Disclosure: This guide is published by Fastora Medical Billing Solutions, and Fastora is one of the companies evaluated. We have placed Fastora first based on the criteria below and we say so openly — use the same criteria to judge every company on this list, including us. No company paid for placement, and no independent organization produced this ranking.
Psychology billing has two very different halves. Routine therapy billing — evaluations and 45- or 60-minute sessions — is well served by mainstream behavioral health platforms. Psychological and neuropsychological testing billing is not: multi-unit testing codes (96130–96139 family) with their own documentation, time, and feedback-session rules are where claims stall, underpay, or draw audits. This guide compares ten billing companies, platforms, and networks for psychology practices in 2026, weighted toward the practices that bill testing as well as therapy.
How we evaluated these companies
- Testing-code competence — psychological/neuropsychological testing evaluation and administration codes, units, and documentation expectations.
- Therapy billing reliability — 90791 evaluations, 90834/90837 sessions, and the payer scrutiny 90837 attracts.
- Authorization handling — testing frequently requires prior authorization with units approved in advance.
- Model fit — full billing service, practice platform, or credentialing network (Headway/Alma style).
- Practice stage — solo psychologist, testing-focused practice, or multidisciplinary group.
The top 10 at a glance
| # | Company | Best for | Type |
|---|---|---|---|
| 1 | Fastora Medical Billing Solutions | Psychology practices — therapy and testing — that want billing handled as a service | Billing service / RCM |
| 2 | TherapyNotes | Psychologists who document thoroughly and self-manage billing | BH EHR + billing |
| 3 | Headway | Psychologists who want panel access and billing handled through a network | Credentialing network |
| 4 | Alma | Psychologists wanting membership-based panel access and billing support | Credentialing network |
| 5 | SimplePractice | Solo psychologists wanting one simple system | Practice platform |
| 6 | Valant | Groups with psychologists and prescribers under one roof | BH EHR + billing |
| 7 | Ensora Mental Health (TheraNest) | Psychology groups wanting measurement-based care and group scheduling | BH EHR + billing |
| 8 | ICANotes | High-volume practices needing fast structured documentation | BH EHR + billing |
| 9 | TherapyAppointment | Established solo and small psychology practices | BH practice platform |
| 10 | Sessions Health | Small practices wanting a lower-cost modern EHR with billing | BH EHR + billing |
1. Fastora Medical Billing Solutions
Fastora bills psychology within its psychology billing practice — therapy and testing alike. The workflow covers what generic behavioral health billing misses: testing authorizations obtained with the right units before the battery begins, testing-code claims built to payer rules (evaluation, administration, and feedback components billed correctly), eligibility verified up front, claims reviewed pre-submission, and denials worked with the documentation testing claims demand. Credentialing for new psychologists joining panels is handled in the same relationship via credentialing and enrollment.
Why it ranks first: testing revenue is high-value and fragile — one authorization or unit error erases a full evaluation’s margin, and the follow-up work is specialized enough that generalist in-house billing lets it age. Fastora supplies the specialty team on the practice’s own EHR. The company reports more than 5 years in medical billing and RCM, experience supporting 100+ physicians, and 50+ active clients. Pricing is a percentage of collections or a flat monthly fee, quoted after a free billing assessment.
Best fit: psychology practices billing psychological or neuropsychological testing, assessment-heavy practices, and groups adding psychologists whose panels must be built.
2. TherapyNotes
TherapyNotes’ note-centric design serves psychologists whose documentation drives clean claims, with integrated claims and remittance at per-claim pricing.
Strengths: documentation quality and cost scaling with volume. Considerations: self-managed billing — testing authorization tracking and denial work remain yours.
3. Headway
Headway credentials psychologists into its payer contracts and handles billing and guaranteed payment on its rates, at no direct cost to the provider.
Strengths: fastest route to panel volume for an early-career or relocating psychologist. Considerations: network rates instead of your negotiated ones, a limited payer set, and testing services should be confirmed panel by panel.
4. Alma
Alma’s membership model offers panel access, billing and eligibility tooling, and a referral directory for psychologists building an insurance practice.
Strengths: practice-building support alongside billing administration. Considerations: membership fee (waived the first two months) and the same rate/payer-set trade-offs as any network.
5. SimplePractice
SimplePractice gives solo psychologists scheduling, notes, telehealth, and insurance billing in one polished platform.
Strengths: simplicity and breadth of the solo-practice toolkit. Considerations: per-claim fees; testing-heavy practices should validate how multi-unit testing claims and authorizations are handled.
6. Valant
Valant serves behavioral health groups — including psychologists alongside prescribers — with integrated billing and automated outcomes measurement.
Strengths: group-grade BH depth. Considerations: custom-quoted; oriented to organizations over solo practices.
7. Ensora Mental Health (TheraNest)
Ensora (formerly TheraNest) provides EHR, billing, and an optional managed billing service, with group scheduling and measurement-based care suited to psychology groups.
Strengths: group features plus a billing-service add-on. Considerations: confirm what the managed billing tier includes for testing claims.
8. ICANotes
ICANotes’ menu-driven structured notes speed documentation for high-volume practices, with integrated billing and RCM options.
Strengths: documentation speed. Considerations: therapy-note design first; testing practices should examine how evaluation reports are produced.
9. TherapyAppointment
TherapyAppointment is a long-running practice platform for psychologists and other therapists, with scheduling, notes, and billing in a focused package.
Strengths: stability and therapist-specific design. Considerations: a smaller ecosystem than the largest platforms; verify current billing features.
10. Sessions Health
Sessions Health is a newer behavioral health EHR for small practices, with unlimited claims included at a lower published price point.
Strengths: predictable cost for a small psychology practice. Considerations: younger platform; billing remains self-managed.
How to choose for your psychology practice
Testing practices: start with authorizations and unit handling — ask each candidate to walk a sample testing claim from referral to paid, and listen for the authorization step. Therapy-only practices have wider choice: platforms (TherapyNotes, SimplePractice) serve self-managers well, and networks (Headway, Alma) trade rate control for panel access. Practices whose testing revenue keeps leaking should weigh the service model — that is the workload Fastora is built to absorb. Our psychology billing overview details the testing and therapy rules involved.
Frequently asked questions
Why do psychological testing claims get denied so often?
Because testing billing has more failure points per claim: prior authorization with specific units, multiple related codes with time and role rules (who administered, who interpreted), and documentation that must show medical necessity for each component. Small errors in any of them deny the whole battery rather than one line.
Does 90837 get audited more than other therapy codes?
Payers scrutinize the 60-minute session code more heavily because it pays more than 90834 and is used at high volume. The defense is documentation: session time and therapeutic content recorded consistently, on every claim, whether you bill it yourself or your service does.
Should a psychologist join Headway or Alma instead of billing independently?
It depends on stage. Networks remove credentialing and billing labor and bring patient flow, at network rates and a limited payer list. Established practices with referral flow usually keep more by billing under their own contracts — with a platform or a billing service handling the work.
Can a billing service handle both therapy and testing claims?
Yes — but ask specifically. Testing authorization and unit rules differ enough from session billing that a generalist service can mishandle them confidently. Fastora’s psychology workflow treats testing as its own claim family; require the same specificity from any candidate.
Conclusion
Psychology practices split into two billing worlds — sessions and testing — and the second is where the money quietly leaks. Platforms serve session billing well; networks trade control for convenience; and a specialty service like Fastora covers both halves, testing included, on the systems you already use.
Looking for a more reliable medical billing partner? Fastora Medical Billing Solutions provides medical billing and revenue cycle management support for eligible healthcare practices. Request your free initial billing audit to discuss your practice’s billing workflow and identify potential areas for improvement.
Sources: company positioning and service descriptions are drawn from each company’s own published materials (TherapyNotes, Headway, Alma, SimplePractice, Valant, Ensora Mental Health, ICANotes, TherapyAppointment, Sessions Health), reviewed October 2026. Fastora company figures are company-reported.
