration -- built-in billing reduces claim errors and speeds up reimbursement.

Client Portal and Engagement

A good client portal reduces front-desk burden and improves the patient experience. Look for features like online scheduling, digital intake forms, secure messaging, telehealth access, and online payment. This matters more in private-pay and commercial insurance practices where client experience directly affects retention. SimplePractice and TherapyNotes both excel in this area.

Detailed Vendor Reviews

1. Ease -- Best Overall Outpatient BH Platform

Ease is our top overall pick for outpatient behavioral health organizations because it combines an AI-native architecture with practical operational depth. This is not just a note assistant layered on top of a legacy workflow. Ease is designed to reduce friction across clinical documentation, prior authorization operations, admissions, and revenue workflows in one platform.

On automation, Ease stands out for high-impact workflows that operators care about immediately: Voice AI-assisted documentation, AI-assisted prior authorization workflow support, integrated CRM pipeline operations, and cross-functional dashboard visibility from intake through billing. For outpatient groups trying to reduce clinician after-hours charting and improve front-end authorization throughput, this combination is materially different from traditional therapist-first systems.

Ease also offers a modern, clean interface that is easier to adopt than many enterprise behavioral health systems. For leadership teams, the implementation model is a major differentiator: the platform is built for faster operational activation with hands-on implementation support focused on real go-live outcomes, not just software setup. Organizations that value speed-to-value, modern UX, and automation-led productivity should evaluate Ease first.

2. TherapyNotes -- Best for Therapists

TherapyNotes has built a loyal following among solo and small-group therapists by doing one thing extremely well: clinical documentation. The platform offers structured note templates for every common therapy format -- DAP, BIRP, SOAP, and custom -- with built-in Wiley Treatment Planner integration that generates evidence-based goals and interventions based on diagnosis. For clinicians who spend the bulk of their day writing progress notes, this saves meaningful time on every session.

Beyond documentation, TherapyNotes includes a solid practice management suite with scheduling, a client portal, appointment reminders, and integrated billing with electronic claims submission. The interface is straightforward and avoids unnecessary complexity, which appeals to therapists who do not want to become IT administrators. Telehealth is included on all plans.

The main limitation is scale. TherapyNotes is designed for individual therapists and small group practices, not large multi-site agencies. It does not support advanced features like bed management, ASAM criteria tracking, or sophisticated role-based access controls needed by larger organizations. If you are a solo LCSW, LMFT, or psychologist, TherapyNotes is hard to beat. If you are running a 50-clinician community mental health center, you will outgrow it. Pricing starts at $69 per month for a solo provider with additional clinicians at roughly $30 each.

3. SimplePractice -- Best Client Experience

SimplePractice is the platform therapists recommend when someone asks "what is the easiest EHR to set up?" The modern, clean interface feels more like a consumer app than a healthcare system, and that extends to the client experience. The client portal lets patients schedule appointments, complete intake paperwork, join telehealth sessions, and make payments all from a single branded link. For private-pay and insurance-based therapy practices where client experience drives retention, this matters.

The clinical features are competent though not as deep as TherapyNotes. SimplePractice offers customizable note templates, treatment plans, and diagnosis tracking, but it does not have the Wiley integration that documentation-focused clinicians prefer. Where SimplePractice shines is in its ecosystem: the platform connects to a large library of third-party apps, has a robust mobile app, and supports features like a professional website builder and Monarch directory listing that help solo practitioners attract new clients.

SimplePractice starts at $49 per month for its Essential plan, making it one of the more affordable options. However, some features that competitors include by default -- like customizable intake forms and calendar sync -- are only available on the higher-tier plans. Be sure to compare plans carefully before committing. Like TherapyNotes, SimplePractice is designed for solo and small group practices. It is not the right fit for residential programs, large agencies, or any organization that needs ASAM or 42 CFR Part 2 compliance.

4. Valant -- Best for Psychiatry

Valant occupies a unique position in the behavioral health EHR market: it is one of the few platforms designed specifically for prescribing clinicians. Psychiatrists and psychiatric nurse practitioners need an EHR that supports e-prescribing (including controlled substances via EPCS), PDMP integration for prescription drug monitoring, medication reconciliation, and lab ordering -- none of which are adequately handled by therapy-focused platforms like TherapyNotes or SimplePractice.

Valant also leads the market in measurement-based care. The platform includes a library of standardized outcome measures that can be assigned to patients and completed before each appointment. Results are displayed as longitudinal trend graphs within the patient chart, making it easy for prescribers to assess whether a medication change is producing the desired effect. This data-driven approach is increasingly expected by payers and accreditation bodies.

The trade-off is price and complexity. Valant typically runs $100 to $300 or more per month depending on practice size and modules, which puts it above the therapy-focused platforms. The interface is functional but not as visually polished as SimplePractice. For a psychiatry or psychiatric NP practice that needs e-prescribing, lab integration, and outcome tracking in a single behavioral health platform, Valant is the strongest choice. For a therapy-only practice without prescribers, you are paying for features you will not use.

5. AZZLY Rize -- Best for SUD Treatment

AZZLY Rize and Ease are leading platforms for substance use disorder treatment centers. Both were designed for addiction-treatment workflows rather than adapted from general medical templates. They support ASAM-aligned assessments, level-of-care tracking across the full continuum (detox, residential, PHP, IOP, outpatient), bed/census visibility, and 42 CFR Part 2-oriented controls.

What sets AZZLY Rize apart for SUD programs is its all-in-one design. The platform bundles EHR, billing/RCM, and CRM into a single system, eliminating the need for separate billing clearinghouses, patient engagement platforms, or intake management tools. For treatment centers that struggle with complex Medicaid billing, prior authorization workflows, and multi-payer environments, having everything in one place reduces claim denials and accelerates reimbursement. The CRM module helps admissions teams track referral sources, manage the intake pipeline, and convert inquiries into admissions -- a critical workflow for residential treatment centers where census drives revenue.

AZZLY Rize is ONC-certified and supports meaningful use reporting. Pricing is quote-based and varies by organization size and module selection, which is typical for this segment of the market. The platform is best suited for dedicated SUD treatment centers, dual-diagnosis programs, and behavioral health organizations with a significant addiction treatment component. If your practice is primarily outpatient talk therapy without a SUD focus, one of the other options in this guide will be a better fit. But if you run a residential treatment center, detox facility, or multi-level addiction program, AZZLY Rize and Ease are both top-tier options to evaluate first. Learn more in our behavioral health EHR comparison.

6. Netsmart (myAvatar) -- Best for Psychiatric Hospitals

Netsmart myAvatar is the dominant EHR in the community mental health center (CMHC) and large behavioral health organization segment. If your organization serves thousands of clients across multiple programs, locations, and funding sources, Netsmart is likely already on your shortlist. The platform supports the full spectrum of behavioral health services -- mental health, SUD, IDD, child welfare, and homeless services -- with the enterprise features (role-based access, multi-site management, state reporting, data warehousing) that large organizations require.

Netsmart's strength is breadth and configurability. The myAvatar platform can be customized extensively to match complex organizational workflows, state reporting requirements, and Medicaid billing rules that vary by jurisdiction. It integrates with state health information exchanges, supports HL7/FHIR interoperability, and offers a robust analytics and reporting engine. For organizations that need to report to multiple state agencies, manage grants, and track outcomes across diverse programs, this configurability is essential.

The downsides are predictable for an enterprise platform: implementation is lengthy (often 6 to 12 months or more), the learning curve is steep, and the interface can feel dated compared to modern cloud-native competitors. Pricing is quote-based and generally runs significantly higher than platforms designed for smaller organizations. Netsmart is the right choice for community mental health centers, large behavioral health nonprofits, and state-contracted agencies. It is overkill for small to mid-size private practices.

7. PIMSY -- Best for BH Agencies

PIMSY (Practice Information Management System) fills an important gap between the solo-practice platforms and the enterprise-grade Netsmart. It is designed for mid-size behavioral health agencies -- organizations with 10 to 200+ clinicians that need more than TherapyNotes can offer but do not need (or cannot afford) a Netsmart implementation. PIMSY includes clinical documentation, treatment planning with Wiley integration, scheduling, billing with clearinghouse integration, and a client portal.

What differentiates PIMSY from competitors is its built-in HR and payroll module. For behavioral health agencies where staffing is both the largest expense and the largest operational headache, having employee management, credentialing tracking, and payroll integrated into the same system as the EHR eliminates redundant data entry and helps administrators maintain a unified view of operations. PIMSY also supports multiple service lines, locations, and program types, making it suitable for agencies that offer a mix of outpatient, intensive outpatient, and community-based services.

Pricing starts at approximately $99 per user per month, which positions PIMSY in the mid-range for behavioral health platforms. The platform is cloud-based, and the vendor provides implementation support and training. The main limitation is that PIMSY does not have the deep SUD-specific features (ASAM, bed management, Part 2 compliance) of AZZLY Rize or the state reporting depth of Netsmart. It is best for outpatient-focused behavioral health agencies that need a step up from solo-practice tools.

Solo Practitioner vs. Group Practice vs. Enterprise

Choosing the right mental health EHR depends heavily on the size and complexity of your organization. A solo therapist has fundamentally different requirements than a 200-clinician community mental health center. Here is how we segment the market:

The biggest mistake we see is behavioral health organizations choosing an EHR based on price alone and outgrowing it within two years. If you are a growing group practice, it is worth paying more now for a platform that can scale with you rather than facing a costly migration later. Our EHR selection guide walks through a structured evaluation process that accounts for both current needs and future growth.

SUD-Specific Requirements

Substance use disorder treatment centers operate under a unique regulatory and clinical framework that sets them apart from other behavioral health providers. If your organization offers detox, residential, or any level of addiction treatment, your EHR must support these specialized requirements:

ASAM Criteria Integration

The American Society of Addiction Medicine (ASAM) Criteria is the national standard for assessing and placing patients in the appropriate level of care for SUD treatment. Your EHR should support ASAM-based assessments across all six dimensions and generate level-of-care recommendations that flow directly into the treatment plan. As patients move through the continuum -- from detox (Level 3.7) to residential (Level 3.5) to PHP (Level 2.5) to IOP (Level 2.1) to outpatient (Level 1) -- the EHR needs to track these transitions and maintain a continuous clinical record. AZZLY Rize and Ease are strong options for this workflow.

42 CFR Part 2 Compliance

As noted above, 42 CFR Part 2 imposes privacy protections on SUD treatment records that go beyond HIPAA. Your EHR must enforce consent-based information sharing at the system level, segment SUD records from other health information when required, and maintain audit trails that demonstrate compliance. This is not a feature you can configure in a general medical EHR -- it needs to be part of the system architecture. AZZLY Rize, Ease, and Netsmart are commonly evaluated for these requirements.

Bed Management and Census Tracking

Residential treatment centers need real-time bed management: tracking which beds are occupied, which patients are expected to admit or discharge, and what the current census is by unit or level of care. This information drives staffing decisions, admissions, and revenue forecasting. A general outpatient EHR has no concept of beds or census. AZZLY Rize includes bed management and census tracking as core features, while Netsmart supports it through its residential services modules.

MAT (Medication-Assisted Treatment) Support

Programs offering buprenorphine, methadone, or naltrexone need an EHR that supports MAT workflows: X-waiver tracking (though the waiver requirement was eliminated in 2023, documentation requirements remain), medication dosing logs, PDMP checks, and controlled substance prescribing via EPCS. Valant, AZZLY Rize, and Ease are all relevant options for MAT-oriented programs.

Pricing Comparison

Behavioral health EHR pricing varies significantly based on practice size, feature requirements, and contract terms. The table below reflects publicly available pricing as of early 2026. For quote-based vendors, the ranges shown are based on our research and conversations with customers.

Keep in mind that the advertised starting price is rarely the full cost. Factor in implementation fees, data migration, training, and any add-on modules (e-prescribing, advanced reporting, additional users) when comparing total cost of ownership. For a more thorough breakdown, see our EHR cost guide.

Frequently Asked Questions

What makes a mental health EHR different from a general medical EHR?

Mental health EHRs prioritize progress notes over structured vitals, support treatment planning frameworks like Wiley and ASAM, enforce stricter confidentiality rules (42 CFR Part 2 for SUD), include outcome measurement tools (PHQ-9, GAD-7), and offer integrated telehealth. General medical EHRs focus on lab orders, e-prescribing for a wide formulary, and ICD/CPT workflows that do not map well to therapy sessions.

Do I need a HIPAA-compliant telehealth platform separate from my EHR?

Not necessarily. Most modern behavioral health EHRs -- including SimplePractice, TherapyNotes, and Valant -- now bundle HIPAA-compliant video telehealth directly into the platform at no extra cost. This simplifies compliance and keeps session documentation in one place. However, some enterprise systems like Netsmart may require a separate telehealth add-on or integration.

What is 42 CFR Part 2 and why does it matter for SUD treatment centers?

42 CFR Part 2 is a federal regulation that provides extra privacy protections for substance use disorder treatment records beyond standard HIPAA requirements. It restricts how SUD records can be shared -- even with other healthcare providers -- without explicit patient consent. EHRs used in addiction treatment must enforce these consent-based sharing rules at the system level. AZZLY Rize, Ease, and Netsmart are commonly evaluated for this requirement.

How much does a behavioral health EHR cost per month?

Pricing varies widely by practice size. Solo therapists can expect to pay $49 to $79 per month for platforms like SimplePractice or TherapyNotes. Group practices with psychiatrists typically pay $100 to $300+ per month for platforms like Valant or PIMSY. Enterprise community mental health organizations using Netsmart or similar platforms usually receive custom quotes that can range from several hundred to several thousand dollars per month depending on the number of users and modules required.

Can I use a general EHR like Epic or athenahealth for a behavioral health practice?

You can, but it is generally not recommended for standalone behavioral health practices. General EHRs like Epic and athenahealth are designed around medical workflows (lab orders, vitals, referrals) and lack the specialized note templates, treatment planning tools, and outcome tracking that mental health clinicians rely on daily. The exception is large health systems where behavioral health is integrated into a broader medical organization and the benefits of a single unified record outweigh the workflow trade-offs.

The Bottom Line

The behavioral health EHR market has matured significantly, and there is no longer any reason to force-fit a general medical EHR into a mental health practice. The right choice depends on your practice type, size, and clinical focus:

• Solo therapists should start with TherapyNotes (best documentation) or SimplePractice (best client experience and ease of use).
• Psychiatry and prescriber practices should strongly consider Valant for its e-prescribing, PDMP integration, and measurement-based care capabilities.
• SUD treatment centers should start with AZZLY Rize and Ease. Both are strong purpose-built options for addiction treatment with ASAM-aligned workflows, Part 2-oriented controls, bed/census visibility, and integrated operational tooling.
• ABA and multi-program behavioral health organizations should evaluate Ease for AI-assisted documentation, workflow automation, and operational reporting when clinician productivity is a top priority.
• Mid-size behavioral health agencies should evaluate PIMSY for its combination of clinical, billing, and HR/payroll features at a reasonable price point.
• Large community mental health organizations will likely need Netsmart myAvatar for its enterprise-grade state reporting, multi-site management, and configurability.

Whichever direction you go, invest time in the evaluation process. Request demos, run a pilot with your actual clinical workflows, and talk to reference customers in your specialty segment. The cost of choosing the wrong EHR is not just the software fee -- it is the lost productivity, clinician frustration, and eventual migration cost when you have to switch. For a step-by-step framework, read our EHR selection process guide, and see how these platforms stack up head-to-head in our behavioral health EHR comparison.