The Best Mental Health EHRs

If you’re opening a private practice, one of the first big decisions you’ll make is which EHR to use.

Ask ten therapists what they recommend, and you’ll probably get ten different answers.

The truth is, there isn’t one “best” EHR for everyone. The right choice depends on how you run your practice, whether you accept insurance, how much billing you plan to do yourself, and what features you’ll actually use.

I’ve worked behind the scenes with therapy practices for years, and one thing I’ve learned is this: the fanciest software isn’t always the best investment. A simple system that saves you time every day is usually worth more than a platform packed with features you’ll never touch.

Here’s a look at some of the most popular options and what they’re best suited for.

What Should You Look for in an EHR?

Every therapist’s needs are a little different, but these are the features I recommend paying attention to before signing up.

• Appointment scheduling
• Secure client portal
• Insurance billing
• Electronic claim submission
• Progress note templates
• Treatment plans
• Online payments
• Telehealth
• Automated appointment reminders
• Customer support
• Pricing that fits your budget

If you’re planning to bill insurance, don’t assume every EHR handles claims the same way. Some have robust billing features, while others require additional services or integrations.

1. TherapyNotes

TherapyNotes has earned its reputation. It’s purpose-built for behavioral health, which means the documentation templates actually make sense for therapy — they’re not just repurposed from a general medical EHR. The billing side is solid too. Claims submission, ERA posting, and the accounts receivable dashboard are all in one place and work reliably.

What catches people off guard is that the interface feels dated compared to newer platforms. It’s not hard to use — it’s actually quite logical — but it doesn’t have the polished, modern feel that SimplePractice does. If aesthetics matter to you, that’s worth knowing before you start a trial.

One thing I genuinely appreciate about TherapyNotes is their customer support. It’s consistently praised, and in billing work, having a platform that picks up the phone and actually resolves issues matters more than people realize.

Pros

• Built specifically for behavioral health
• Excellent insurance billing tools
• Built-in claim submission
• Reliable scheduling
• Good documentation templates
• Strong customer support

Cons

• Interface isn’t the most modern
• Fewer customization options than some competitors

Best for: Therapists who bill insurance regularly and want an established platform.

2. SimplePractice

SimplePractice is probably the most recognizable name in the space, and for good reason. The client experience is excellent — the portal is clean, intake forms work smoothly, and telehealth is built right in. For therapists who care about the first impression their clients get, SimplePractice delivers.

Where I’d pump the brakes is on pricing. It’s not unreasonable for what you’re getting, but go in with eyes open.

SimplePractice has also raised prices and made plan changes over the years with less notice than some therapists would like. It’s worth reading the fine print before committing to annual billing.

Pros

• Very user-friendly
• Attractive client portal
• Online scheduling
• Telehealth included
• Paperless intake forms
• Insurance billing available

Cons

• Can become expensive as you add features
• Some therapists outgrow it as their practice expands

Best for: SimplePractice is great for new solo therapists who want an all-in-one system that’s easy to learn.

Also see:

• SimplePractice vs Jane
• SimplePractice vs TherapyNotes
• CarePatron vs SimplePractice
• TherapyNotes vs. SimplePractice
• Sessions Health vs. SimplePractice
• Healthie vs SimplePractice

3. Sessions Health

Sessions Health has quietly become one of the most talked-about options for solo therapists who feel like the bigger platforms are charging for features they’ll never use. The $39 base price is genuinely hard to argue with, and the core features — scheduling, notes, billing, client portal — are all there.

What stands out most in the reviews I’ve seen is the customer support and the pricing stability. In a space where price increases have become almost annual news, Sessions Health has been unusually consistent. That matters if you’re trying to budget predictably for your practice.

The trade-off is that Sessions Health has fewer third-party integrations and isn’t as feature-rich as TherapyNotes or SimplePractice for high-volume insurance billing. If you’re seeing a moderate caseload and want something clean and affordable, it’s worth a trial. If you’re submitting 80+ claims a month and need robust AR reporting, you may eventually want more.

Pros

• Affordable
• Easy to learn
• Excellent customer support
• Insurance billing
• Secure messaging
• Clean interface

Cons

• Fewer third-party integrations
• Smaller company, so updates may roll out more gradually

Best for: Budget-conscious solo therapists who still want a full-featured EHR.

4. Jane

Jane has built a loyal following among therapists and other wellness professionals, and it’s easy to see why. The software feels clean, intuitive, and doesn’t take long to learn, even if you’re not especially tech-savvy.

One thing I like about Jane is that it strikes a nice balance between functionality and simplicity. It gives you the tools you need without feeling cluttered or overwhelming.

Depending on the plan you choose, Jane offers features like:

• Online appointment scheduling
• Automated appointment reminders
• Secure telehealth
• Clinical documentation
• Insurance billing
• Payment processing
• Online intake forms
• Waitlists
• Digital charting
• Financial reporting

Clients also tend to appreciate the online booking experience, which is straightforward and easy to navigate.

If your practice is primarily private pay, Jane is an especially strong option. If you bill insurance regularly, it’s still worth considering, but I’d compare its billing workflow with TherapyNotes and Sessions Health to see which better matches your needs.

Pros

• Clean, modern interface
• Easy to learn
• Excellent online scheduling
• Strong client experience
• Reliable customer support
• Works well for both solo therapists and small group practices

Cons

• Billing features may not be as robust as some platforms that focus heavily on insurance claims
• Pricing can increase as your practice grows or if you need additional features

Best for: Jane is best for solo therapists and small practices looking for an intuitive, all-in-one practice management system with an excellent client experience.

5. TherapyAppointment

TherapyAppointment doesn’t get as much buzz as the other platforms, but it has a loyal user base for a reason. The session-based pricing model is genuinely different from anything else on this list — you pay $10 a month when you’re seeing fewer than 10 clients, and $39 when your caseload grows. Every feature is included at every tier, no upsells.

The honest downside is that the interface is older and hasn’t kept pace with what newer platforms look like. If you value a modern, polished experience, it’ll probably feel clunky. But if you’re in the early stages of building a practice and want to keep costs low while you’re getting started, there’s a real argument for starting here and switching later when your caseload justifies it.

Pros

• Insurance billing
• Scheduling
• Client portal
• Secure messaging

Cons

• Older interface
• Fewer modern workflow features

Best for: Therapists who value stability over flashy design.

6. Carepatron

Carepatron has gained traction fast, largely on the strength of its free plan — a genuinely usable tier that includes unlimited clients, telehealth, an AI scribe, and clinical documentation templates, not just a stripped-down trial.

Pros

• Real free plan, not just a trial
• Paid tiers still land well below most competitors, generally starting under $20/user/month
• Clean, modern interface
• Built-in AI scribe even on lower tiers

Cons

• Reporting and analytics are limited compared to established platforms
• Insurance billing and some automation features require a paid tier
• Less of a track record with high-volume insurance billing than TherapyNotes or SimplePractice

Best for: Budget-conscious solo therapists, especially those just starting out or primarily private-pay, who want a modern system without a big monthly commitment appreciate CarePatron.
→ See how it stacks up specifically against SimplePractice: Carepatron vs. SimplePractice.

What About Headway and Alma?

This is one of the most common questions I hear.

Technically, Headway and Alma aren’t EHRs.

They’re insurance contracting and billing platforms that can help therapists get credentialed and submit claims. Many therapists use them alongside an EHR instead of replacing one.

If your goal is to simplify insurance billing or join insurance panels more quickly, they’re worth looking into. Just keep in mind you’ll still need a place to store clinical documentation and manage your practice.

See Also: Headway vs. Alma

Which EHR Is Best for Insurance Billing?

If insurance billing is a major part of your practice, I’d focus on systems that make claims, payment posting, and reporting as straightforward as possible.

Features to look for include:

• Electronic claim submission
• ERA posting
• Eligibility verification
• Clearinghouse integration
• Accounts receivable reports
• Patient balance tracking

The easier it is to see what’s been paid—and what hasn’t—the less time you’ll spend chasing down unpaid claims.

A Note on HIPAA Compliance and Data Security

This is something that comes up in almost every conversation I have with therapists who are new to EHR shopping, and it deserves more than a passing mention.

All five of the platforms listed here are HIPAA-compliant and will provide a Business Associate Agreement (BAA), which is the legal contract that documents a vendor’s responsibility to protect patient health information. If a platform won’t sign a BAA, that’s not a platform you should be using to store client records, full stop.

What HIPAA Compliance Actually Means

HIPAA compliance in an EHR means the vendor has put technical, administrative, and physical safeguards in place to protect electronic protected health information (ePHI). In plain terms, look for:

• Data encryption in transit and at rest
• Two-factor authentication (2FA) for logins
• Role-based access controls (important if you add admin staff)
• Audit logs that track who accessed what and when
• Automatic logoff after a period of inactivity
• U.S.-based servers (some vendors use international hosting that can complicate compliance)

Most reputable EHRs will publish a Trust Center or security overview on their website where you can review their specific practices. It’s worth a few minutes to read before you sign up.

Your Responsibilities Don’t End with the Software

Here’s the part that often gets skipped: choosing a HIPAA-compliant EHR is necessary, but it doesn’t make your whole practice compliant on its own. You’re still responsible for how you handle data outside the EHR — things like communicating with clients via unencrypted email, using personal devices without proper safeguards, or sharing login credentials with staff.

If you’re running a private practice and haven’t done a basic HIPAA risk assessment, that’s worth putting on your to-do list. It doesn’t have to be complicated, but it does need to exist.

Don’t Choose Based on Price Alone

It’s tempting to compare monthly subscription costs and pick the cheapest option.

But think about how much your time is worth.

If one platform saves you just an hour or two each week by making scheduling, documentation, or billing easier, that can easily outweigh a slightly higher monthly fee.

Many EHRs also offer free trials, so take advantage of them. Click around, enter a few test appointments, and see which one feels intuitive. If you’re already frustrated after ten minutes, imagine how you’ll feel six months from now.

How to Actually Evaluate an EHR During a Free Trial

Most EHR platforms offer a free trial of 14 to 30 days, and I’d strongly encourage you to use at least two or three before committing. But clicking around aimlessly won’t tell you what you need to know. Here’s how to make a trial actually useful.

Test the Things You’ll Do Every Single Day

Think about your typical Monday morning. You probably schedule appointments, write notes, and check on any outstanding billing. That’s your testing checklist. How long does it take to add a new client? Can you create a progress note and find it again easily? Where do you see what hasn’t been paid?

If any of those workflows feel confusing or frustrating during a trial, imagine doing them 20 times a week for the next three years. The time you save — or lose — on daily tasks adds up fast.

Test the Billing Workflow Specifically

If you plan to bill insurance, don’t skip this part of the trial. Walk through the full process: enter a test client, run an eligibility check, create a claim, and see how the system handles it. Some EHRs make this feel intuitive. Others bury it in menus or require you to set up integrations before you can test anything useful.

Also look at the reporting side. Can you easily see which claims are outstanding? Is there an aging report? How do you post a payment when insurance pays? These are the things that will matter most when you’re trying to figure out why your collections are off.

Test the Client-Facing Experience

Send yourself a test intake form. Go through the client portal as if you were a new patient. Is it easy to navigate? Does it look professional? Clients won’t know or care what EHR you’re using, but they’ll definitely notice if your intake process feels clunky or if your telehealth link doesn’t work reliably.

Contact Support During the Trial

This one’s underrated. Pick something you can’t figure out and contact customer support. How long does it take to hear back? Was the response actually helpful? Did you reach a real person?

Support quality is one of the biggest differentiators between EHR platforms, and it’s almost impossible to evaluate from a feature list. Testing it during the trial is one of the few ways to get a real sense of what you’re signing up for.

Quick Evaluation Checklist

• Can I add a new client in under 2 minutes?
• Is creating a progress note intuitive, or do I have to hunt for it?
• Can I run an eligibility check before a session?
• Where do I see unpaid claims and overdue balances?
• How does the client portal look from the client’s perspective?
• Does telehealth work reliably from the browser without extra downloads?
• How quickly does support respond, and are they actually helpful?
• Can I export my data if I decide to switch?

Questions to Ask Before You Decide

Before committing to any software, ask yourself:

• Do I plan to accept insurance?
• Will I submit my own claims?
• Do I need telehealth?
• Will I eventually hire another clinician?
• Can clients complete paperwork online?
• Does the software include appointment reminders?
• How responsive is customer support?
• Can I easily export my data if I decide to switch later?

These questions can help narrow the field quickly.

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Thinking About Switching EHRs? Here’s What to Consider First

You chose your current EHR in a hurry, or your practice has grown past what it can handle, or you’ve just gotten tired of paying for features you don’t use. Whatever the reason, switching EHRs is more manageable than most therapists think — but it’s also not something to do impulsively.

What Switching Actually Involves

At minimum, switching EHRs means:

• Exporting your existing client records (notes, intake forms, treatment plans, billing history)
• Importing that data into the new system, either automatically or manually
• Re-entering any configuration settings (your session types, fee schedules, payer information)
• Notifying clients about any changes to their portal or scheduling links
• Running two systems in parallel for a short period while you transition active billing

Some platforms make data export easy. Others make it harder than it should be — which is worth researching before you commit to a new EHR, not after. Ask the new vendor directly: what format does my data export in, and can I import it here?

The Timing Matters

If you bill insurance, the best time to switch EHRs is not in the middle of a busy season or when you have a backlog of outstanding claims. Ideally, you want to close out as many open claims as possible in your current system before you move, or at minimum, have a clear tracking method for anything that’s still in process.

January is a common switching point for practices because it coincides with new plan years and deductibles resetting anyway. It’s not a rule, but it’s a natural clean break.

Don’t Assume Your Old Data Will Transfer Perfectly

This is the part that trips people up. Even when two systems support the same data format, things rarely import exactly as expected. Notes may lose formatting. Custom fields may not map correctly. Billing history may come over as a flat export that doesn’t integrate with your new system’s AR tracking.

Plan to spend some time cleaning up data after a migration, and don’t switch right before a high-volume stretch in your schedule.

Is It Worth It?

Usually, yes — if the platform you’re switching to genuinely fits your practice better. A system that saves you even 30 minutes a week pays for the inconvenience of switching within a few months. But if you’re switching primarily because of price and the new system is missing features you actually use, that’s worth thinking through before you commit.

If you’re not sure whether to switch or stay, make a short list of the specific pain points you have with your current system. If all of them are addressable in your current EHR (settings you haven’t configured, features you haven’t explored), it may be worth a conversation with their support team before making a move.

My Take

After working with therapists and their billing for years, I’ve noticed something interesting.

The practices that run the smoothest aren’t always using the most expensive software. They’re using software that fits the way they actually work.

A therapist who sees 15 private-pay clients each week has very different needs than someone managing a full insurance-based caseload.

Take the time to think about your workflow before choosing an EHR. Switching systems later is possible, but it’s never as fun as getting it right the first time.

Best For	Recommendation

Insurance-heavy practice

TherapyNotes

Best all-around

Jane

Budget-conscious

Sessions Health

Largest ecosystem & marketplace

SimplePractice

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Frequently Asked Questions

Final Thoughts

Your EHR is one of the few business tools you’ll use every single day. It’s where you’ll schedule appointments, write notes, submit claims, collect payments, and keep your practice organized.

There’s no perfect platform, but there are several excellent options.

The best one is the one that helps you spend less time wrestling with software and more time focusing on your clients.

If you’re still deciding, start by making a short list of your must-have features, take advantage of free trials, and don’t be afraid to ask other therapists what they like—and what they wish they had known before signing up.

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