TherapyNotes has established itself as one of the most trusted names in behavioral health practice management, serving thousands of mental health professionals since 2010. With its structured workflows and exceptional customer support, it has become the go-to solution for practices that value reliability and a systematic approach to clinical documentation. But as the field of mental health increasingly embraces evidence-based practices and comprehensive outcome tracking, some practitioners are discovering they need more advanced features beyond traditional practice management.
To create this TherapyNotes review, I’ve analyzed the platform extensively. I believe it’s the ideal choice if:
However, TherapyNotes might not be the best choice if:
In this case, you should consider CarePaths: a comprehensive practice management platform that combines traditional EHR functionality with advanced clinical improvement tools developed with leading psychotherapy researcher Bruce Wampold, PhD. While TherapyNotes includes basic outcome measures, CarePaths focuses on how practices track and improve patient outcomes through automated weekly assessments and comprehensive progress visualization.
Because of that, I’ve included a detailed look at CarePaths later in this TherapyNotes review, as the best alternative for evidence-based practices seeking integrated outcome tracking. If you’re ready to explore a platform built around clinical outcomes, you can start with CarePaths’ 30-day free trial here.
Table of contents:
TherapyNotes was founded in 2010 by Dr. Debra Pliner, a licensed clinical psychologist, and her husband Brad Pliner, a web technologies expert.
The platform emerged from Dr. Pliner’s own group practice needs, where she recognized the necessity for a secure, organized electronic system for storing therapy notes. After refining the software through use, they launched it commercially to create a widely available service.
Today, TherapyNotes operates as a comprehensive, web-based Electronic Health Record (EHR) and practice management system serving behavioral health professionals across the United States.
The platform combines scheduling, clinical documentation, billing, and patient communication tools in one system. With approximately 300 to 350 employees and headquarters in Horsham, Pennsylvania, the company has grown steadily over the years.
TherapyNotes presents itself as a solution built specifically for mental health workflows, with a focus on ease of use and reliability.
The platform is mainly for solo practitioners and small to medium-sized group practices who value structured processes, strong customer support, and a system that guides them toward compliance with documentation standards. Its users include therapists, counselors, social workers, and psychologists who prioritize administrative efficiency and appreciate having customer support readily available.
| Pros | Cons |
|---|---|
| ✅ Exceptional 24/7 phone and email customer support | ❌ No dedicated mobile app for iOS or Android |
| ✅ Intuitive interface with structured workflows | ❌ Limited customization of forms and templates |
| ✅ Comprehensive integrated features (scheduling, notes, billing) | ❌ Expensive add-ons (e-prescribing costs $65/month) |
| ✅ Strong billing capabilities with claim scrubbing | ❌ Interface can feel dated to some users |
| ✅ Reliable platform with HIPAA compliance | ❌ Basic outcome tracking without advanced analytics |
TherapyNotes centers around its automated To-Do List system, which serves as a command center for practice operations.
Source: TherapyNotes
When you schedule an appointment, the system automatically generates a task to complete the corresponding note once the session time passes. This extends beyond documentation: completed notes trigger billing tasks, signed documents from the patient portal create processing reminders, and insurance claim rejections generate review items.
The To-Do List recently evolved into “My To-Do Summary,” organizing tasks into categories including Account Settings, Notes, Patient Records, ePrescribe, Portal, and Billing.
TherapyNotes stands out for its To-Do List System, which links scheduling, notes, and billing into one organized workflow.
It’s one of the few EHRs where every clinical action automatically generates its corresponding administrative task — a major win for compliance-focused practices.
Still, while this structure helps clinicians stay organized, platforms like CarePaths go a step further — turning data from sessions into measurable clinical insights that support better outcomes.
Each category displays pending item counts, allowing clinicians to quickly assess their workload. When configured to do so, the system can enforce a logical documentation flow, preventing progress notes from being written without an existing treatment plan, ensuring the “golden thread” of documentation remains intact.
Work schedules can be defined for each clinician, with the system warning when appointments fall outside designated hours. The platform supports various appointment types, from individual therapy sessions to group therapy, scheduled events, and blackout periods. Each appointment type links to specific note templates and service codes, automating the connection between scheduling and billing.
Source: TherapyNotes
The Notes feature provides form-based templates tailored to behavioral health disciplines.
Psychotherapy templates include Intake Notes for comprehensive biopsychosocial histories, Treatment Plans outlining goals and interventions, Progress Notes in SOAP format, Psychological Evaluations for testing documentation, and Termination Notes summarizing treatment courses. Psychiatry templates offer specialized fields for medication management, vital signs, and physical exams.
Source: TherapyNotes
Each template combines dropdown menus, checkboxes, and text fields to balance efficiency with depth. The Quick History Review function allows clinicians to retrieve information from previous notes, while new progress notes can be auto-filled with content from the last session. The system includes searchable DSM-5 diagnosis integration, with previous codes copied into new notes automatically.
Source: TherapyNotes
Electronic signatures lock completed notes to maintain record integrity, though amendments remain possible with documentation. For training practices, the supervisor co-signing workflow automatically generates review tasks when supervising complete notes. The entire documentation system maintains an audit trail, tracking every view, edit, and signature for compliance purposes.
TherapyNotes streamlines much of the billing workflow through its integration with clinical documentation.
When a clinician signs a note containing a CPT code, the system automatically posts charges to the patient account and queues the corresponding insurance claim for review and submission. The claim scrubbing feature, provided through the clearinghouse partner, checks for common errors before submission, thereby reducing rejection rates.
Source: TherapyNotes
The platform submits electronic claims to over 2,000 insurance payers nationwide, including Medicare and Medicaid. Real-time eligibility verification costs $0.14 per request but this helps prevent coverage refusals. When payers process claims, Electronic Remittance Advice (ERA) files assist with payment posting, though manual review is still required before finalizing transactions to patient accounts.
Source: TherapyNotes
Patient statements can be generated individually or in batches, with customizable formats and comments. The integrated credit card processing through CardConnect enables next-day deposits for transactions processed before 9:30 PM ET, with a 2.9% plus $0.30 per transaction fee. Revenue reports provide detailed breakdowns by clinician, service, or payer, helping practices track financial performance and identify trends.
TherapyPortal, the free patient portal included with all subscriptions, allows practices to customize branding with logos and color schemes.
Source: TherapyNotes
Patients can request appointments online, viewing available slots based on set schedules. The portal enables electronic completion of certain intake forms and consent documents, with integrated forms like Client Information and Client History filling relevant chart fields.
Secure messaging provides HIPAA-compliant communication between sessions, with audience-based access control determining whether messages go to clinical, billing, or administrative staff.
While patients receive email notifications of new messages, the actual content remains within the secure portal. Documents shared through the portal can require electronic signatures, either by drawn signatures or typed names.
Source: TherapyNotes
Automated appointment reminders via email, text ($0.14 each), or phone calls help reduce no-shows. Reminder preferences can be set generally or customized per patient, including options to notify emergency contacts. The portal also facilitates online bill payment and provides patients access to their completed documents, though direct access to session notes requires clinician sharing.
While TherapyNotes excels at structured practice management and includes basic outcome tracking features, several limitations become apparent for practices embracing modern, comprehensive clinical approaches. These constraints reveal a platform optimized for traditional documentation rather than advanced clinical innovation.
Limited Clinical Innovation Features: Although TherapyNotes includes an Outcome Measures library and Insights visualization tab, the implementation remains basic compared to platforms designed around continuous clinical improvement.
Source: TherapyNotes
The system lacks automated weekly assessment batteries, comprehensive patient engagement through outcome tracking, and analytics that help clinicians identify patterns and optimize treatment approaches. Practices committed to robust measurement-based care may find these tools insufficient for their needs.
Mobile Technology Gap: The lack of a dedicated mobile app represents a significant limitation in today’s digital health landscape.
While the platform works on mobile browsers through a progressive web app, the absence of native iOS and Android apps means clinicians cannot efficiently manage their practice with the full functionality of a mobile-first experience, and patients miss the convenience of app-based engagement for completing assessments, scheduling appointments, or communicating with their providers.
Source: TherapyNotes
Cost Escalation Through Add-Ons: Although the base subscription appears competitive, essential features increase costs.
E-prescribing adds $65 monthly per prescriber, the AI-powered TherapyFuel costs $40 per clinician, and text reminders incur per-message charges. A practice needing these features faces substantially higher costs than the advertised base price, reducing pricing transparency and increasing long-term expenses.
Focus on Administration Over Clinical Excellence: TherapyNotes prioritizes administrative efficiency and documentation compliance over clinical innovation.
While it includes basic outcome measures, the platform lacks comprehensive tools for automated patient feedback collection across multiple domains, progress analytics, or evidence-based treatment protocols. For practices committed to data-driven care and continuous quality improvement, these limitations represent a significant gap in functionality.
These limitations reflect TherapyNotes’ prioritization of structured workflows and administrative efficiency over comprehensive clinical innovation and advanced outcome tracking. For practices working towards automated evidence-based care and modern patient engagement, these gaps create clear opportunities for alternative solutions.
While TherapyNotes refines traditional practice management, CarePaths transforms it.
By integrating Measurement-Based Care, automated weekly assessments, and mobile-first patient engagement, CarePaths helps therapists not only manage their practice but improve treatment outcomes — a shift from administration to true clinical advancement.
CarePaths addresses the gap in traditional practice management by building comprehensive outcome tracking and communication tools directly into its platform foundation.
Founded in 2000 by clinical psychologists Geoff Gray, PhD and Maureen Hart, PhD, CarePaths emerged from their recognition that technology could both reduce administrative burden and improve clinical outcomes.
The cornerstone of CarePaths is its integrated system for improving therapy outcomes, which includes Measurement-Based Care developed under the supervision of Bruce Wampold, PhD, a leading psychotherapy researcher.
The platform provides patient feedback collection, sending weekly updates of standardized measures via email or text notifications. These assessments cover depression and anxiety symptoms, overall well-being, feelings of connection, and the therapeutic relationship quality.
Patients receive assessments on different days to avoid survey fatigue: symptom measures on Mondays, well-being assessments on Wednesdays, and therapeutic alliance scales on Fridays. Each assessment takes just a few minutes to complete. Beyond the updates, clinicians can choose from over 40 additional assessments in the library, scheduling them for specific intervals based on clinical needs.
Results appear immediately as visual progress graphs at the top of the patient chart, providing clinicians with real-time insights into treatment effectiveness. Patients can also view their progress graphs through the CarePaths Connect mobile app, fostering transparency and collaborative treatment planning. The system is designed to alert clinicians to concerning responses, enabling timely intervention when needed.
Remarkably, CarePaths offers its clinical improvement tools free for up to 30 clients per therapist, making evidence-based practice accessible even for small practices. This commitment to democratizing outcome measurement reflects the founders’ mission to help therapists achieve better patient outcomes while building sustainable practices.
CarePaths Connect, the platform’s mobile application for iOS and Android, creates what the company calls a “Digital Front Door” for practices.
New patients can find therapists, verify insurance coverage, view open appointment slots, and self-schedule initial sessions directly through the app. This streamlines patient acquisition while reducing administrative workload.
Existing patients use the app to manage their care between sessions.
They can request appointments, complete clinical assessments, engage in secure messaging with their therapist, and make payments. The app becomes a continuous interface for engagement, extending the therapeutic relationship beyond scheduled sessions. Unlike TherapyNotes’ web-only approach, this native mobile experience meets patients where they naturally engage with digital services.
The platform’s telehealth integration works seamlessly through both the web portal and mobile app, requiring no additional software installation. Patients join sessions with a single click, while clinicians can launch video sessions directly from the patient chart. This approach contrasts with platforms that treat telehealth as an add-on feature.
CarePaths includes numerous features in its base $49 monthly subscription that competitors charge extra for, delivering value for practices.
By Bruce Wampold PhD
Complete Practice Management System
Getting Started?
AI-generated session summaries, developed in-house as a HIPAA-compliant tool, come free rather than the $40 monthly fee charged by TherapyNotes for similar functionality. Electronic claims submission, eligibility verification, and SMS appointment reminders are all included without per-use fees. This transparent pricing structure can result in significant savings compared to traditional EHR systems with multiple add-on fees.
The billing system automates charge posting from clinical notes, with claims generated and queued for submission automatically. The platform processes Electronic Remittance Advice files, posting insurance payments automatically. Financial reports can track revenue across various dimensions, providing insights into practice performance.
Clinical documentation includes an extensive template library with forms for various disciplines and session types. New progress notes can be auto-filled from previous sessions, while diagnoses are transferred automatically. The system supports batch documentation for group sessions, allowing clinicians to create individual notes and billing codes for multiple participants simultaneously.
For practices with limited session volumes, CarePaths offers a $10 monthly plan for up to 15 sessions, making it accessible for new practitioners building their caseload.
Group practices benefit from discounted rates for part-time therapists ($34/month) and students ($5.75/month), with unlimited administrative staff accounts included. This predictable pricing structure supports practice expansion without unexpected increase in cost.
| Feature | TherapyNotes | CarePaths |
|---|---|---|
| Monthly Pricing (Solo) | $59 | $49 |
| Clinical Improvement Tools | ⭐⭐ Basic outcome measures | ⭐⭐⭐⭐⭐ Comprehensive automated MBC |
| Mobile App | ❌ No native app (web only) | ✅ iOS and Android app |
| Customer Support | ⭐⭐⭐⭐⭐ 24/7 phone support | ⭐⭐⭐ Phone and ticket support |
| AI Session Summaries | $40/month extra | ✅ Included free |
| E-Prescribing | $65/month extra | $49/month extra |
| Telehealth | ✅ Included (basic) | ✅ Included with group support |
| Transparent Pricing | Higher with multiple add-ons | All-inclusive with fewer surprises |
| Best For | Structured workflows and support | Evidence-based practices and growth |
The choice between TherapyNotes and CarePaths ultimately depends on your practice philosophy and priorities.
👉 Choose TherapyNotes if you value having access to knowledgeable support staff during extended hours and prefer working within structured, guided workflows that ensure compliance.
It’s ideal for practices that prioritize administrative efficiency, appreciate systematic approaches to documentation, and want the peace of mind that comes from exceptional customer service. The platform serves practitioners who view their EHR primarily as an operational tool for managing the business side of practice.
Get started with TherapyNotes here
👉 Choose CarePaths if you're committed to improving therapy outcomes through comprehensive clinical tools and want automated feedback mechanisms integrated into your daily workflow.
It’s designed for clinicians who see every session as an opportunity to enhance treatment effectiveness, value mobile technology for patient engagement, and want comprehensive features without hidden costs or unexpected price increases as you grow. The platform serves practices that view their EHR as both an operational tool and a clinical partner in delivering better patient outcomes while building a sustainable, profitable practice.
Get started with CarePaths here
Both platforms competently handle the fundamentals of practice management. The distinction lies in their vision: TherapyNotes perfects traditional practice operations while CarePaths redefines practice management through the lens of comprehensive clinical improvement, transparent pricing, and modern patient engagement.
