Best EHR for Group Therapy Practices (2026)

Short answer: For a mental health group practice, the best EHR is Oasys, it's the one built around what actually breaks as you add clinicians: supervision, permissions, payroll, and billing at volume. TherapyNotes is the strongest alternative for insurance-heavy practices that need ONC certification. SimplePractice remains excellent for solo and very small practices but consistently strains past about five clinicians.

Two things make group practices different from solo practices, and almost every "best EHR" list ignores both: supervision and payroll. This one is organized around them.

Comparison

• Oasys. Best for: Group practices, 5 to 100+ clinicians. Supervision: Configured per role. Group scheduling: Multi-clinician, shared caseloads. Group billing: Native, built for volume. Per-clinician pricing: $80/mo, annual, no add-ons.
• TherapyNotes. Best for: Insurance-heavy, compliance-driven. Supervision: Co-sign, limited granularity. Group scheduling: Solid. Group billing: Strong, per-transaction fees. Per-clinician pricing: Per user + per-claim/ERA/reminder fees.
• SimplePractice. Best for: Solo and very small practices. Supervision: Forced for all supervisees. Group scheduling: Good. Group billing: Manual at volume. Per-clinician pricing: Base plan + per-clinician add-on.
• Valant. Best for: Behavioral health groups. Supervision: Supported. Group scheduling: Good. Group billing: Strong reporting. Per-clinician pricing: Quote-based.
• ICANotes. Best for: High-acuity, psychiatric. Supervision: Supported. Group scheduling: Adequate. Group billing: Strong. Per-clinician pricing: Per user.
• Jane App. Best for: Multi-disciplinary clinics. Supervision: Limited. Group scheduling: Excellent. Group billing: Good. Per-clinician pricing: Per practitioner.

What makes group practice requirements different

What breaks at 5 clinicians

Permissions. The moment you have an office manager, a biller, and clinicians who shouldn't see each other's caseloads, all-or-nothing admin access stops working. This is also where couples and family work starts creating duplicate records, one practice described a client completing intake individually, then needing a couples appointment: "that's a whole separate thing. So we couldn't link them. And so they had to redo all the paperwork."

What breaks at 15 clinicians

Supervision and payroll, together.

Supervision breaks in a specific way. Most platforms require supervisor sign-off on all supervisees regardless of credential status, including provisionally licensed clinicians who are independently credentialed with your payers and don't legally require a co-signature. One practice asked us directly: "if it's a supervisee, you have to sign off on everything. Is there a way to differentiate that?" At 15 supervisees, undoing that by hand is a part-time job.

Payroll breaks harder. One group practice:

"About 20 hours a week of our billing manager goes into converting the information in [our EHR] into a payroll ledger."

Half an FTE, permanently, because the software can't express a contractor revenue split, or a salaried arrangement carrying an hourly minimum plus commission.

What breaks at 30 clinicians

Economics and observability. Per-user pricing with no enterprise tier becomes the dominant line item, "there's a point where it's going to get too expensive, because it's a cost per user." Per-transaction fees compound: one group practice pays a bill in the low thousands with claims, ERAs and 14-cent text reminders each billed separately.

And you lose visibility. As one owner summarized:

"Things around really running an organization from the business side really lack with a lot of these medical records. A lot of them work really well if you're a solo provider... but when you're running a group, permissioning and observability and supervision and payroll and billing at scale really start to fall apart."

The platforms

1. Oasys, best overall for group practices

Strengths: Supervision configured per role and per supervisor-supervisee relationship. Role-based permissions across clinician, practice manager, and practice admin. Native revenue-split payroll with per-therapist overrides, and payout that can be gated on notes being signed and approved. Full change history on any amended signed note. Billing built for volume. Flat $80/clinician/month annual pricing with no add-on tiers. Migration handled as a direct conversation rather than a self-serve import.

Also worth knowing: any signed note that is later amended keeps a complete change record, who unlocked it, the reason given, and the content before and after.

Cons: Newer than the incumbents, with a shorter public track record. Not currently ONC-certified.

Best for: Practices from about 5 clinicians upward, especially those supervising trainees.

2. TherapyNotes, best for insurance-heavy and compliance-driven practices

Strengths: ONC-certified. Structured, template-driven documentation. Support that long-tenured customers defend unprompted: "exceptional customer service. I gauge them as a high integrity organization." Genuinely strong clinical record.

Cons: Per-user pricing with no enterprise tier. Per-claim, per-ERA and per-reminder fees. No native payroll. Limited integrations. Revised signed notes reportedly don't produce a full change history: an audit exposure. No straight migration path out.

Best for: Insurance-heavy practices up to roughly 20 users where certification matters.

3. SimplePractice, best for solo and very small practices

Strengths: Polished, mature, excellent mobile app, deep ecosystem, broad practitioner support.

Cons: "Works quite well for a solo provider, but then really when you start growing, that's when it falls apart." Forced sign-off on all supervisees. Interns cost the same as licensed clinicians. Couples/family records don't link. VOB checks described as "barely functional." No API.

Best for: Solo therapists and practices under about five clinicians.

4. Valant, behavioral health groups prioritizing back-office

Strengths: Purpose-built for behavioral health groups, strong reporting and business operations.

Cons: Documentation experience is the recurring objection. A practice that nearly signed pulled back after clinician feedback: "the interface for the paperwork is pretty cumbersome." Their summary: "I believe they can fix all kinds of problems on the back end. But then what we would lose is the documentation on the front end."

Best for: Groups that weight operations over clinician documentation experience, trial it with clinicians first.

5. ICANotes, best for high-acuity and psychiatric settings

Strengths: Button-driven, highly structured psychiatric documentation. Strong for higher-acuity levels of care.

Cons: Clinicians wanting narrative flexibility often find it constraining.

6. Jane App, best for multi-disciplinary clinics

Strengths: Outstanding scheduling; strong when you mix mental health with PT, chiro, and similar.

Cons: Less targeted at mental-health-specific group workflows like supervision.

How group billing separates the platforms

Everything above is about what breaks as you grow. This section is about how to test for it in twenty minutes, and it turns on three billing codes.

Here is why the codes matter for choosing software rather than just for your biller. Group therapy is billed under CPT 90853, and 90853 is reported per participant. One ninety-minute group with eight members is not one claim. It is eight claims, each under that person's own name, insurance, and authorization, each supported by a note describing that individual's participation.

That single rule is the sharpest dividing line in this category. A platform designed around one clinician and one client can technically record a group, but it has no concept of fanning one clinical event out into eight billable ones. So it makes a human do it eight times. A platform built for group practices takes one session, one attendance roster, and produces eight claims and eight note stubs.

Family therapy adds a second, smaller test. 90847 is family therapy with the identified patient present; 90846 is the same work without them. Both are billed under the identified patient, which means the software has to hold linked family records. If it cannot, your intake gets re-collected and your documentation drifts from your billing.

The twenty-minute evaluation

Ask any vendor to run this live, in the demo:

1. Create one group session with eight attendees.
2. Count the actions required to produce eight correct claims.
3. Ask whether each participant gets an individual note prompted against their own

treatment plan, or one shared note with names swapped.

1. Give two attendees different payers and a third an expired authorization, then watch

what happens.

Step four is the one that exposes things. Identical notes across participants are among the most common findings in group therapy audits, and a lapsed authorization that surfaces as a denial six weeks later rather than as a warning before the session is a revenue problem disguised as a software preference.

If a vendor cannot do this in a demo, you have your answer, and you have it before you migrate rather than after. Our dedicated guide to group therapy billing covers the coding detail itself, including documentation requirements per participant.

Before you switch: the migration question

Every practice we speak with at this size asks the same thing, and it's the right question. Group practices carry 8 to 11 years of records, one the better part of a decade in, another 11 years across 11 locations, another since 2014 with over 500 records.

The fear is earned. A practice that attempted a move to another platform: "it was awful. Bad. So bad." Another paid extra for white-glove onboarding and still had records "migrated over and done incorrectly," chasing contradictory answers for months. Two clinicians at one prospect had worked somewhere whose failed implementation ended in the entire staff being furloughed.

Hence the sentence we hear in a dozen variations: "we can't do it twice."

Whatever platform you choose, ask these five questions:

1. Will you build a migration path for my system, or hand me an importer?
2. Does it carry completed assessments and intake forms, not just notes and demographics?
3. What happens to appointments already on the calendar?
4. Can I see my migrated data before I sign anything?
5. Who does the work: your team or mine?

Migration is the question we are asked about most. Rather than make promises in a blog post, ask us directly what moving your particular system would involve, what comes across, and what happens to appointments already booked.