The best EHR for an IOP in Texas: which one fits your program

The answer by kind of program

"Best" depends on what your Texas license covers and how your contracts pay. Find your row, then check the shortlist against the Texas rules below.

Your Texas program	Start your shortlist with	Why
IOP plus detox or residential, now or within a year	A full-continuum treatment-center platform (Kipu is one)	Kipu's public pages describe medication orders and administration, inventory and diversion controls, an admissions CRM with a bed board, and revenue cycle tools. It doesn't publish prices; expect a consultation and a quote.
A licensed SUD program running PHP, IOP and OP only	An outpatient program EHR (Cima's Program plan is one)	Levels of care with day and week hours, hours counted from signed group notes, one per diem charge per day that meets its hours, 837P and 837I claims, and continued-stay prompts. No detox, residential or medication administration.
A small IOP growing out of a therapy practice	The therapy EHR you already use (SimplePractice, TherapyNotes), if it can carry the program	Both publish prices, group notes and professional claims. Neither vendor's public pages describe levels of care, attendance-driven per diem billing or UB-04 claims, so you'd track those beside the EHR.
A multi-program agency or community mental health center	An enterprise behavioral health system	State reporting and many service lines are the deciding needs, and this comparison is too small for them.

The four kinds are explained in how to read the IOP EHR comparison.

What a Texas IOP's EHR must handle

HIPAA is the floor everywhere. A licensed Texas IOP also answers to these state and federal rules, and the EHR either carries each one or leaves it to a spreadsheet and a reminder. Take this column to every demo.

Rule	What it requires	Ask the vendor to show you
SB 1188 (Health and Safety Code ch. 183)	Electronic health records physically kept in the US from January 1, 2026, including by vendors and cloud services; a practitioner who uses AI for diagnosis or treatment recommendations reviews it and tells patients; a female-or-male sex at birth field with changes limited to set reasons.	Where the database, backups and files sit; the client AI notice and opt-out; the sex at birth field and its change history.
HB 300 (Health and Safety Code ch. 181)	Privacy training within 90 days of hire with a signed statement (§181.101); a copy of an electronic record within 15 business days of a written request (§181.102).	Training records per user; a records request running on the Texas clock, not HIPAA's 30 days.
26 TAC 564 (HHSC's rules for chemical dependency treatment facilities)	A QCC-signed assessment within 3 individual service days, the treatment plan within 5, every service note within 72 hours, a plan review by the midpoint of the projected stay, a discharge summary within 30 days (564.803 to 564.805); records kept at least 6 years, originals in Texas (564.508); per-session telehealth consent and identity checks (564.911).	Due dates on the chart for each deadline; intern notes waiting for a QCC co-sign; a telehealth note that can't be signed without the session's consent and identity check.
42 CFR Part 2 (federal, for SUD programs)	Written consent with the §2.31 elements before records go out, and the required notice with each disclosure.	A Part 2 release signed by a made-up client, the notice attached to a disclosure, and the client's accounting.
Texas Medicaid claims (1 TAC 354.1003)	Claims within 95 days of the date of service, to TMHP for fee-for-service or to the member's managed care plan. Superior HealthPlan has required the HCPCS code (H0015, S9480, S0201 or H0035) on adult PHP and IOP claims since July 1, 2025.	A claim to each Medicaid plan you'll bill, with the HCPCS code on the line, and who the submitter is.
Commercial claims (Insurance Code 1301.102, 843.337)	95 days from the date of service for fully insured Texas PPO and HMO plans.	A warning before the filing limit, and the claim form each contract wants (837P or 837I/UB-04).

Each rule is explained, with what to ask, in the Texas rules a behavioral health EHR must handle. The full 26 TAC 564 map, rule by rule, is Cima Consulting's 26 TAC 564 requirements guide.

Four vendors against the Texas list

The program rows below are exactly what our IOP EHR comparison found on each vendor's public pages on October 24, 2026. That comparison didn't check other vendors' pages for the Texas-only rules, so those cells say "ask"; it doesn't mean the vendor lacks it. The Cima column is how Cima works today.

Criterion	Kipu	SimplePractice	TherapyNotes	Cima EHR
Built for	SUD, behavioral health, eating disorder and MAT treatment centers	Private practices	Behavioral health practices	Therapy and prescriber practices; outpatient IOP/PHP on the Program plan
Levels of care	Featured customers run detox, residential, PHP and IOP	Not found	Not found	PHP, IOP and OP, each with day and week hours and a per diem code
Per diem from attendance	Not found; ask	Not found	Not found	Hours from signed notes; one per diem charge per day that meets its hours
Claim forms	Claim creation and submission in Kipu RCM; ask which forms	CMS-1500 documented; UB-04 not found	CMS-1500 and electronic claims documented; UB-04 not found	837P, and 837I (UB-04) for program days
Utilization review	Listed in Kipu RCM	Not found	Not found	Continued-stay review prompted 5 days ahead with ASAM dimensions 1 to 6
Medications	Orders, administration, inventory, diversion controls; e-prescribing via Surescripts	ePrescribe add-on	ePrescribe add-on	Medication list and allergies; e-prescribing not live yet; no administration record
US storage, AI notice, sex at birth (SB 1188)	Ask	Ask	Ask	US hosting on AWS under AWS's BAA; AI notice and opt-out when AI drafting is on; sex at birth required on new charts
15-business-day records requests (HB 300)	Ask	Ask	Ask	Requests run on the 15-business-day clock and show on Today
26 TAC 564 chart deadlines	Ask	Ask	Ask	Assessment, plan and review due dates you set (defaults 3, 5 and every 30 days); intern notes wait for a co-signer
Part 2 releases	Ask	Ask	Ask	§2.31 elements, consent checked before release, notice attached, accounting printed
TMHP and Medicaid plans	Ask	Ask	Ask	Through its clearinghouse to payers that take electronic claims; no TexMedConnect link
Published price	Not published; consultation	$49 / $79 / $99 first clinician; claims from $0.39	Solo $69; Group $89 + $60 per clinician from Dec 1, 2026; claims 25¢	Program $399 a month (up to 25 clients) + $39 per added clinician; claims 30¢
Leaving	Not found; ask for export terms	Complete data export; data kept no more than 64 days after termination	Export before leaving recommended; per-client download documented	Full export any time; readable at least 90 days after cancelling

Vendor rows: see Sources and the full 12-row table in the IOP EHR comparison, which also lists other program EHRs we haven't put in the table. Sunwave and Lightning Step merged in 2025 and now sell as one company; see the Sunwave and Lightning Step comparison. An "Ask" may well be covered in a demo; get each answer in writing.

Our candid answer, and where Cima isn't the best fit

We make Cima EHR, and we also run a licensed Texas outpatient program, so here's the answer we'd give a friend:

• Cima's Program plan is built for one kind of Texas program: a licensed outpatient program running PHP, IOP and OP only, up to 25 clients at a time, billing program days per diem to commercial plans and Medicaid plans that take electronic claims. If that's you, put it on your shortlist and demo it against one other vendor on the same made-up program day. See Cima for IOP and PHP.
• Pick a full-continuum platform instead if you run detox or residential, need a medication administration record or an admissions CRM with a bed board, or need e-prescribing today. Cima has none of those yet. Our Kipu comparison covers the trade-off.
• Stay on your therapy EHR for now if your IOP is a few clients, you bill professional claims only, and you can keep hours, per diem days and authorizations straight beside it. Run a mock payer audit with the chart audit checklist before you grow.
• Cima's other gaps, today: no TexMedConnect connection, no lab orders, no Columbia screening (C-SSRS) built in, no built-in video, and the BAA, Terms and Privacy Policy are drafts under attorney review. Above 25 clients, talk to us first.

Decide in two weeks

1. Write one page about your program: levels of care, your HHSC license, payers and their claim forms, census and staff. The buyer's checklist lists what to include.
2. Pick your row in the answer by kind of program and cut to two or three vendors.
3. Send the Texas column from the rules table to each vendor and ask for written answers.
4. Run the same program day in each demo and score it with the weighted scoring sheet.
5. Price the same month as one number per vendor with the EHR cost worksheet, then call two references your size.

Questions

What is the best EHR for an IOP in Texas?

The one that meets Texas's record rules (SB 1188 storage, HB 300 requests, 26 TAC 564 chart deadlines, Part 2) and fits your levels of care. Programs with detox or residential usually need a full-continuum platform such as Kipu; outpatient-only PHP and IOP programs can use an outpatient program EHR such as Cima's Program plan, which we make.

Does Texas require an EHR to be certified for IOPs?

Not that we know of for behavioral health programs. Texas sets rules on how records are kept, stored and shared, and HHSC's 26 TAC 564 sets what a licensed program's chart must contain and when. Ask each vendor to show how it meets each one.

Can a Texas IOP use SimplePractice or TherapyNotes?

Some small IOPs do, for notes and professional claims. Neither vendor's public pages describe levels of care, attendance-driven per diem billing or UB-04 claims, so plan how you'd track billable hours and authorizations, and how you'd bill a contract that wants a facility claim.

Does my EHR need to keep records in Texas?

SB 1188 requires electronic health records to be physically kept in the United States from January 1, 2026. Separately, 26 TAC 564.508 says a licensed chemical dependency treatment facility's original records stay in Texas; ask your attorney how that applies to your EHR and backups.

Can an EHR bill Texas Medicaid for IOP?

If it reaches the payer. Fee-for-service claims go to TMHP and managed care claims to the member's plan, within 95 days. Medicaid plans such as Superior require the HCPCS code (H0015 for SUD IOP) on PHP and IOP claims. Cima sends claims through its clearinghouse to payers that take them electronically and has no TexMedConnect link.

Is this answer biased toward Cima?

We make Cima, so treat our column with care. The other vendors' facts come only from their public pages, dated and linked, and Cima's gaps are listed. Score every vendor, us included, on a live demo of your own program day.

Sources

1. Texas Legislature, SB 1188, 89th Legislature, enrolled text (Health and Safety Code chapter 183).
2. Texas Health and Safety Code §181.101 (training) and §181.102 (electronic records requests).
3. 26 TAC chapter 564, including §564.804 and §564.508 (Cornell LII).
4. eCFR, 42 CFR 2.31, consent requirements.
5. 1 TAC §354.1003, Texas Medicaid time limits for claims; TMHP.
6. Superior HealthPlan, "Behavioral Health PHP and IOP Billing Code Update," September 11, 2025.
7. Texas Insurance Code chapter 1301 (§1301.102) and chapter 843 (§843.337).
8. Vendor pages, read October 24, 2026: Kipu Health Products; SimplePractice features by plan; TherapyNotes December 2026 Pricing Updates. The full list is in the comparison's sources.
9. Cima EHR's handling of each rule: the Texas rules guide and cimaehr.com/pricing.

Vendor names are trademarks of their owners, used only to compare published facts. Cima makes Cima EHR. General information, not legal advice; if a cell is out of date, send us the public page.