Opus EHR vs TherapyNotes
TherapyNotes scores 8.2/10 vs 7.0/10. Best for: Behavioral health clinicians who spend too much time on documentation and want an EHR that was actually designed around therapy notes, not adapted from a general medical template.
TherapyNotes scores higher overall at 8.2/10 vs 7.0/10. Buy TherapyNotes if documentation and insurance billing are your top priorities and you want a platform that thinks like a clinician. Skip if you need integrations with external tools or if per-message reminder costs would eat into your margins.
Opus EHR 
TherapyNotes Rank
#27 of 41
Rank
#3 of 41
Features
18/18
Features
17/18
Starting at
$79/mo
Starting at
$69/mo
User reviews
4/5 (50)
User reviews
4.4/5 (1052)
What they cost
| Opus EHR | TherapyNotes | |
|---|---|---|
| Starting at | $79 /mo | $69 /mo |
| Free trial | Free tier available | 30 days |
| Number of plans | 2 | 3 |
What the pricing really means
At first glance, TherapyNotes looks cheaper at $69/month vs $79/month. But sticker price is only part of the story. Look at what is included on the base plan, how many users you get, and whether you need add-ons to get the features you actually need. The $99/month plan that requires $200 in add-ons is actually more expensive than the $250/month plan that includes everything.
Where Opus EHR wins
- Purpose-built for addiction treatment and SUD with workflows that match how residential and outpatient centers actually operate
- E-prescribing with full DEA compliance and lab integration for substance abuse monitoring built into every paid plan
- Combines EHR, CRM, and revenue cycle management in one platform, so facilities do not need to stitch together three separate tools
- Capterra rating of 4.8 across 50 reviews with 100% positive sentiment, which is unusually high for behavioral health EHRs
- Free Starter plan lets you test scheduling and basic billing before committing to the $79/user paid tier
Where TherapyNotes wins
- Purpose-built for behavioral health notes with structured templates that match how therapists actually document, not generic medical forms bolted on
- Insurance billing and ERA posting are genuinely good, with electronic claim submission and automated payment reconciliation
- E-prescribing with EPCS included in the base price, so psychiatrists do not need a separate add-on
- Capterra 4.7 with nearly 1,000 reviews is one of the highest satisfaction scores in the category
Where Opus EHR falls short
- Small review count (50 total across platforms) means less community knowledge compared to established players like SimplePractice
- Multiple reviewers report slow issue resolution, with bugs sometimes taking weeks to fix after being reported
- Pricing requires contacting sales for anything beyond the base plan, and enterprise costs are not published
- Built for facilities and organizations, so solo therapists or small talk-therapy practices will find it overkill
Where TherapyNotes falls short
- No open API, so you cannot connect to tools they have not pre-built integrations for
- Per-text reminder charges of $0.14 each add up fast if you send confirmations and follow-ups to every client
- Premium telehealth is a $15/clinician/mo add-on on top of the base price, while competitors include it
- Mobile app only launched January 2026 and is still maturing compared to SimplePractice's years-old app
Who is each product built for?
Opus EHR
Target: 5-100+ staff
Buy Opus EHR if you run an addiction treatment center or behavioral health facility that needs SUD-specific workflows with built-in e-prescribing and lab integration. Skip if you are a solo therapist or small practice that does not need facility-level features.
TherapyNotes
Target: 1-50 clinicians
Buy TherapyNotes if documentation and insurance billing are your top priorities and you want a platform that thinks like a clinician. Skip if you need integrations with external tools or if per-message reminder costs would eat into your margins.
Feature comparison
| Feature | Opus EHR | TherapyNotes |
|---|---|---|
| Compliance & Security | ||
| HIPAA compliant | ||
| Telehealth / video sessions | ||
| Secure messaging | ||
| Scheduling & Clients | ||
| Online scheduling | ||
| Client portal | ||
| Intake forms / assessments | ||
| Automated reminders | ||
| Clinical | ||
| Progress notes / documentation | ||
| Treatment plans | ||
| E-prescribing | ||
| Outcome measures / assessments | ||
| Billing & Payments | ||
| Insurance billing / claims | ||
| Payment processing | ||
| Superbill generation | ||
| Automated billing | ||
| Platform | ||
| Group practice support | ||
| Mobile app | ||
| Integrations / API | ||
Common questions
TherapyNotes scores 8.2/10 vs Opus EHR's 7.0/10 in our ranking. TherapyNotes is the better pick for 1-50 clinicians. Opus EHR is better if you need behavioral health and addiction treatment facilities that need ehr, crm, and billing in one system built specifically for substance use disorder workflows.
Opus EHR starts at $79/month. TherapyNotes starts at $69/month. Watch for add-on costs — the base price often does not include all features. Pricing last verified 2026-04-01.
Opus EHR: Free tier available. TherapyNotes: Yes, 30-day free trial. Always test with your actual workflow before committing to an annual plan.
Opus EHR covers 18 of 18 features we track. TherapyNotes covers 17 of 18. Opus EHR has broader feature coverage, but more features does not always mean better — pick the tool that covers what your business actually needs.
Yes, Opus EHR has a mobile app. TherapyNotes does too.
Yes. The main effort is migrating your data (customer lists, job history, invoices). Plan for 1-2 weeks of overlap where you run both. Most healthcare practice management tools can import CSV data. Ask both vendors about migration support before you sign.
The bottom line
Pick Opus EHR if...
Behavioral health and addiction treatment facilities that need EHR, CRM, and billing in one system built specifically for substance use disorder workflows.
Pick TherapyNotes if...
Behavioral health clinicians who spend too much time on documentation and want an EHR that was actually designed around therapy notes, not adapted from a general medical template.