Practice Management Software With Built-In Telehealth for Therapy Practices
Which therapy platforms run video visits without a second tool, what telehealth costs on each, and whether the session note is written in the same seat.
Yes, a therapy practice can run video visits without a second tool. Ona, TherapyNotes, SimplePractice, Valant and ICANotes all put telehealth inside the platform. The real difference is what the call leaves behind: whether the session note is drafted inside the same seat price, or billed as an add-on on top.
Quick answer:
- Video inside the platform is no longer the thing to shop for. Every serious therapy platform has it, so the question has moved on.
- The add-on line is where the money hides. ICANotes charges $20 per user per month for telehealth itself, and TherapyNotes, SimplePractice and ICANotes each charge again for AI note drafting.
- In Ona, encrypted browser video, the waiting room and the ambient scribe that drafts the note all sit inside the $130 practitioner seat. The trade is multi-participant work: Ona is 1:1 today.
What built-in telehealth actually means
Ona's own telehealth page puts it plainly: built-in telehealth means the video visit runs inside your practice management platform instead of a separate app, so the encrypted call opens from the patient's chart and the visit note is drafted on that same record.
That definition does real work, because "integrated telehealth" gets used for three different things: a video product the vendor built and owns, a third-party room the platform can launch, or a field that stores a link you pasted in from somewhere else. Only the first one removes a tool from your week.
The test is not whether a vendor says the word. It is whether, from the moment you open the visit to the moment you sign, you ever leave the record.
Three things a therapy session needs, and only one of them is video
Shop this by the visit, not by the feature grid.
A room the client can actually get into. A client who has to install something, make an account, or hunt for a link in three inboxes is a client who joins four minutes late into a fifty-minute hour. In Ona the client clicks a link in their email and lands in a browser, no download and no account, on Safari, Chrome, Edge or Firefox, on a laptop or a phone. A waiting room runs pre-flight microphone and camera checks with a live preview and a countdown, and the Join button unlocks at the scheduled start.
The chart open beside it. A virtual session where the clinician is watching one window and typing into another is a session with a hole in it. In Ona the call opens from the consultation record, so the history, the interview template and the note sit alongside the video, with screen-share, image review and in-call chat attached to that same record.
A note at the end. This is the part almost every buyer forgets to price, and it is the part that decides whether the evening is yours.
Where the second tool creeps back in
It is rarely the video any more. It is the note.
On TherapyNotes, Basic Telehealth is included with every plan and covers unlimited one-on-one sessions, a virtual waiting room, screen sharing and a clinician guest link. Good, and genuinely built in. But TherapyFuel, the AI layer that drafts progress notes from a session, is a separate line at $40 per clinician per month.
On SimplePractice, telehealth is listed among the core features on every plan, from Starter at $49 upward. Note Taker, which generates the progress note from a telehealth or in-person session, is an add-on at $35 per month, or comes bundled inside Care Aide at $59 per month for the account owner and $49 for each additional clinician.
On ICANotes, telehealth itself is in the optional features column at $20 per user per month, and the AI Scribe is another $49 per user per month on top of a $75 Non-Prescribing clinician seat.
On Valant, telehealth is properly integrated and unusually capable for group work. What you cannot do is price it, because Valant's plans page publishes no figures and states that telehealth and AI-assisted documentation are among the optional features that may influence the quote.
So the honest version of "built-in telehealth" in 2026 is: the video is usually included, and the note usually is not.
How a session runs in Ona, from link to signature
Ona is a general ambulatory EHR that scales from solo clinicians to multi-location groups and enterprise systems, and therapy and psychiatry are among the practice types it serves. The telehealth path is the same one every Ona practice uses.
- Open the visit from the patient's chart and join in one click. No pasted links, no third-party app.
- The client joins from an emailed link, grants microphone and camera access in the waiting room, sees a live preview, and comes in when the countdown hits the start time.
- Screen-share, review images and chat in call, with the visit, the interview template and the history beside the video.
- With per-visit consent, Ona records the audio, transcribes it and drafts a structured note against your template. The ambient scribe works to SOAP, DAP, BIRP, a format you build, or freeform, and nothing leaves the chart until you review and sign.
- If the connection degrades, LiveKit drops stream quality automatically and the visit keeps going as audio, so the conversation survives and the note still lands.
Two guardrails, because therapy buyers ask about both. Recording is consent-first, with a banner at the start of each visit and the option to run the session without recording at all. And the call is encrypted end to end, a BAA is signed at onboarding, every session is access-logged, and Ona does not use patient audio to train models. Full-video recording is not the default.
Structured intake travels the same path. Ona ships PHQ-9 and GAD-7 as ready-to-import self-scoring screening forms: each answer carries a point value, Ona totals the score on submission, bands it against cutoffs you define, and raises the risk flags you configure. Scores are visible to clinicians only, and the patient never sees a number. Ona does not do reporting across patients or trend those scores over time, so if that is the centre of your model, read the next section carefully.
How therapy platforms compare on this
One axis only: how much of a therapy video visit, meaning the room, the waiting room and the note that comes out of it, one subscription covers before you add a tool or an add-on. It is not a quality ranking. Prices are from each vendor's own pricing page, checked in September 2026.
| Coverage order | Platform | Video in the base subscription | Note drafted from the session | Multi-participant video | Published price | Best fit |
|---|---|---|---|---|---|---|
| 1 | Ona | Yes, on every plan. Encrypted browser video on LiveKit, waiting room with pre-flight checks, one-click join from the chart | Included in the seat. Ambient scribe records with per-visit consent and drafts against your template | No. 1:1 visits only today | $130 practitioner seat, $45 staff seat, monthly | Therapy and psychiatry practices of any size, from solo clinicians to multi-location groups and enterprise systems, that want the video, the chart, the note and the claim on one record |
| 2 | TherapyNotes | Yes. Basic Telehealth on every plan: unlimited 1:1 video, virtual waiting room, screen share, clinician guest link | Add-on. TherapyFuel, which includes its scribe, is $40 per clinician per month | Yes, with Premium Telehealth at $15 per clinician per month, up to 16 participants | Solo $69 per month; Group $79 for the first clinician plus $50 per additional clinician, non-clinical staff free | Therapy practices that want couples and family video, published prices and 24/7 phone support |
| 3 | SimplePractice | Yes. Telehealth is a core feature on every plan | Add-on. Note Taker $35 per month, or inside Care Aide at $59 per month for the account owner | Included on Plus; $20 per month add-on on Essential | Starter $49, Essential $79, Plus $99 per month; additional practitioners from $74 each | Solo and group practices that want the lowest published entry price and a deep template library |
| 4 | Valant | Yes. Integrated telehealth with a waiting room, launched from the EHR and joined from the MYIO portal | AI Notes Assist, priced inside the quote | Yes, up to 30 participants, with attendance tracking for IOP and PHP programs | Not published. Custom quote by licence type and add-ons | Psychiatry practices and IOP or PHP programs running structured multi-participant sessions |
| 5 | ICANotes | No. Telehealth is an optional feature at $20 per user per month | Add-on. AI Scribe at $49 per user per month | Not stated on the pricing page | Full-time clinician: Notes Only $55, Non-Prescribing $75, Prescribing $213 plus a $99 activation fee | Documentation-heavy practices that want a large pre-built template library and ONC certification |
What this costs a solo therapist who works on video
Take one clinician who wants a video room and a drafted note, and nothing else changed.
Ona is $130 a month, with the video, the waiting room, the scribe, scheduling, the client portal and billing in that one seat. TherapyNotes is $69 plus $40 for TherapyFuel, so $109, and $124 if couples work means Premium Telehealth. SimplePractice is $49 plus $35 for Note Taker, so $84 on Starter, or $114 on Essential once appointment reminders and secure messaging matter. ICANotes is $75 plus $20 for telehealth plus $49 for the AI Scribe, so $144. Valant cannot be placed on this line at all, because nothing is published.
Read that honestly: on the solo teletherapy question alone, Ona is not the cheapest headline number, and SimplePractice's entry stack is meaningfully below it. What the $130 buys is that the line does not move as the practice does. There is no separate video licence to add, no scribe tier to upgrade, no per-clinician AI charge when the second and third clinician arrive, and no add-on that unlocks the features a second clinician needs. Every feature is on every plan.
The seat also carries the parts of the week that sit either side of the session: scheduling with a public booking page, version-controlled consents that capture timestamp, signer, template version and IP, and the eligibility and claims workflow on the same chart, with the checks and claims themselves metered by an Ona Clearing House plan from $69 a month. For a practice billing payers, that last one is where the audit trail either exists or does not. It is the same argument made at length in our guide to built-in telehealth across practice types and in behavioral health documentation software.
Full pricing sits on the pricing page. Annual billing takes 10 percent off everything, and the 14-day trial needs no credit card.
Where another platform is the better buy
You run couples, family or group sessions. Ona's visit model is 1:1 today and purpose-built group visits are not in the product. TherapyNotes Premium Telehealth carries up to 16 participants, SimplePractice includes group appointments and group telehealth on Plus and adds them to Essential for $20 per month, and Valant supports up to 30 participants with attendance tracking built for IOP and PHP programs. If a meaningful share of your calendar is multi-participant, that is a hard requirement and you should buy for it.
You need a person on the phone at 11pm. TherapyNotes includes 24/7 phone and email support on every plan. Ona's human support is in-app chat and email from a primarily business-hours team, and we aim for a same-day answer on anything non-trivial. That is a real difference, and if it decides your purchase, it should.
Your model is built on repeat assessments. Valant's intake and assessment page advertises "80+ Outcome Measures with Automatic Assignment". Ona scores PHQ-9 and GAD-7 inside the chart but does not report across patients or chart those scores over time. If that capability is the spine of how you practice, Valant is the better fit.
Ona earns the switch when the video is the least of it: when the same week contains unanswered calls, notes stacking past 7pm, consents nobody can find and claims nobody is sure about. A wider look at that argument sits in the Ona Health review and in software for mental health group practices.
Frequently asked questions
Does Ona do telehealth without a second tool?
Yes. Ona telehealth is encrypted, browser-based video built on LiveKit that opens from the patient's chart in one click. There is no separate video app, no third-party account and no pasted links. The client joins from an emailed link in Safari, Chrome, Edge or Firefox, on desktop or mobile.
Is telehealth included in Ona's price, or is it an add-on?
Included. Every feature is on every plan, so telehealth comes with the $130 practitioner seat and the $45 staff seat, and so does the ambient scribe that drafts the session note. The separately priced add-ons are e-prescribing, EPCS, calls, omnichannel messaging, the AI receptionist and the clearing house plans.
Do therapy clients need to download an app or create an account?
No. Clients join a one-time visit from a link in their email, in any modern browser on desktop or mobile, with no download and no account. Before the start they grant microphone and camera access, see a live preview, and wait in the waiting room until Join unlocks at the scheduled time.
Does the session note get written from the video visit?
Yes, with per-visit consent. Ona records the visit audio, transcribes it and drafts a structured note against the template you chose, whether that is SOAP, DAP, BIRP, your own format or freeform. Nothing leaves the chart until a clinician reviews and signs. Full-video recording is not the default, and Ona does not use patient audio to train models.
Can I run couples or family sessions on video in Ona?
Not today. Ona's visit model is 1:1, one clinician and one patient, and purpose-built group visits are not in the product. TherapyNotes Premium Telehealth supports up to 16 participants at $15 per clinician per month, SimplePractice includes group telehealth on its $99 Plus plan and sells it as a $20 per month add-on on Essential, and Valant's telehealth page states up to 30 participants. If multi-participant sessions are core to your work, buy one of those.
Which therapy platforms charge extra for telehealth?
ICANotes lists telehealth as an optional feature at $20 per user per month. TherapyNotes and SimplePractice include video on every plan and charge for the upgrade instead, at $15 per clinician per month for Premium Telehealth and at the $99 Plus plan or $20 per month on Essential respectively. Valant's telehealth is integrated but its pricing page publishes no figures, so the number arrives in a quote. Prices checked on each vendor's own site in September 2026.
Next step
Run one real session end to end and watch what the call leaves behind. Book a visit with a colleague, join from the chart, let the scribe draft the note, then sign it and see how much editing it actually took. Book a 15-minute demo and we will do it by video, or start the 14-day free trial with full access and no credit card.
Written by
Ona Health team