Best EHR for Therapists & Counselors in 2026

What Therapists Need from an EHR

Therapists, counselors, and psychotherapists have fundamentally different EHR requirements than primary care physicians or hospital systems. General medical EHRs are designed around chief complaints, physical exams, lab orders, and medication management. Therapy practices, by contrast, revolve around session notes, treatment plans, progress tracking, and the therapeutic relationship itself. An EHR that forces a therapist into a medically-oriented documentation workflow will slow down sessions, frustrate clinicians, and ultimately compromise the quality of care.

The best EHR for therapists prioritizes clinical note templates built for behavioral health -- formats like DAP (Data, Assessment, Plan), SOAP (Subjective, Objective, Assessment, Plan), and BIRP (Behavior, Intervention, Response, Plan). It should support treatment plan builders that align with evidence-based practices and insurance documentation requirements. Integrated billing is critical because most therapy practices submit insurance claims using CPT codes like 90834 (45-minute individual therapy) and 90837 (60-minute individual therapy), and errors in claim submission directly impact revenue. Finally, telehealth is no longer optional -- the majority of therapy practices now offer at least some virtual sessions, and the EHR should make launching a HIPAA-compliant video call as seamless as clicking a button from the calendar.

Other features that matter specifically to therapists include client self-scheduling, automated appointment reminders (no-show rates in therapy practices average 12-18%), secure messaging, digital intake forms, consent management, and a client portal where patients can complete assessments between sessions. If your practice involves substance use disorder (SUD) treatment, the platforms reviewed here are not the right fit -- you need specialized SUD EHR functionality like ASAM-level documentation, bed management, and 42 CFR Part 2-oriented controls. See our AZZLY Rize profile and Ease profile for platforms purpose-built for addiction treatment.

Solo Therapist vs. Group Practice Needs

The right EHR choice depends heavily on whether you are a solo practitioner or running a group practice. Solo therapists typically prioritize simplicity, low cost, and fast documentation workflows. You need to get notes done between sessions without a steep learning curve. Platforms like TherapyNotes and SimplePractice excel here because they were originally designed for the solo clinician and keep their interfaces lean.

Group practices introduce additional complexity. You need multi-provider scheduling with visibility across clinicians, centralized billing with the ability to track revenue by provider, role-based access controls so that intake staff cannot view clinical notes, and reporting dashboards that give practice owners insight into utilization rates and outstanding claims. Larger groups may also need supervisor-review workflows for provisionally licensed clinicians, group therapy session documentation, and multi-location support. Platforms like PIMSY and Valant are built with these organizational needs in mind, while TherapyNotes and SimplePractice can handle small groups (up to roughly 15 clinicians) but may feel constrained beyond that.

For community mental health agencies or organizations with 50+ clinicians, the platforms in this guide may not be sufficient. At that scale, you should evaluate enterprise behavioral health EHRs -- see our behavioral health EHR comparison for options like Netsmart and Qualifacts.

Detailed Vendor Reviews

1. TherapyNotes -- Best Overall

TherapyNotes has been the default recommendation for therapy practices since its founding in 2010, and it continues to earn that position in 2026. The platform was built specifically by and for mental health professionals, and its clinical documentation engine reflects that focus. TherapyNotes includes the Wiley Treatment Planner integration, which provides thousands of pre-written treatment goals, objectives, and interventions mapped to DSM-5 diagnoses. For therapists who find treatment planning tedious, this feature alone can save hours each week.

The note-taking experience is highly structured. TherapyNotes provides dedicated templates for individual therapy, group therapy, couples sessions, intake evaluations, and discharge summaries. Each template includes the fields that insurance companies expect to see, which reduces claim denials. The built-in billing module handles electronic claim submission, ERA posting, and patient statements. Claim submission costs $0.14 per claim or $65/month for unlimited submissions -- transparent pricing that most competitors do not match.

Where TherapyNotes falls short is its interface design. The UI is functional but dated compared to SimplePractice. The client portal is adequate but not best-in-class. Mobile access is limited to a responsive web interface rather than a native app. For a deeper comparison, see our TherapyNotes vs. SimplePractice breakdown. Pricing starts at $69/month for a solo clinician, with additional providers at approximately $39/month each.

2. SimplePractice -- Best Design

SimplePractice is the most visually polished EHR in the therapy space. Its interface feels more like a modern SaaS product than a clinical system, which appeals to therapists who value usability and aesthetics. The onboarding experience is exceptionally smooth -- most solo practitioners can have their practice fully configured within a few hours, including importing client lists, setting up insurance, and customizing intake paperwork.

The client portal is SimplePractice's standout feature. Clients can request appointments, complete intake forms, sign consent documents, make payments, and join telehealth sessions -- all from a single, branded portal. Automated appointment reminders via email, text, and voice reduce no-shows significantly. The platform also supports a public-facing professional website with online booking, which is valuable for therapists who want to attract new clients without maintaining a separate website.

SimplePractice's clinical documentation is flexible but less structured than TherapyNotes. Templates are customizable, which gives experienced clinicians control but may leave newer therapists without enough guidance. The platform has expanded its billing features over the years, but claim submission accuracy and ERA processing are not quite as reliable as TherapyNotes based on user feedback. Pricing starts at $49/month for the Starter plan (which excludes telehealth and insurance billing) and $69/month for the Essential plan that most practices need. Group practice pricing adds $39/month per clinician.

3. BreezyNotes -- Best Budget Option

BreezyNotes was built by a licensed therapist who wanted a simpler, more affordable alternative to the dominant platforms. Its defining feature is a per-note pricing model that charges based on actual usage rather than a flat monthly fee. The base plan starts at $19/month with notes charged individually, scaling up to $189/month for unlimited usage. For therapists with a light caseload -- say, 10-15 sessions per week -- BreezyNotes can cost significantly less than TherapyNotes or SimplePractice.

Despite the lower price, BreezyNotes does not cut corners on clinical features. The platform includes pre-built DAP, SOAP, and BIRP templates, a treatment plan builder, insurance billing with electronic claim submission, appointment reminders, and HIPAA-compliant telehealth. The interface is clean and straightforward, reflecting its therapist-designed origins. Documentation workflows are fast -- most notes can be completed in under five minutes using the structured templates.

The tradeoffs are real, however. BreezyNotes has a smaller development team, which means new features arrive more slowly. The client portal is basic compared to SimplePractice. Reporting and analytics are limited, which can be a problem for group practices that need financial visibility. And because the platform is newer, the knowledge base and community support resources are thinner. BreezyNotes is best suited for solo therapists or very small practices (two to three clinicians) who want to keep costs low without sacrificing core EHR functionality.

4. Valant -- Best for Psychiatry Integration

Valant occupies a unique niche: it serves practices that combine therapy and psychiatric prescribing under one roof. If your practice includes both licensed therapists and psychiatrists or psychiatric nurse practitioners, Valant is purpose-built for that hybrid model. The platform includes a full e-prescribing module (EPCS-certified for controlled substances), medication management tracking, and clinical decision support tools that therapy-only platforms simply do not offer.

On the therapy side, Valant provides configurable note templates, outcome measurement tools (including PHQ-9 and GAD-7 integration), and a structured treatment planning workflow. The platform also includes a patient portal, online scheduling, automated reminders, and telehealth. Valant's reporting is more robust than most therapy EHRs, with dashboards for clinical outcomes, financial performance, and operational metrics. This makes it a strong fit for mid-size practices that need data to make business decisions.

The downsides are cost and complexity. Valant's pricing ranges from approximately $100 to $300+ per month depending on practice size and module selection, making it the most expensive option on this list for therapy-only practices. The interface is functional but not as intuitive as SimplePractice -- there is a steeper learning curve, particularly for the billing and reporting modules. If your practice does not involve prescribing, Valant's medication management features add cost and complexity you do not need.

5. PIMSY -- Best for Agencies

PIMSY (Practice Information Management System) targets behavioral health agencies and larger group practices that need more than just an EHR. It is a full practice management platform that includes HR and payroll tracking, staff credentialing, productivity dashboards, treatment planning, and compliance management -- features that solo-practitioner platforms do not attempt. If you run a community counseling center, a group practice with 10+ clinicians, or a multi-service behavioral health agency, PIMSY addresses operational needs that TherapyNotes and SimplePractice were never designed to handle.

Clinical documentation in PIMSY supports multiple note formats and is configurable to match your agency's workflows. The treatment planning module is comprehensive, with goal tracking, outcome measurement, and audit-ready documentation. Billing supports both insurance and grant-funded services, which is important for community mental health organizations that rely on multiple funding sources. The platform also includes robust reporting for regulatory compliance, including state-mandated outcome reporting in many jurisdictions.

PIMSY's pricing starts at $99 per user per month, which makes it expensive for small practices but competitive for agencies when compared to enterprise EHRs like Netsmart or Qualifacts that can cost significantly more. The interface is not as modern as SimplePractice, and the initial setup requires more configuration time because of the platform's depth. PIMSY is not the right choice for a solo therapist or a small group -- it is built for organizations that have outgrown simpler tools and need a platform that scales with operational complexity.

Note Template Comparison: DAP, SOAP, and BIRP

The three most common therapy note formats each serve different documentation philosophies. Understanding which formats your EHR supports -- and how well -- matters for both clinical quality and insurance compliance.

TherapyNotes offers the deepest template library of any platform in this comparison. Its Wiley Treatment Planner integration auto-populates treatment goals and objectives based on diagnosis, and its note templates include structured fields that map directly to the DAP, SOAP, and BIRP formats. This structure is especially helpful for newer clinicians or practices that need consistency across multiple providers.

SimplePractice takes a more flexible approach -- its templates are customizable, so you can build any note format you want. The downside is that SimplePractice does not provide as many pre-built structured templates out of the box. BIRP-style notes require manual template creation. BreezyNotes includes pre-built DAP, SOAP, and BIRP templates that are clean and fast to complete. Valant supports configurable clinical notes but emphasizes its own structured format rather than traditional therapy note acronyms. PIMSY supports all major formats and allows agency-wide template standardization, which is useful for organizations with documentation compliance requirements.

Telehealth Feature Comparison

Every platform in this guide now includes integrated telehealth, but the quality and depth of these features varies meaningfully.

SimplePractice has the most robust telehealth implementation, supporting up to 15 participants in group video sessions and offering a polished client experience with branded waiting rooms. TherapyNotes integrates telehealth tightly with its scheduling and documentation workflows -- launching a session automatically creates a telehealth note template. BreezyNotes covers the basics well but lacks screen sharing and group video, which limits it for practices that run group therapy sessions virtually. Valant and PIMSY both offer solid telehealth with group session support, though their video interfaces are not as polished as SimplePractice's.

Client Portal and Intake Comparison

A well-designed client portal reduces administrative burden and improves the client experience. Here is how each platform handles the pre-session and between-session touchpoints.

SimplePractice leads the field in client experience. Its portal is modern, mobile-friendly, and handles the entire client journey from initial booking through intake paperwork, payment, and session access. The voice-call reminder feature is unique among therapy EHRs and is particularly effective for older client populations. TherapyNotes provides a solid portal that covers the essentials but lacks the visual polish and configurability of SimplePractice's offering.

Valant differentiates itself with built-in outcome measurement tools. Clients can complete PHQ-9, GAD-7, and other validated assessments through the portal before each session, giving therapists objective data to track treatment progress. This is valuable for practices that emphasize measurement-based care or need outcome data for insurance authorizations. PIMSY also includes outcome assessment capabilities as part of its broader agency management feature set.

Pricing Comparison

For solo therapists on a budget, BreezyNotes offers the lowest entry point at $19/month with per-note pricing. SimplePractice's Starter plan at $49/month is attractive but excludes telehealth and insurance billing -- most therapists will need the $69/month Essential plan. TherapyNotes at $69/month includes everything a solo practitioner needs with transparent claim pricing. Valant and PIMSY are more expensive but include features (e-prescribing and agency management, respectively) that justify the premium for practices that need them.

Frequently Asked Questions

What is the best EHR for a solo therapist?

For most solo therapists, TherapyNotes offers the strongest combination of structured clinical documentation, integrated billing, and affordability at $69 per month. SimplePractice is an excellent alternative if you prioritize a polished client-facing experience and modern interface design. BreezyNotes is worth considering if you see a low volume of clients and want per-note pricing to keep costs minimal.

Do therapy EHRs include telehealth?

Yes, all five EHRs reviewed in this guide include built-in HIPAA-compliant telehealth. TherapyNotes, SimplePractice (Essential plan and above), and BreezyNotes bundle telehealth into their standard plans. Valant includes telehealth across its plans as well. PIMSY offers telehealth with optional add-on pricing depending on the tier. Most platforms allow you to launch sessions directly from the scheduling calendar.

Can I use a therapy EHR for substance use disorder treatment?

General therapy EHRs like TherapyNotes and SimplePractice are not designed for SUD treatment programs. They lack ASAM-level documentation, bed management, 42 CFR Part 2 compliance workflows, and the discharge-planning features that residential and outpatient addiction treatment centers require. For SUD-specific needs, AZZLY Rize is purpose-built for behavioral health and addiction treatment facilities.

What note formats do therapy EHRs support?

Most therapy EHRs support DAP (Data, Assessment, Plan), SOAP (Subjective, Objective, Assessment, Plan), and BIRP (Behavior, Intervention, Response, Plan) note formats. TherapyNotes offers the deepest template library with Wiley Treatment Planner integration. SimplePractice provides customizable templates that can be adapted to any format. BreezyNotes includes pre-built DAP, SOAP, and BIRP templates. Valant supports configurable clinical notes with structured treatment planning fields.

How much does an EHR for a therapy practice cost?

EHR pricing for therapy practices typically ranges from $49 to $300 per month depending on the platform and practice size. Solo practitioners can expect to pay between $49 and $79 per month. Group practices usually pay a base fee plus $30 to $59 per additional clinician. BreezyNotes offers a unique per-note pricing model starting at $19 per month that can be cost-effective for low-volume practices. Most platforms charge additional fees for insurance claim submissions, typically $0.14 to $0.25 per claim.

The Bottom Line

Choosing the right EHR for your therapy practice comes down to three factors: practice size, clinical workflow preferences, and budget.

Solo therapists who prioritize documentation quality and billing accuracy should start with TherapyNotes. If client experience and interface design matter more, SimplePractice is the better fit. Budget-conscious clinicians with lighter caseloads should evaluate BreezyNotes and its per-note pricing model. For a detailed side-by-side of the two most popular options, see our TherapyNotes vs. SimplePractice comparison.

Group practices that combine therapy and prescribing should look at Valant for its e-prescribing and outcome measurement capabilities. Agencies and larger organizations that need HR, compliance, and multi-funder billing should evaluate PIMSY -- or, if the organization has grown beyond 50 clinicians, move up to enterprise platforms covered in our behavioral health EHR comparison.

If your practice focuses on substance use disorder treatment -- whether residential, partial hospitalization, or intensive outpatient -- none of the platforms in this guide are the right choice. You need an EHR with ASAM integration, bed management, and addiction-specific compliance features. AZZLY Rize is purpose-built for that use case and is our top recommendation for SUD treatment facilities.