How much does a behavioral health EHR cost?

The six ways EHRs charge

Almost every behavioral health EHR bill is some mix of these. A quote that leaves one out isn't the full price.

Model	How it's billed	What to watch
Per clinician (per seat)	A monthly price for the first clinician, then a price for each added one. The most common model for therapy practices.	Who counts as a seat: some vendors charge for billers, schedulers or practice managers; others give them free logins. Volume tiers can lower or raise the seat price as you grow. Cima for group practices charges only for clinicians.
Per client or census	A price tied to active clients, beds or admissions. Common with program and facility EHRs.	How "active" is counted (on any day of the month, or on average), and what happens in a busy month.
Per transaction	A fee for each electronic claim, remittance (ERA), eligibility check or claim status check, usually passed through from a clearinghouse.	Whether claims are "included" up to a cap, and the price above it. For an insurance-heavy practice this can rival the subscription.
One-time setup	Implementation, training, form building and data migration, charged once.	What's in scope: how many forms, reports and hours of training, and what more costs.
Add-ons	Monthly extras per clinician: e-prescribing, AI note-taking, telehealth, reminders, client portal, extra storage.	Features shown in the demo that are actually add-ons. Ask for the price of each by name.
Percentage of collections	A share of what you collect, usually when billing services come bundled with the software, and in credentialing networks.	It grows with your revenue forever. If a billing company takes a percentage, have your attorney approve the arrangement. Our page on leaving Headway or Alma shows what a network's cut costs over a year.

Published prices, side by side

These are list prices from each vendor's own pages, read on October 24, 2026. Plans include different features, so a lower number isn't automatically a better deal; check what each plan actually includes. Promotions, annual discounts and taxes aren't shown.

Line	SimplePractice	TherapyNotes	Cima EHR
First clinician, per month	Starter from $49, Essential from $79, Plus from $99	Solo $69; Group $79 for the first clinician	Solo $59, Solo Prescriber $129, Program $399
Each added clinician	$74 (2–5 clinicians), $72 (6–15), $69 (16+)	$50 on Group; announced as $89 first + $60 each from December 1, 2026	$39; billing and front-desk logins free
Electronic claims	From $0.39 each since October 1, 2026, lower above 250 a month; free claims ended	25¢ each, with ERAs at 9¢, from December 1, 2026	30¢ a claim, 20¢ an ERA, at the clearinghouse's standard rate
E-prescribing	$49 a month per clinician, plus $89 one-time setup per clinician	Offered; price not shown on the pages we checked	Included in Solo Prescriber and Program; coming soon, not live yet
AI note help	Note Taker $35 a month per clinician	TherapyFuel $40 a month per clinician	Included in every plan
Built-in video	Check by plan	Check by plan	Not built in; you add your own video link
Setup fee	None found for the subscription	None found	None

Sources: SimplePractice's pricing FAQs and insurance pricing changes; TherapyNotes' pricing and subscription options and December 2026 pricing updates; Cima's pricing page. All read October 24, 2026. "Check by plan" means we didn't confirm it from the vendor's own page.

Program-focused EHRs, the ones built around levels of care, groups and per diem billing, often quote after a demo instead of publishing a price list. That's not a reason to rule one out, but it means you have to ask for the full quote, line by line, in writing. Choosing for a solo or group therapy practice rather than a program? The therapy practice EHR checklist covers the features to check alongside the price. The worksheet below tells you which lines to ask for.

Fees outside the headline price

The subscription is the number on the pricing page. These are the ones that show up on the invoice:

• Clearinghouse fees. Each claim, each ERA (the electronic payment explanation that posts the payment), each eligibility check and each claim status check can be a separate charge. Ask whether the vendor's own clearinghouse is required or you can bring yours.
• Payment processing. Running clients' cards costs a percentage plus a fee per charge through whatever processor the EHR uses. Ask the rate, and whether you can use your own processor.
• Text reminders. Some vendors charge per text or per reminder package.
• E-prescribing, especially controlled substances. Prescribing controlled substances electronically means meeting the DEA's EPCS rules in 21 CFR part 1311: identity proofing and two-factor signing for each prescriber. Vendors often price that as a per-prescriber add-on with its own setup. The DEA Diversion Control Division publishes the rules.
• Implementation and training. Fixed fees, hourly rates, or "packages" of hours. Ask what a second training session or a new staff member's training costs.
• Custom forms and reports. Some vendors build your intake packet or state report for a fee.
• Data migration in, and data export out. What it costs to bring records over, and what it costs to leave. An export fee at the end of the contract is a real cost of choosing that vendor.
• Price escalators. A clause allowing a yearly increase, or a discount that ends after the first term.

Every vendor that stores your clients' records must sign a business associate agreement under HIPAA (45 CFR 164.308(b)). If a vendor charges extra for the BAA, or for the security features the HIPAA Security Rule expects, count it in the price.

Turn any quote into one monthly number

Write every quote the same way. Use your real numbers: clinicians who see clients, insured claims a month, prescribers, and the add-ons you'll actually use.

Line	How to figure it
1. Base plan	The plan that has the features you need (not the cheapest plan shown).
2. Added seats	(Clinicians − 1) × the seat price, plus any non-clinical logins that cost money.
3. Claims	Insured claims a month × (claim fee + ERA fee). Add claim status checks if they're charged.
4. Eligibility checks	Checks a month × the price per check. Count automatic checks before each visit too.
5. Add-ons	Each add-on × the clinicians who need it (e-prescribing per prescriber, AI notes per clinician).
6. Payment processing	Card payments a month × the processing rate.
7. One-time costs, spread out	(Setup + training + migration + the exit export fee) ÷ the months you expect to stay, for example 24.
Total	Lines 1 to 7. Compare this number, never the headline price.

Worked examples on Cima EHR

Here's the worksheet filled in with Cima's prices for four common practice shapes, counting each claim sent and its payment coming back electronically. Claim counts are examples, not averages; use your own. The numbers come from the same price list as our pricing page and its estimator.

Practice	How it adds up on Cima EHR	Monthly total
A solo therapist, 20 insured sessions a week	Solo $59 80 claims × 50¢ (claim + payment back) = $40.00	$99.00
A psychiatric NP, 25 insured visits a week	Solo Prescriber $129 100 claims × 50¢ (claim + payment back) = $50.00	$179.00
A group practice: owner and 3 associates	Solo $59 3 added clinicians × $39 = $117 320 claims × 50¢ (claim + payment back) = $160.00	$336.00
An IOP/PHP program with 4 clinicians, about 20 clients	Program (IOP / PHP) $399 3 added clinicians × $39 = $117 300 claims × 50¢ (claim + payment back) = $150.00	$666.00

Cima has no setup fee, no export fee and no add-ons, so lines 5 and 7 are zero; card processing isn't part of Cima (you record card, cash and check payments from your own processor). Eligibility checks are 30¢ per question to the payer when you run them.

Pricing for IOP and PHP programs

Programs are where quotes diverge most, because the work is different: daily attendance, group notes for a room of clients, per diem claims and authorizations. When you compare program EHR quotes, ask:

• What's the unit? Per clinician, per active client, per bed or per program. Model your quiet month and your busiest month.
• How many claims will you send? A program that bills each program day on its own claim sends far more claims than a therapy practice with the same staff. Per-claim fees matter more here.
• Is the facility claim (837I/UB-04) included, or only the professional claim? If one contract needs UB-04s and the EHR can't produce them, you'll pay a biller to rekey them.
• Is utilization review in the base price, or a separate module?
• Which levels of care are covered? If you'll add residential or detox later, price that now.

Our guide on how to choose an EHR for an IOP or PHP has the full checklist and a vendor scoring sheet. Cima's Program plan is $399 a month for up to 25 clients in the program, with each clinician after the first at $39; Cima for IOP and PHP shows what it includes. Opening a new program? Cima Consulting's IOP / PHP Program Launch includes six months of Cima EHR.

Contract terms that change the price

• Term and renewal. Month to month, annual, or multi-year, and whether it renews on its own unless you give notice by a date.
• Annual prepay. A discount for paying a year up front is only a discount if you stay the year.
• Price-change notice. How many days' notice before a price increase, and whether you can leave without penalty when one comes.
• Minimums. A minimum number of seats or a minimum monthly charge.
• Leaving. Early termination fees, the export you get (format and scope), what it costs, and how long you can still read records after cancelling. You must keep records as long as your state and licensing board require, wherever they live.

Have your attorney read any multi-year agreement. Cima Consulting isn't a law or accounting firm.

Cima's pricing, every line

We publish all of it, because the worksheet above should take five minutes, not five emails:

What	Price
Solo (one clinician)	$59 a month: calendar, booking, reminders, paperwork, notes with AI drafting, claims, superbills, reports
Solo Prescriber	$129 a month: adds E/M and medication-management coding, and e-prescribing when it's live
Program (IOP / PHP)	$399 a month for up to 25 clients in the program: adds levels of care, group notes, attendance, per diem billing and continued-stay reviews
Each added clinician	$39 a month, prorated; billing and front-desk logins free
Claims and insurance	30¢ per claim, 20¢ per ERA, 30¢ per eligibility question, 30¢ per claim status check: the clearinghouse's standard rate, as one line on the next bill
Setup, AI, export	No charge
Terms	30 days free with no card; month to month; cancel any time; 30 days' notice of a price change; records readable and exportable at least 90 days after you cancel; never a percentage of collections

What you don't get for that price, today: built-in video visits, live e-prescribing, lab orders and client card processing. If you need one of those, count what it costs elsewhere in your total. See the full Cima price list and estimator or the feature list.

Questions

How much does an EHR cost per month for a therapist?

On the published prices we checked on October 24, 2026, one clinician pays about $49 to $99 a month for the subscription, depending on the plan. Insurance billing adds a fee per claim (25¢ to 39¢ on the pages we checked), and add-ons such as AI note-taking or e-prescribing can add $35 to $49 a month per clinician. Work out your own total with the worksheet above.

Why don't some EHRs publish their prices?

Vendors that sell to programs and facilities often price by census, levels of care and modules, and quote after a demo. It's common, not a red flag by itself. Ask for every line in writing, including clearinghouse fees, setup, training, add-ons and the exit export, so you can compare it to published prices.

What does a clearinghouse charge per claim?

It depends on the clearinghouse and the deal your EHR has with it. On the pages we checked, EHRs charge 25¢ to 39¢ per claim, and Cima passes through its clearinghouse's standard rate of 30¢ per claim and 20¢ per ERA. Some clearinghouses also charge for eligibility checks, claim status checks and paper claims.

Is a per-client price better than a per-clinician price?

Neither is better on its own. Per-clinician pricing is predictable for therapy practices; per-client pricing can suit programs with many clients per counselor, until census grows. Model both on your quiet month and your busiest month.

Are there free EHRs?

Some offer a free tier with limits on clients, features or support, or make money from payment processing or claims instead. Check what the free tier leaves out, whether a BAA is included, and what it costs to move off it later.

Should I pay annually to save money?

Only once you're sure. An annual prepay locks you in for the year; a month-to-month plan lets you leave if the EHR doesn't work out. Many practices trial month to month first.

Sources

1. SimplePractice Help Center, Subscription plan and pricing FAQs; What's changing with insurance pricing?. Read October 24, 2026.
2. TherapyNotes, Pricing and Subscription Options; December 2026 Pricing Updates; TherapyFuel Overview. Read October 24, 2026.
3. eCFR, 21 CFR part 1311 (electronic prescriptions for controlled substances); DEA Diversion Control Division.
4. eCFR, 45 CFR 164.308 (business associate contracts); HHS, HIPAA Security Rule.
5. Cima EHR prices: the app's plan and clearinghouse price lists (alturaops server/solo/subscription.ts, clearing-usage.ts), the same numbers as cimaehr.com/pricing.

Vendor names are trademarks of their owners and are used only to cite their published prices. If a price here is out of date, tell us and we'll fix it.