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ICANotes vs Tebra: Which EHR Fits Your Mental Health Practice Best?
Comparing ICANotes vs Tebra? Both platforms serve behavioral-health and mental-health professionals — but they differ in depth of clinical documentation, behavioral-health-specific workflows, and the "built for practice" features that matter when you're focused on therapy, psychiatry and case management. This article breaks down how each stacks up across documentation, billing, telehealth, practice growth and scalability, while also examining recent user experiences and known challenges with both platforms.
Last Updated: January 23, 2026
Why Clinicians Are Comparing ICANotes and Tebra
Tebra markets itself as a modern, cloud-based "all-in-one" platform for independent practices, including mental-health specialties. It emphasizes scheduling, intake, payments, and practice growth alongside clinical documentation. ICANotes, in contrast, is purpose-built for behavioral health — emphasizing structured documentation, compliance, depth of note types (e.g., group therapy, case management, PRP) and workflows tailored to the unique needs of mental-health clinicians.
If your practice is purely individual therapy and small scale, Tebra might feel simpler. But as caseloads change, billing gets more complex, or you add roles like case managers or PRP programs, ICANotes tends to show its advantage.
Platform Overviews
ICANotes is purpose-built for behavioral health practices. It centers on structured clinical documentation with templates designed specifically for therapy, psychiatry, case management, group therapy, and programs like PRP (Psychiatric Rehabilitation Program). The platform is built around the documentation workflows that mental health clinicians actually use.
Tebra positions itself as a comprehensive practice management platform for independent healthcare practices, including mental health. It emphasizes patient experience, practice growth tools, and streamlined administrative workflows alongside clinical documentation. Tebra takes an integrated approach to scheduling, billing, patient engagement, and EHR functionality.
Recent User Feedback (2025)
Tebra: Recent reviews show mixed experiences. Positive feedback highlights good onboarding support and an intuitive interface for scheduling and basic documentation. However, growing concerns include pricing transparency, e-prescribing reliability, and customer service consistency. Multiple users report challenges with cancellation processes and unexpected fees. For behavioral health specifically, some users note that execution hasn't matched the marketing promises, with one reviewer stating the platform has "yet to prove themselves in practice" and that the "transition has been more disruptive than expected."
ICANotes: User reviews consistently praise the behavioral health specialization and documentation efficiency, with clinicians reporting they can complete notes in 2-3 minutes. The platform maintains an 81% user satisfaction rating based on aggregated reviews. The main challenges mentioned include a steeper learning curve initially and some users reporting billing module complexity. Users particularly appreciate the "smart narrative charting feature" and how thorough it is for specialized applications like substance use disorder (SUD) treatment.
Feature Comparison: ICANotes vs Tebra
Side-by-side breakdown of key EHR features for mental health and behavioral health practices.
| Feature | ICANotes | Tebra | Verdict |
|---|---|---|---|
| Clinical Documentation & Templates | Menu-driven, structured templates for therapy, psychiatry, case management, PRP, and nursing (behavioral-health depth). | Cloud-based EHR geared toward psychology and specialty practices; good range but less specialty-depth documented publicly. | ICANotes for behavioral-health specialization |
| Billing & Revenue Cycle | Built for behavioral health workflows; tighter linkage between documentation and claims (supports audit/denial defense). | Emphasizes billing and payments automation, but users report mixed experiences with claims reliability. | ICANotes for audit defense; Tebra for simplicity (when reliable) |
| Telehealth & Patient Engagement | Integrated telehealth and portal; some users note the portal could be more modern/mobile-friendly. | Strong emphasis on online scheduling, portal tools, messaging, intake, and telehealth as core strengths. | Tebra may have the edge for patient experience |
| Scalability & Role-Based Workflows | Templates across roles (therapists, prescribers, case managers), group therapy workflows, agency-friendly permissions. | Supports independent practices; scales for adding providers, but less public detail on multi-role behavioral health teams. | ICANotes for multi-role behavioral health teams |
| Support & Training | Behavioral-health depth may require more onboarding; users report mixed support responsiveness. | Often praised for onboarding; support consistency varies by user reports. | Depends on your team’s needs |
| Pricing & Growth Suitability | Behavioral-health focus may cost more but offers depth for complex practices; transparent pricing structure. | Often positioned as cost-effective for smaller practices; user feedback includes pricing transparency concerns. | Tebra for smaller practices; ICANotes for long-term depth |
| Known Issues / Limitations | Learning curve for some users; billing module complexity; occasional downtime; portal could be more modern. | Pricing transparency and cancellation complaints; e-prescribing reliability issues; support inconsistency; slow document uploads reported. | Consider priorities carefully |
Note: Feature availability and user experience can vary by plan, implementation, and updates. Confirm details during demos and trials.
Download this EHR Evaluation Checklist
Choosing a new EHR is one of the most important decisions your practice will make. To help you evaluate vendors confidently and avoid costly surprises, download our free guide: Questions to Ask Mental Health EHRs.
This expert-designed checklist covers the essential questions to ask about documentation, compliance, telehealth, billing, integrations, scalability, pricing, analytics, and more — so you can compare systems side by side and choose the right fit for your practice.
Clinical Documentation
ICANotes offers menu-driven, structured templates across the full spectrum of behavioral health services. You'll find specialized note types for individual therapy, group therapy, psychiatry evaluations, medication management, case management, and various levels of care. The templates are designed to reduce documentation time while maintaining compliance with payer requirements and audit standards. Users consistently report being able to complete comprehensive notes in just 2-3 minutes.
Tebra provides cloud-based documentation tools for psychology and mental health practices with customizable templates and intake workflows. The system offers solid documentation capabilities for traditional therapy practices, though the publicly available information suggests less depth in specialized areas like case management or intensive outpatient programming.
If your practice requires diverse note types beyond standard therapy sessions—such as psychiatry, group therapy, or case management—ICANotes offers more specialized, audit-ready documentation support. For straightforward outpatient therapy documentation, both systems can work well, depending on your workflow preferences.
Billing and Revenue Cycle Management
ICANotes integrates billing directly with its behavioral health workflows. Documentation flows into claims submission with linkage designed to reduce denials and support audit defense. The system is built around the specific billing patterns common in behavioral health. Some users report the billing process can be complex initially, but many find it becomes manageable with proper training.
Tebra markets billing and payments automation as a core strength, with tools for eligibility verification, claims management, and patient payments designed to minimize administrative burden for independent practices. However, recent user feedback indicates mixed experiences with billing reliability and claims processing. Some users report unexpected fees and pricing transparency issues, including complaints about hidden charges and "new required fees" appearing without consent. Practices should request detailed information about all fees and cancellation policies before committing.
For practices with complex behavioral health billing needs and a strong focus on audit defense, ICANotes offers tighter integration between documentation and claims. Tebra may appeal to smaller practices seeking billing simplicity, but recent user feedback suggests billing reliability and fee transparency should be carefully vetted.
Telehealth and Patient Engagement
Tebra puts significant emphasis on patient experience features. The platform includes online scheduling, patient portals, secure messaging, digital intake forms, and integrated telehealth. These tools are designed to be intuitive for both staff and patients, with a focus on reducing front-desk workload and improving patient access. The 24/7 patient portal makes it easy for patients to view records, send messages, and manage payments.
ICANotes offers telehealth and patient portal functionality designed for behavioral health contexts, with secure, HIPAA-compliant video built directly into the EHR. You can launch sessions, complete notes, and bill all from the same screen. Some users note that the patient portal could be more modern in appearance and mobile responsiveness.
If patient-facing tools like online scheduling, portals, and ease of use are a top priority, Tebra likely has the edge. If your priority is keeping telehealth, documentation, and billing tightly connected within a single clinical workflow, ICANotes offers a more clinician-centered experience.
Scalability and Multi-Provider Support
ICANotes is built to support behavioral health organizations with multiple provider types, roles, and service lines. The system handles role-based permissions, group therapy documentation, case management workflows, and the complexity that comes with agencies offering various levels of care.
Tebra supports independent practices with multiple providers and emphasizes growth tools for expanding practices. The platform scales well for practices adding providers, though less information is publicly available about supporting large teams with diverse behavioral health roles.
Practices planning to grow beyond individual therapy—by adding psychiatrists, case managers, group programs, or multiple service lines—will likely find ICANotes better equipped for long-term scalability. Tebra may be sufficient for independent practices with simpler team structures.
Training and Support
Both platforms offer training and ongoing support. ICANotes' behavioral health specialization may require more detailed onboarding to fully leverage its template depth and workflow features. Users report mixed experiences with support responsiveness. ICANotes Support is available by phone and online chat 24x7. Individual virtual training sessions are available on weekends. Premium support and training is included in the base subscription price.
Tebra users generally report positive onboarding experiences, with the platform's intuitive design potentially shortening the learning curve. However, some users note that customer service consistency can vary, and support may be "sometimes not helpful" according to recent reviews.
ICANotes’ depth comes with a learning curve, making onboarding and training an important consideration. Tebra may feel easier to adopt initially, but support experiences appear to vary. The right choice depends on your team’s technical comfort level and available training time.
Pricing Considerations
ICANotes offers transparent pricing based on provider type: $75/month for full-time non-prescribing clinicians and $213/month for prescribing professionals, with part-time options starting at $45/month. The specialized behavioral health functionality may come at a higher initial cost but could provide value through reduced documentation time and better audit defense.
Tebra offers customizable pricing plans designed to fit practice needs. However, recent user feedback raises concerns about pricing transparency, with multiple reports of unexpected fees and charges. Some users describe pricing as "incredibly high for such a subpar system," and there are complaints about hidden fees like a "$119.99 new required fee" appearing without consent. Request complete fee disclosure in writing before signing.
ICANotes offers transparent, role-based pricing that aligns with more complex behavioral health workflows. Tebra may be more affordable upfront for smaller practices, but practices should request detailed fee disclosures and cancellation terms before committing.
Important Considerations When Evaluating These Platforms
For Tebra:
- Request complete pricing documentation including all potential fees in writing
- Clarify cancellation policies and procedures in writing before signing (multiple users report difficulty canceling and continued billing after termination requests)
- Test the e-prescribing module thoroughly during demos (recent reports indicate ongoing malfunctions and system instability)
- Verify customer support response times and escalation procedures
- Ask about known issues with your specific specialty or workflow, particularly for behavioral health
For ICANotes:
- Budget time for training on the documentation system and expect an initial learning curve
- Verify billing module capabilities match your needs and complexity level
- Test the patient portal to ensure it meets modern expectations and mobile accessibility needs
Which EHR Fits Your Practice?
Consider ICANotes if you:
- Provide services beyond traditional outpatient therapy (psychiatry, case management, PRP, group therapy)
- Need structured, audit-ready documentation across multiple service types
- Operate or plan to grow into a multi-role behavioral health organization
- Prioritize clinical depth and compliance over administrative simplicity
- Are prepared for an initial learning curve and training investment
- Value transparent pricing and the efficiency gains of 2-3 minute documentation
Consider Tebra if you:
- Run a smaller therapy or psychology practice focused on outpatient services
- Value streamlined patient experience and front-office automation
- Want an intuitive platform that's quick to learn and easy to use
- Prefer an all-in-one system with strong scheduling and engagement tools
- Can thoroughly vet pricing, fees, and cancellation policies before committing
- Are willing to work through potential e-prescribing and customer service challenges
Making Your Decision
The right EHR isn't just about features — it's about fit. Consider these questions:
- What services do you provide now, and what might you add in the next 2-3 years?
- How complex is your billing, and how important is audit defense?
- What roles need access to the system, and what workflows do they need?
- How much training time can your team invest in learning a new system?
- What's most frustrating about your current documentation or practice management process?
- Have you reviewed the complete pricing structure, including all potential fees?
- What are the cancellation terms, and are they acceptable to your practice?
- Have you spoken with current users of similar size practices in your specialty?
- What specific issues have been reported recently, and how does the vendor address them?
Request demos of both systems. Have actual clinicians test the documentation workflows. Ask to see examples of the note types, reports, and workflows your practice uses most often. Talk to current users in practices similar to yours. For Tebra specifically, ask direct questions about billing transparency, e-prescribing reliability, and cancellation processes.
The best EHR is the one that supports your clinical work without getting in the way — allowing you to spend less time on documentation and more time with the patients who need you.
Important Note
Software platforms evolve continuously. The information in this comparison reflects available data as of January 2026. We strongly recommend:
- Conducting thorough demos of both systems with your actual clinical workflows
- Speaking with current users in practices similar to yours
- Reviewing all contractual terms, pricing, and cancellation policies carefully before committing
- Testing critical workflows during trial periods, including e-prescribing and billing functions
- Verifying that recent user-reported issues have been resolved or have acceptable workarounds
Frequently Asked Questions: ICANotes vs Tebra
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Experience the most intuitive, clinically robust EHR designed for behavioral health professionals—built to streamline documentation, improve compliance, and enhance patient care.
- Simplify clinical charting
- Stay organized with appointment scheduling
- Reduce no-shows with automated reminders
- Improve client engagement with a secure patient portal
- Provide flexible care with HIPAA-compliant telehealth
Simplify clinical charting
Stay organized with appointment scheduling
Reduce no-shows with automated reminders
Improve client engagement with a secure patient portal
Provide flexible care with HIPAA-compliant telehealth
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Sandy Crowley
Chief Marketing Officer
About the Author
Sandy Crowley is the Chief Marketing Officer at ICANotes, a leading EHR platform purpose-built for behavioral health. Sandy has over two decades of experience bridging healthcare, marketing, and software innovation. Formerly the company’s CEO, she guided ICANotes through a period of rapid growth and product expansion. With a background in communications from Stanford University and a passion for helping clinicians streamline documentation and improve outcomes, Sandy continues to drive ICANotes’ mission to make behavioral health software smarter, more efficient, and clinician-focused.