What is TherapyNotes?
TherapyNotes is a web-based electronic health record (EHR) and practice management platform purpose-built for mental health professionals. Founded in 2012 by clinical psychologist Dr. Debra Pliner and software engineer Brad Pliner, TherapyNotes was designed from a clinical perspective — Dr. Pliner built the tool she wished she had when running her own private practice. The platform serves over 100,000 therapists nationwide and has earned a reputation as the strongest billing and claims management platform in the mental health EHR space. In independent user reviews (G2, Capterra, TrustRadius), TherapyNotes consistently receives the highest ratings for billing features among all mental health EHRs, with particular praise for its electronic claim submission workflow, ERA auto-posting accuracy, and denial management tools.
The platform's philosophy is reflected in its design: TherapyNotes prioritizes the billing workflow as the backbone of the platform, with clinical documentation designed to feed clean, complete data into the billing engine. Every clinical note includes mandatory billing fields (diagnosis codes, CPT codes, service location, time modifiers), and the system validates that all required fields are populated before a claim can be submitted. This integrated approach — billing is not a separate module but the natural downstream of clinical documentation — reduces the administrative errors that cause claim denials. In the mental health billing landscape, where denial rates average 10-15% industry-wide (compared to 5-7% for medical billing), TherapyNotes' integrated approach is specifically designed to push that number lower. The company reports that its average denial rate across users is under 5%, though this is a self-reported figure rather than an independently audited metric.
Key Features
Best-in-Class Billing & Claims Management
TherapyNotes' billing engine is the platform's cornerstone. Claims are auto-generated from signed progress notes — diagnosis codes, CPT codes, dates of service, duration, location, and modifiers are all pulled directly from the clinical documentation, eliminating the manual data re-entry that causes most billing errors. Electronic claims are submitted through TherapyNotes' integrated clearinghouse (a partnership with a major clearinghouse; the specific partner may vary by user region) to over 1,000 payers. The ERA (Electronic Remittance Advice) auto-posting system matches incoming insurance payments to client ledgers with high accuracy — users report that 90-95% of ERAs post correctly without manual intervention, a rate significantly above industry average. When claims are denied, TherapyNotes presents the denial reason in clear language, links to the payer's specific denial code definition, and allows the therapist to correct and resubmit the claim directly from the denial screen without re-entering all claim data. The billing dashboard provides real-time visibility into accounts receivable: total outstanding, aging buckets (0-30, 31-60, 61-90, 90+ days), expected revenue, collection rate by payer, and denial rate by payer. This payer-level data is actionable — if Blue Cross is denying at 12% while Aetna is at 3%, the therapist can investigate what is different about their Blue Cross submissions (authorization issues? Diagnosis code restrictions?) and address the systemic problem.
Integrated Credit Card Processing
TherapyNotes includes integrated credit card processing through a merchant services partnership. Clients can store their card on file through the secure client portal, and therapists can charge copays, deductibles, and self-pay fees with a single click. The system supports automatic payment at the time of service — when the therapist signs the progress note, TherapyNotes can automatically charge the client's stored card for the copay amount, eliminating the awkward end-of-session payment conversation. The integrated processing also handles the financial side of telehealth: when a telehealth session is completed and the note is signed, the copay is charged automatically. Transaction fees are competitive with standalone processors like Stripe or Square (typically 2.9% + $0.30 per transaction for standard cards). For therapists who currently use a separate payment processor and manually reconcile payments with their EHR, the integrated approach saves 2-4 hours per month of bookkeeping work. TherapyNotes also generates superbills for self-pay clients who wish to submit claims to their insurance for out-of-network reimbursement — the superbill includes all the required elements (diagnosis codes, CPT codes, provider NPI, dates of service, amounts paid) in a format insurers accept.
Clinical Documentation with Built-in Billing Validation
TherapyNotes' note templates are designed to produce both clinically useful documentation and billing-compliant claims. Templates include SOAP, DAP, and progress note formats, each with built-in fields for diagnosis codes (searchable DSM-5-TR library), CPT codes (90837, 90834, 90832, 90847, 90853, and others), time modifiers, place of service codes, and session duration. The system flags incomplete billing fields before the note can be signed — missing diagnosis code, invalid CPT code combination, session duration inconsistent with CPT code — preventing errors from reaching the claim submission stage. This proactive validation is more efficient than the reactive approach of finding errors after a claim is denied. Notes can pull forward data from previous sessions (diagnosis, treatment plan goals), reducing redundant data entry. For treatment plans, TherapyNotes provides a built-in library of problems, goals, objectives, and interventions that therapists customize for each client — less comprehensive than TheraNest's Wiley Treatment Planner integration, but sufficient for standard clinical documentation and insurance audit requirements. All notes are time-stamped, version-tracked, and include an audit log of who created, modified, or viewed each note.
Calendar with Billing-Aware Scheduling
TherapyNotes' calendar integrates directly with the billing system: when a session is completed, the calendar entry becomes the foundation for the billing entry. Appointment types are pre-configured with the appropriate CPT code, duration, and place of service code, so scheduling an "Individual Therapy - 60 min" appointment automatically maps to CPT 90837 with the correct billing parameters. The calendar supports recurring appointments, waitlist management, appointment reminders (email, text, and voice call at configurable intervals), and two-way sync with Google Calendar and Outlook. For group practices, the calendar shows all clinicians' availability and supports room assignment. The appointment status tracking (scheduled, arrived, no-show, cancelled, completed) feeds into the billing system automatically — completed appointments generate claims; no-shows and cancellations do not, but are tracked for practice analytics. The calendar also integrates with the client portal: clients can request appointments within parameters the therapist sets (available time slots, minimum notice requirements, maximum appointments per week), and therapists approve or modify requests.
Integrated Telehealth
TherapyNotes includes a built-in HIPAA-compliant telehealth platform included with all plans at no additional per-session cost. Clients join through a secure link sent automatically with their appointment reminder — no app downloads, no accounts to create. The telehealth interface includes screen sharing, a virtual waiting room, and the ability to have the client's chart open in a side panel during the session for real-time documentation. After the session ends, TherapyNotes prompts the therapist to complete the progress note immediately, with the session duration and telehealth place of service code (02 or 10, depending on the client's location) pre-populated. The telehealth-secured session data (duration, client location) feeds directly into the claim generation process, ensuring telehealth claims include the required modifiers that payers increasingly demand for virtual sessions. As of 2026, most major insurers reimburse telehealth at parity with in-person sessions (a policy solidified during the COVID-19 pandemic and largely maintained), but the billing requirements (modifiers, place of service codes) are stricter for telehealth than in-person sessions — TherapyNotes handles this automatically.
Practice Analytics & Financial Reporting
TherapyNotes' reporting suite is designed for the business side of private practice. Key reports include: Revenue by Payer (which insurance companies generate the most revenue, which have the lowest reimbursement rates), Accounts Receivable Aging (who owes what, for how long), Collection Rate by Payer and by Clinician (percentage of billed charges actually collected), Appointment Volume and Attendance (sessions scheduled, completed, cancelled, no-show rate by clinician and by client), and Revenue per Session and per Hour (actual reimbursement divided by session time, including no-shows and cancellations in the denominator). For group practices, the reporting includes clinician-level financial metrics: revenue generated, collection rate, accounts receivable, and productivity (sessions per week). This supports compensation models tied to collections rather than billings (common in group practices where clinicians are paid a percentage of collected revenue). The reporting also supports tax preparation: TherapyNotes can generate reports of total revenue, total expenses (if tracked), and 1099-eligible payments to contractors. While TherapyNotes is not a full accounting system, the financial reports provide the data that a practice's accountant needs to prepare tax filings and analyze practice profitability. The reports are exportable as PDF, CSV, and Excel.
TherapyNotes Pricing (2026)
| Plan | Monthly Price | What You Get |
|---|---|---|
| Solo | $49/month | 1 clinician, unlimited clients. Full EHR: scheduling, notes, billing and claims, integrated clearinghouse, ERA auto-posting, credit card processing, client portal, telehealth (unlimited sessions), treatment plans, mobile app, standard support (phone, email, chat). |
| Group | $50/month base + $30/month per additional clinician | Everything in Solo plus: group practice calendar, multi-clinician scheduling, role-based access control, practice-wide billing and financial reports, per-clinician productivity analytics, supervision tools. Example: 5 clinicians = $50 + (4 × $30) = $170/month. |
| Enterprise | Custom pricing | 10+ clinicians. Everything in Group plus: dedicated account manager, custom onboarding and training, advanced reporting, API access, priority support with guaranteed response times. For large group practices and behavioral health organizations. |
Pricing verified June 2026. All plans include unlimited clients, unlimited telehealth sessions, and integrated clearinghouse access. Credit card processing fees (~2.9% + $0.30/transaction) are additional. TherapyNotes offers a 30-day free trial with full feature access — no credit card required.
Pros & Cons
Pros
- Billing and claims management is the strongest in mental health EHRs: TherapyNotes' integrated billing — where clinical documentation automatically generates clean claims and ERA auto-posting accurately reconciles payments — is widely considered best-in-class. This is the primary reason therapists switch to TherapyNotes from other platforms.
- Integrated clearinghouse with no separate fees: Unlike some competitors that require therapists to contract separately with a clearinghouse, TherapyNotes includes clearinghouse access in the subscription. This simplifies setup and reduces the number of vendor relationships a practice must manage.
- Excellent, responsive customer support: In user reviews and industry surveys, TherapyNotes' support consistently receives the highest marks. Phone, email, and chat support is included at all tiers, and response times are typically under 2 hours during business hours. Support staff are knowledgeable about both the software and mental health billing — they can help troubleshoot claim denials, not just software bugs.
- Proactive billing validation prevents denials before submission: The note-signing validation that flags missing diagnosis codes, invalid CPT code combinations, and billing inconsistencies catches errors at the point of creation rather than after a claim is denied. This proactive approach is more efficient than reactive denial management.
- Unlimited telehealth at no extra cost: Integrated telehealth is included with all plans with no per-session limits or fees — consistent with the platform's all-inclusive pricing philosophy.
Cons
- User interface feels dated compared to competitors: TherapyNotes' interface prioritizes function over form. It works reliably, but the visual design and navigation patterns feel like software from the early 2010s rather than a modern SaaS platform. Therapists coming from visually polished tools like SimplePractice may find the transition jarring.
- Limited customization for clinical note templates: TherapyNotes provides standardized templates (SOAP, DAP, progress notes) but offers less flexibility to create fully customized templates with conditional logic than competitors. Therapists with highly specialized documentation needs may feel constrained.
- No Wiley Treatment Planner integration: Unlike TheraNest (which includes Wiley) and SimplePractice (which offers it as a $20/month add-on), TherapyNotes does not integrate with Wiley Treatment Planners. Treatment plans are built using TherapyNotes' built-in library, which is adequate for standard documentation but less comprehensive than Wiley's evidence-based content.
- Per-clinician pricing adds up for groups: At $30/month per additional clinician, a 10-clinician practice pays $320/month — higher than TheraNest's group pricing for comparable features. TherapyNotes justifies this with its superior billing features, but for practices that do primarily self-pay and don't need billing muscle, this pricing may be hard to justify.
- No built-in Wiley assessments library: SimplePractice includes a library of built-in clinical assessments (PHQ-9, GAD-7, PCL-5, and dozens more) scored automatically. TherapyNotes supports custom forms but does not include a pre-built assessment library, meaning therapists must create assessment templates manually or use external tools.
Frequently Asked Questions
Should I choose TherapyNotes or SimplePractice?
This is the most common decision therapists face when selecting an EHR, and the answer depends on your practice's billing profile. Choose TherapyNotes if: you accept insurance and file claims yourself (as opposed to using a billing service), billing and claims management is a significant part of your administrative workload, you want an integrated clearinghouse without managing a separate vendor relationship, you value responsive phone support, and you are willing to trade visual polish for billing functionality. Choose SimplePractice if: you are primarily self-pay and do not file insurance claims, you value a modern, polished user interface and client experience above all else, you want the largest library of built-in assessment templates, you need highly customizable intake forms with conditional logic, or you want the Wiley Treatment Planner integration (available as an add-on). For therapists who file insurance claims themselves, TherapyNotes' billing advantages are substantial enough that the platform justifies any UI trade-offs. For self-pay therapists, SimplePractice's more modern design and assessment library typically provide better value. The best approach: use both platforms' free trials (30 days each) and process real claims and real client documentation to see which workflow feels more natural.
How does TherapyNotes handle ERA auto-posting?
ERA (Electronic Remittance Advice) auto-posting is the process by which an electronic payment and explanation of benefits from an insurance company is automatically matched to the correct client and session in the EHR, and the payment is posted to the client's ledger. It is one of the most time-saving features in any billing system, and it is also one of the most technically challenging to get right — ERAs arrive in a standardized but complex format (ANSI X12 835), and matching them to specific sessions requires reconciling patient identifiers, dates of service, charge amounts, and claim reference numbers across systems. TherapyNotes' ERA auto-posting engine is widely considered the most accurate in the mental health EHR market. When an ERA arrives, TherapyNotes: (1) matches the payment to the correct client and date of service using claim reference numbers and patient identifiers, (2) posts the allowed amount, paid amount, and any adjustments (write-offs, contractual adjustments, deductibles, copays) to the client's ledger, (3) applies the remaining patient responsibility (copay, deductible, coinsurance) to the client's balance, and (4) closes the claim as paid with full reconciliation. In cases where the auto-match fails — typically because of a mismatch in patient identifiers (the insurer has the client under a slightly different name or date of birth) — TherapyNotes flags the unmatched ERA for manual review with the relevant information displayed so the therapist can match it. Users report that 90-95% of ERAs post correctly without manual intervention, which is significantly above the industry average and represents hours of manual bookkeeping saved each month.
Does TherapyNotes support group therapy billing?
Yes. TherapyNotes supports group therapy scheduling and billing through a specific workflow. The therapist creates a group appointment and adds the participating clients. After the session, the therapist writes one group note that applies to all participants. TherapyNotes generates individual claims for each client — using CPT code 90853 (Group Psychotherapy) — and submits them to each client's respective insurer. The billing details (diagnosis codes, modifiers, place of service) are pulled from each individual client's chart, so different clients in the same group can have different billing parameters. Important billing considerations for group therapy: (1) CPT 90853 reimbursement rates are significantly lower than individual therapy rates (typically $25-$45 per client per session compared to $100-$180 for individual 90837), (2) not all insurers cover group therapy — verify coverage before launching groups, (3) some insurers limit the number of clients per group (typically 8-12), and (4) documentation requirements for group therapy include the group topic/focus, each client's participation, and the therapist's interventions — a single group note must capture all of this. TherapyNotes' group note template includes fields for the group topic, individual participation notes, and the therapist's interventions. The billing engine automatically validates that group-specific billing requirements are met before claims can be submitted.
Can I migrate my data from another EHR to TherapyNotes?
TherapyNotes provides data migration tools and a dedicated migration team for therapists switching from another EHR. The migration process typically includes: client demographics (names, contact information, dates of birth, insurance information), appointment history (past and future), and financial data (client balances, payment history). Clinical notes from the previous EHR are typically not migrated — TherapyNotes recommends exporting them as PDFs from the old system and storing them securely for the legally required retention period. This is a common industry practice rather than a TherapyNotes limitation: migrating structured clinical note data between different EHRs is technically complex due to different data models, and most EHRs recommend keeping historical notes in the original system or as exported PDFs. The migration team works with the therapist to map data fields between the old and new systems and to validate the migrated data. The process typically takes 2-4 weeks depending on practice size and the complexity of the data. TherapyNotes' migration support is included with the subscription; there is no additional migration fee. For therapists switching mid-year, the key timing consideration is aligning the migration with billing cycles — ensure all claims are submitted and all payments are posted in the old system before beginning the migration to avoid billing data fragmentation across two systems.
How Therapists Use TherapyNotes: A Daily Billing Workflow
Start of Day: Review Today's Schedule & Billing Status
Open TherapyNotes and review the day's calendar. The dashboard shows each client, their appointment type (which maps to the CPT code), and their billing status — whether their insurance has been verified, whether copay is due, and whether any outstanding balances exist from previous sessions. For clients with insurance, TherapyNotes automatically checks eligibility (through the integrated clearinghouse) and flags any issues: inactive coverage, exhausted benefits, or authorization expirations. The therapist can address these before the session rather than discovering them at claim submission. For clients with outstanding balances, TherapyNotes shows the amount owed and aging period — the therapist can have a brief financial conversation at the start of the session rather than sending an awkward email later. This proactive start-of-day review takes 5-10 minutes and prevents the most common billing problems: submitting claims for ineligible clients, missing authorization expirations, and letting client balances accumulate.
Post-Session: Complete Note → Auto-Generate Claim
After the session, the therapist opens the client's chart directly from the calendar (the appointment is linked to the chart). They complete the progress note using their preferred template. TherapyNotes validates all billing-required fields: diagnosis code, CPT code, date of service, session duration, place of service, and any required modifiers (telehealth modifier 95 or GT, crisis modifier for extended sessions). If any field is missing or invalid, TherapyNotes prevents the note from being signed and highlights what needs to be completed. Once the note is signed, TherapyNotes automatically generates the claim from the note data and either submits it electronically (if the therapist has enabled auto-submission) or places it in the claim queue for review and manual submission. The therapist can configure whether claims are auto-submitted or held for review — new billers often prefer to review claims before submission; experienced billers with established payer relationships typically enable auto-submission to reduce administrative steps. The entire post-session workflow — note, validation, claim generation — takes 3-5 minutes for an experienced user.
End of Week: Financial Review & Denial Management
On Friday afternoon (or whatever day the therapist designates for administrative work), review the billing dashboard. Check: total claims submitted this week, total payments received, claims still pending, denials received, and aging accounts receivable. For each denial, TherapyNotes displays the reason in plain English and links to the specific denial code definition from the payer. Correct the underlying issue — most commonly: authorization expired (resubmit with new auth number), diagnosis code not covered (verify which diagnoses the payer covers for this CPT code), or timely filing exceeded (this is the hardest to fix and often requires a payer appeal). Resubmit corrected claims directly from the denial screen. For aging receivables (claims unpaid beyond 30 days), TherapyNotes shows which payers are slowest — use this data to decide whether to call the payer, submit a follow-up inquiry, or write off small balances that are not worth the collection effort. This weekly financial review takes 30-60 minutes for a typical solo practice and ensures that revenue does not quietly leak through unaddressed denials and aging claims.
TherapyNotes vs Competitors
| Feature | TherapyNotes | TheraNest | SimplePractice |
|---|---|---|---|
| Solo Pricing | $49/month (unlimited clients) | $39/month (30 clients); $60 (unlimited) | $29/month (Starter); $69 (Essential) |
| Group Pricing | $50 base + $30/clinician | $60/month (up to 6 clinicians) | $69/month (up to 6 clinicians) |
| Billing Strength | ✅ Best-in-class: ERA auto-posting, denial management, payer analytics | ✅ Strong: claims submission, ERA posting, payer rules | ✅ Good: claims submission, ERA posting, less advanced denial tools |
| Wiley Treatment Planners | ❌ Not available | ✅ Included in base price | ⚠️ $20/month add-on |
| Built-in Assessments | ❌ Custom forms only | ⚠️ Limited built-in library | ✅ Large library (PHQ-9, GAD-7, etc.) with auto-scoring |
| Telehealth | ✅ Unlimited, included, screen sharing | ✅ Unlimited, included, screen sharing | ✅ Unlimited, included, screen sharing |
| Customer Support | ✅ Phone, email, chat — widely praised | ⚠️ Email/chat only for non-Enterprise | ⚠️ Email/chat; phone at higher tiers |
| Best For | Insurance-heavy practices where billing excellence is the top priority | Solo/group practices wanting Wiley Planners included without add-on fees | Self-pay and mixed practices valuing modern UI, assessments, and client experience |
Comparison verified June 2026. The three platforms serve different priorities: TherapyNotes for billing, TheraNest for treatment planning, SimplePractice for user experience.