Your EHR is the operational backbone of your telehealth practice. It handles scheduling, documentation, billing, telehealth video, and often patient communication. Choose the wrong one and you are migrating mid-launch. Choose the right one and it runs quietly in the background while you focus on patients.
This comparison covers the most popular EHR systems for solo and small-group telehealth practices, with a focus on what actually matters: telehealth integration, billing features, HIPAA compliance, and cost.
What to look for in a telehealth EHR
Before comparing specific platforms, here are the non-negotiable features for a telehealth practice:
- Built-in HIPAA-compliant video (or seamless integration with a compliant platform)
- Signed BAA available from the vendor
- Electronic claims submission (either built-in or via clearinghouse integration)
- Appointment scheduling with automated reminders
- Customizable intake forms and consent documents
- ERA/EOB posting for tracking payments
- Superbill generation for out-of-network patients
Head-to-head comparison
| Feature | SimplePractice | TherapyNotes | DrChrono | Practice Fusion |
|---|---|---|---|---|
| Best for | Behavioral health, therapy | Behavioral health | Medical, multi-specialty | Primary care, medical |
| Telehealth built-in | Yes | Yes | Yes | No (needs integration) |
| BAA provided | Yes | Yes | Yes | Yes |
| Claims submission | Built-in | Built-in | Built-in | Via clearinghouse |
| Starting price | $29/mo (Essential) | $49/mo (Solo) | Contact for pricing | Free (ad-supported) |
| Telehealth tier | $69/mo (Professional) | $49/mo (included) | Varies | N/A |
| Client portal | Yes | Yes | Yes | Yes |
| Intake forms | Customizable | Customizable | Customizable | Basic templates |
| Automated reminders | Yes | Yes | Yes | Yes |
| Mobile app | Yes (iOS, Android) | Limited | Yes (iPad-focused) | No |
| Learning curve | Low | Low | Moderate | Low |
SimplePractice
The most popular EHR for solo behavioral health providers and therapists. The Professional plan ($69/month) includes telehealth video, a client portal, online scheduling, intake forms, and claims submission. The interface is clean and the learning curve is minimal.
Strengths: all-in-one platform, excellent client portal, strong mobile app, easy claims submission. Therapists and counselors can be up and running in a day.
Limitations: the Essential plan ($29/month) does not include telehealth. You need the Professional tier. Insurance claim submission costs an additional per-claim fee. Not ideal for complex medical billing with multiple procedure codes per visit.
TherapyNotes
Purpose-built for behavioral health with a focus on clinical documentation. Telehealth is included at every tier. Strong note templates for therapy, psychiatry, and counseling. Claims submission is built in with no per-claim fees beyond the monthly subscription.
Strengths: excellent progress note templates, telehealth included at base price, no per-claim fees, strong insurance billing tools. Great for providers who prioritize documentation quality.
Limitations: the interface feels more clinical and less modern than SimplePractice. Mobile experience is not as polished. Fewer integrations with third-party tools.
DrChrono
A more full-featured medical EHR designed for multi-specialty practices. Good for NPs, PAs, and physicians who need more complex charting, e-prescribing, and lab integrations. Telehealth is built in.
Strengths: e-prescribing, lab integrations, customizable clinical templates, iPad-native design. Handles medical complexity that therapy-focused EHRs cannot.
Limitations: pricing is not transparent (contact sales). The platform has a steeper learning curve. Overkill for a solo therapy practice. Better suited for primary care or psychiatry with prescribing.
Practice Fusion
A free, cloud-based EHR supported by advertising. Covers basic charting, scheduling, and e-prescribing. Does not include built-in telehealth video, so you would need to pair it with a separate platform like Doxy.me.
Strengths: free, which matters when you are pre-revenue. Basic charting and e-prescribing work. BAA available.
Limitations: ad-supported (ads appear in the interface). No built-in telehealth. Limited customization. Claims submission requires a separate clearinghouse. You get what you pay for.
The TelemedLaunch playbook includes a full tech stack comparison in Module 2 with budget and premium templates, plus a tech stack tracker tab in the SOP that logs BAA status for every vendor. See the full system.
Our recommendation for most solo telehealth providers
For behavioral health (therapists, counselors, psychologists, LCSWs): start with SimplePractice Professional ($69/month) or TherapyNotes ($49/month). Both cover telehealth, billing, and documentation in one platform. SimplePractice has the better interface and mobile app. TherapyNotes has better note templates and includes telehealth at the base price.
For medical providers (NPs, PAs, physicians) who need e-prescribing and lab orders: look at DrChrono or a comparable medical EHR. The therapy-focused platforms are not designed for that workflow.
For providers starting with zero revenue who need to minimize costs: Practice Fusion (free) plus Doxy.me (free HIPAA-compliant video) gets you functional for $0/month. Migrate to a paid platform once you have consistent revenue.
One mistake to avoid
Do not pick your EHR based on price alone. Migrating EHRs after you have patients, notes, and billing history is painful and time-consuming. Pick the platform that fits your specialty and workflow, set it up correctly once, and build on it.
Every tool decision, mapped out
The Telehealth Practice Launch Kit covers EHR selection, telehealth platforms, scheduling tools, and your complete tech stack with budget and premium options.
Get the Launch System: $299