ICANotes Review: EHR Built for Therapy-First Practices

Company Overview

ICANotes is a healthcare IT company dedicated exclusively to behavioral health. Founded in 1999 and based in Annapolis, Maryland, they provide a web-based electronic health record (EHR) platform developed by a practicing psychiatrist.

Their system is built for psychiatrists, therapists, counselors, social workers, nurse practitioners, and other behavioral health professionals working in private practices, group settings, hospitals, and residential treatment programs throughout the United States.

Their software is designed to streamline documentation with minimal typing, allowing clinicians to generate detailed, compliant mental health records using structured templates. ICANotes supports the full range of documentation needs, including intake assessments, progress notes, treatment plans, group therapy notes, and discharge summaries.

Their platform also features automated coding to calculate the highest permissible Medicare or Medicaid billing codes, helping users remain compliant and improve billing efficiency.

As an entirely cloud-based solution, ICANotes gives providers secure access to client records from any device with an internet connection. Their tools are tailored to meet the specific needs of behavioral health practices, including support for substance use treatment and integrated workflows for clinical and administrative tasks.

What Features & Solutions Do They Offer?

Clinical documentation and charting

• AI-enhanced readability tools: ICANotes uses an AI-based readability enhancer to help providers generate clear, concise clinical notes that meet clinical and compliance standards. This supports better documentation quality and helps reduce editing time
• Point-and-click note builder: ICANotes allows users to generate detailed, narrative clinical notes in minutes using a structured, point-and-click interface that aligns with ICD-10 and DSM-5 coding standards
• Preconfigured note templates: The system includes ready-made templates for SOAP, BIRP, DAP, PIRP, nursing notes, psychiatric evaluations, psychotherapy, couples therapy, group sessions, progress updates, and substance use treatment
• Initial psychiatric evaluations: Clinicians can complete full biopsychosocial assessments using clickable menus that populate structured narratives with diagnoses, symptom reviews, and risk indicators
• Customizable treatment plans: ICANotes helps providers create individualized, goal-based treatment plans with linked interventions, justifications for level of care, and built-in integration with progress notes and assessments
• Discharge summaries: Providers can generate complete discharge notes that include patient progress, final diagnoses, risk assessments, medications, and aftercare plans, enhancing clinical documentation quality
• Psychotherapy and psychiatric note separation: The system allows users to store psychotherapy notes securely outside the medical record, using password protection
• Automatic coding suggestions: ICANotes analyzes note content and suggests the highest reimbursable CPT or E/M code, supporting accurate documentation and optimal revenue capture
• Rating scales and clinical assessments: The platform includes over 75 preloaded screening tools for depression, anxiety, PTSD, ADHD, bipolar disorder, addiction, and other behavioral health conditions
• Sample notes and templates library: ICANotes offers a library of editable sample notes and templates, allowing clinicians to reuse and adapt best-practice documentation

Practice management

• Calendar interface: ICANotes includes a visual scheduling calendar with drag-and-drop appointment functionality, color coding, and filtering for individuals, groups, or staff schedules
• Electronic intake and check-in tools: Patients can complete customized intake forms and consent documents online, reducing front-desk workload and digitizing the onboarding process
• Custom form creation and management: Practices can create branded, fillable forms and have clients complete them via the portal, in-office, or secure email links
• Patient portals: The patient portal allows clients to request appointments, complete forms, update information, and message providers. The Premium version adds email appointment reminders and enhanced form features
• Appointment reminders: Up to three automated reminders can be sent per appointment via phone call, SMS, or email, helping reduce no-shows and improve attendance
• Secure two-way messaging: ICANotes includes an encrypted messaging system for internal communication between staff and secure messaging between patients and providers
• Document storage and electronic faxing: Providers can upload, store, fax, and share documents within the platform, using built-in integrations like Kno2 for direct messaging and e-fax workflows
• Consent and signature collection: Electronic signatures can be captured on intake forms, consent documents, or any other patient paperwork submitted through the portal or uploaded to the system

Financial management

• Integrated billing tools: ICANotes connects documentation directly to billing workflows, allowing users to generate accurate superbills, CMS-1500 and UB-04 forms, and patient statements from completed health notes
• Self-pay and insurance billing support: Practices can accept multiple forms of payment, including private pay, insurance, and co-pays, with customizable invoice generation and payment tracking
• Claim submission: ICANotes supports electronic insurance claim submission through popular clearinghouses like Availity, ClaimMD, and Waystar, enabling real-time claim management
• Balance and payment notifications: Patients can be automatically alerted about outstanding balances, and statements can be customized for clarity and compliance
• Batch billing and financial reports: Practices can batch process billing data and generate revenue reports, aging reports, and other financial insights to improve collections and forecasting
• Optional revenue cycle management services: For practices that prefer to outsource, ICANotes offers full-service RCM support to handle claims processing, denials, and collections

Telehealth and virtual care

• Telehealth integration: Providers can initiate video sessions from the patient’s chart or appointment screen without requiring clients to download an app
• Group sessions: ICANotes telehealth supports screen sharing during sessions and allows for group-based virtual therapy when clinically appropriate
• Automated session invitations: Providers can send email or SMS invitations with one-click access to telehealth sessions, reducing friction for clients unfamiliar with technology
• Real-time charting during video visits: Clinicians can open and complete progress notes side-by-side during telehealth appointments, maintaining workflow efficiency
• Virtual waiting room: Patients can enter a waiting room before their session, giving providers full control over session start time and privacy, and improving appointment control

Compliance and security

• HIPAA, HITECH, MACRA & MIPS compliance: ICANotes fully complies with U.S. healthcare privacy and reporting regulations, helping practices meet government and payer documentation standards
• ONC-ATCB certified platform: The software is licensed under the ONC 2015 Edition criteria and supports Meaningful Use Stage 3, making it eligible for federal incentive programs
• Data encryption and user permissions: All stored and transmitted data is encrypted, and users can set role-based permissions to restrict access to clinical or billing information
• Audit trails and login protections: The platform includes complete audit logs, timeout controls, IP restrictions, and alerts to prevent unauthorized access and maintain a secure audit history
• Password-protected psychotherapy notes: Sensitive notes can be locked with an additional password and stored separately from the primary chart, protecting legally protected content
• Biometric login options: ICANotes offers biometric login support to add another layer of account protection for providers using supported hardware

Interoperability and integrations

• Direct messaging and document exchange: With Kno2 integration, ICANotes supports secure document exchange with external providers, labs, hospitals, and payers using direct messaging
• Lab integrations: The platform integrates with major labs, such as Quest Diagnostics, LabCorp, and Millennium, to receive results in structured or PDF format
• Health Information Exchange (HIE) support: ICANotes connects with regional and national HIEs to enable care coordination across systems
• Third-party system compatibility: ICANotes can integrate with billing systems, practice management platforms, data plumbers like Ellkay, and other third-party tools to support custom workflows

Plans & Pricing

Full-time clinicians

• Notes only: This plan is $55 per month and is designed for non-prescribers who only need core note-taking features. It includes 60 monthly notes and customizable, compliant templates stored securely in the cloud
• Non-prescribing: At $75 per month, this plan includes unlimited notes, appointment scheduling with automated reminders, secure client messaging, a HIPAA-compliant patient portal, and basic billing tools to streamline non-prescribing practices
• Prescribing: This plan costs $213 per month and includes everything in the non-prescribing tier, plus e-prescribing capabilities, integrated lab ordering, medication tracking, and prescriber-focused workflows. A $99 one-time activation fee also applies

Part-time clinicians

• Notes only: This entry-level option costs $35 monthly and includes 60 notes. It offers access to the full-time version's customizable templates and secure storage, and is available to non-prescribers only
• Non-prescribing: For $45 per month, part-time users receive all the same features as the full-time non-prescribing plan, including scheduling, messaging, portal access, and billing tools, but usage is limited to 60 notes monthly
• Prescribing: Designed for prescribers, this plan is priced at $138 per month and includes up to 100 notes per month, along with e-prescribing, lab integration, and medication tracking tools. It also requires a $99 activation fee

Optional features include telehealth access for $10 per month per user and text message reminders billed at $0.05 per message. The first non-clinical user is free, while each additional user costs $25 monthly.

Claims processing starts at $34 per month for up to 100 claims, $51 per month for up to 150, $63 per month for up to 185, and $119 per month for up to 350. 

Any usage above the included limit is billed at $0.33 per claim. Enrollment fees are $10 per payer for group NPI setup and $6 per payer per provider for individual NPI enrollment.

ICANotes also offers a Classic platform for practices that prefer the original workflows, with slightly different pricing.

Full-time plans cost $75.30 per month for non-prescribing and $155.30 for prescribing. Part-time plans are $46.30 and $105.30 per month, respectively. 

The first non-clinical user is $6.30 monthly, with additional full-time users at $45.30 and part-time users at $26.30.

Add-ons include telehealth access for $10 per month, e-prescribing at $33 per month for part-time and $58 per month for full-time users, and premium client portal access starting at $10 per month and scaling up to $200 per month depending on the number of providers.

Text message reminders on the Classic platform start at $11 monthly for up to 100 messages, with tiered increases as volume rises. After 3,000 messages, pricing increases by $50 per month for every additional 3,000 texts.

The Advantages of ICANotes

• Explicitly designed for behavioral health: ICANotes was created by a practicing psychiatrist and is purpose-built to meet the unique clinical and administrative needs of mental and behavioral health professionals
• No-typing clinical documentation: Their button-based note generation allows providers to create compliant, detailed clinical documentation with little to no typing, saving time and reducing transcription costs
• AI-enhanced tool: ICANotes includes AI-driven features to improve the clarity and conciseness of clinical notes, making documentation more accessible and reducing editing time
• Secure cloud-based access: As a fully web-based EHR, ICANotes allows users to access patient records securely from any device with internet access, enabling remote work and flexibility
• Comprehensive e-prescribing with safety tools: Their e-prescribing tool includes drug alerts, interaction checks, and clinical decision support, helping reduce the risk of medication errors and adverse events
• Flexible pricing for part-time and full-time providers: ICANotes offers separate pricing tiers and note limits to accommodate different clinician workloads, from part-time therapists to full-time psychiatrists
• Self-service patient portal: Clients can message their provider, complete forms, and access health data securely through a HIPAA-compliant portal that improves engagement and communication
• Built-in compliance support: The system is HIPAA-compliant and includes audit logs, access control, and customizable permissions to help maintain clinical and legal integrity
• First non-clinical user included free: Practices can add administrative users to manage scheduling, billing, or communications, with the first non-clinical account included at no additional cost
• Automatic E/M coding and billing optimization: The system auto-generates the highest permissible Medicare/Medicaid service code based on documentation, helping maximize reimbursement and reduce coding errors
• Specialized templates for behavioral workflows: The platform includes built-in templates for initial assessments, progress notes, treatment plans, group therapy, and discharge summaries tailored for behavioral health use cases
• Integrated telehealth access: Clinicians can add HIPAA-compliant video visits directly into their workflow with a $10/month add-on, extending care delivery to remote or mobility-limited clients
• Free trial access with transparent cancellation terms: ICANotes offers a 30-day risk-free trial to help providers evaluate the platform, and users can cancel with 15 days’ notice to avoid additional charges; patient data can also be exported to a USB for $150 upon termination
• Outsourced billing solution: For practices without in-house billing staff, ICANotes offers RCM add-ons that include claims submission, follow-up, and denials management—providing hands-free revenue operations support

The Disadvantages

• No native app: ICANotes does not offer a dedicated mobile app for patients. Instead, users must access the portal through a third-party app, which requires a manual setup process and additional credentials
• Lack of modern automation features: Despite including an AI readability enhancer, the platform lacks deeper AI-powered automation tools standard in newer EHR systems. This may limit efficiency gains for practices seeking more advanced technology
• Instability in ICANotes+ platform transition: Migration to the ICANotes+ interface has been rocky for many users, with widespread reports of system crashes, lag during uploads, and limited functionality compared to the original platform
• High cost for certain features: Services like data export at cancellation incur a $150 USB fee, while bulk texting, extra users, or e-prescribing require multiple add-ons that may quickly increase the total monthly cost
• Basic analytics and reporting tools: ICANotes lacks robust data visualization, custom dashboarding, or drill-down capabilities found in other platforms, which may limit insights for practice managers or owners tracking performance

The ICANotes Customer Experience

ICANotes receives mixed reviews across major platforms. On G2, they have a score of 3.6 out of 5. On Capterra, the rating is 4.1 out of 5, which matches their rating on Software Advice. However, they are not accredited by the Better Business Bureau (BBB) and hold a B rating.

Positive feedback

Users frequently praise ICANotes for being easy to navigate, fast for documentation, and highly compliant with insurance and regulatory standards. The platform’s click-to-insert note templates, customizable chart screens, and detailed clinical workflows help providers complete progress notes quickly and accurately.

E-prescribing and audit-ready documentation are also standout features for many. The system is especially appreciated by solo providers and school-based therapists for its flexibility, ease of training, and tailored support.

ICANotes' customer service consistently earns high marks. Users highlight responsive chat, remote assistance, and helpful onboarding sessions. Many note how the platform reduces time spent on charting, billing, and tracking medications.

Their library of screening tools, customizable forms, and easy-to-use calendar interface add to the appeal. Long-term users value the platform's regular updates and continued efforts to improve usability and compliance.

Critical feedback

Many users reported serious challenges after transitioning to ICANotes+, describing it as unstable and lacking essential features. Technical issues included frequent bugs, system crashes, telehealth glitches (where only video or audio would work), and slow load times, especially during record uploads.

Users also criticized the clunky interface, repetitive screens, poor calendar design, and difficulty navigating between provider views. Some noted the software isn’t optimized for AI integration, lacks modern UX features, and requires workarounds for basic actions like updating goals or accessing charts efficiently.

Support and billing concerns were equally prominent. Users cited unauthorized charges, unexpected rate hikes, and disruptions during cancellations, including account lockouts before agreed-upon dates. One reviewer reported significant business losses due to delayed financial reporting and billing failures.

Many described unhelpful support, long wait times, unresolved tickets, and poor communication, even during system outages. While ICANotes offers chat and remote assistance, some customers felt abandoned during critical moments, mainly when legal or compliance needs arise.

What Customer Service Options Do They Offer?

ICANotes offers multiple support channels, including phone at 866-847-3590, text at 866-302-1160, email at ticket@icanotes.com, and live chat through their website. Users can also submit and track support tickets, access remote support, download support tools, and upload documents securely.

For onboarding and training, ICANotes provides a free trial, scheduled live demos, training sessions, printable user guides, and a searchable knowledge base to help users navigate the platform efficiently.

Conclusion

ICANotes is a behavioral health-focused electronic health record system that simplifies charting for mental health professionals. With structured templates, automatic coding, and efficient narrative notes, they support streamlined documentation across solo practices, group settings, and residential care.

Their robust tools for psychiatric assessments, group therapy sessions, and medication management help clinicians stay compliant while improving real-time patient care.

Key strengths include smooth documentation workflows, secure patient portals, and integrated features for managing patient demographics, medical history, and eligibility verification. The platform enhances behavioral health notes without requiring heavy manual input.

That said, challenges with the ICANotes+ transition, occasional system bugs, and higher add-on costs may affect some users, and the learning curve remains a concern for new adopters.

To compare ICANotes to other leading EHRs, explore our medical software reviews, try our comparison tool, and read more on our blog page for valuable insights into the industry.