Best EHR for a Solo Private Practice Therapist

The right EHR+billing stack depends on exactly one thing: how much of your caseload is insurance vs cash-pay. Pick below in 60 seconds.

60-second chooser

Mostly cash-pay (80%+), premium rates, low insurance volume.
-> SimplePractice ->

Insurance-heavy (60%+ claims), need serious claim scrubbing.
-> TherapyNotes ->

New to insurance, don't want to credential alone.
-> Alma ->

Want insurance panels without running claims yourself.
-> Headway ->

Affiliate disclosure: links pay us a referral if you subscribe or credential. We get nothing if you pick the wrong tool and cancel in 30 days - which is why we segment by insurance mix, not by brand.

Before you subscribe: if you're not yet credentialed with any panels and don't want to spend 4-6 months on CAQH, W-9s, and re-attestations, your EHR choice changes. In that case, Alma or Headway is almost always the right first step - they do the credentialing and you keep your clinical work. You can layer SimplePractice / TherapyNotes later once panels are live.

Side-by-side

Factor	SimplePractice	TherapyNotes	Alma	Headway
Model	EHR + billing	EHR + billing (insurance-first)	Credentialing + EHR (community)	Credentialing + claims (platform)
Best for	Cash-pay or mixed, lifestyle practice	Insurance-heavy caseload	Solo therapists wanting panel access	Insurance panels without doing claims
Handles credentialing?	No	No	Yes (in-network for you)	Yes (in-network via Headway)
You submit claims?	Yes (via clearinghouse)	Yes (strong scrubbing)	Yes (through Alma)	No (Headway submits)
Cost model	$39-99/mo	~$59/mo + $25/credentialing	~$185/mo (no cut on sessions)	% cut of session (varies by state)
Clinical notes quality	Strong	Strong (psychiatry-friendly)	Good	Basic
Telehealth	Built-in	Built-in	Built-in	Built-in

The real fork: do you want to run claims?

Running insurance yourself gives you the full reimbursement minus no-cut. But it also means CAQH, re-credentialing, EOB posting, denials follow-up, and 30-60 day cash-flow float. For most solo therapists in year 1-2, the hidden time cost is 5-15 hours/week.

Platforms like Headway and Alma take a cut (or a flat monthly fee) in exchange for doing credentialing, eligibility checks, and claims. The math works best when your insurance mix is high but your admin time is expensive.

SimplePractice and TherapyNotes assume you're running claims yourself. If you're cash-pay dominant, SimplePractice. If insurance-heavy, TherapyNotes's scrubbing saves more in denials than it costs.

Trust / who we are

We're not a billing company, a credentialing firm, or a clinic. We publish comparison pages and take an affiliate referral when you sign up. Because refunds and 30-day cancels zero our payout, the advice is honest: picking the wrong platform doesn't make us money.

If your mix is 50/50 and you don't know yet - the safest bet is SimplePractice for the first 6 months, then reassess when you have enough data to know your real payer mix.

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