Opus EHR EHR Review (2026)

Overview

Opus EHR is a cloud-based electronic health record platform built specifically for addiction treatment and behavioral health organizations. Founded in 2015, it has established itself as a mid-market alternative to larger incumbents like Kipu and Netsmart, with a particular focus on substance use disorder (SUD) treatment centers that need more than just clinical documentation -- they need a unified system that covers the entire patient lifecycle from first contact through recovery.

The platform's defining characteristic is its integration of three traditionally separate systems into one: a CRM for admissions and referral management, a clinical EHR for documentation and treatment, and a revenue cycle management (RCM) engine for billing. This CRM-to-RCM architecture mirrors the approach taken by newer entrants like Ease, but Opus has been building on this model since 2015, giving it a longer runway of iteration and customer feedback in the SUD treatment vertical.

One feature that genuinely stands out is recovery coaching rounds documentation. Residential SUD programs rely heavily on recovery coaches and behavioral health technicians who conduct rounds -- checking on patients, documenting observations, and flagging concerns. Most EHRs treat this workflow as an afterthought, forcing facilities to use paper logs or improvised workarounds. Opus built dedicated tooling for it. For residential treatment centers, this is the kind of operational detail that separates a platform that understands the business from one that merely supports clinical documentation.

Opus also ships with Copilot AI, which the company claims reduces documentation time by up to 40%. The AI assists with clinical narrative generation and is integrated into the documentation workflow. While many behavioral health EHR vendors are racing to add AI capabilities, Opus's implementation is production-ready and positioned as a core feature rather than a beta add-on.

The platform serves organizations across the size spectrum -- from smaller outpatient programs to multi-facility enterprise operations -- and offers a notable pricing wrinkle: a free complimentary user for basic scheduling and billing. This freemium entry point is unusual in the behavioral health EHR market, where most vendors require a sales conversation before you can touch the software.

Disclosure: EHR Source is an independent review site with no business relationship with Opus EHR or any vendor listed on this site. Our reviews are based on publicly available information, user feedback, and hands-on evaluation.

Key Features

Copilot AI Documentation

Opus EHR's Copilot AI is the platform's flagship technology differentiator. The AI assists clinicians by generating clinical narratives from structured data inputs, auto-populating progress notes, and suggesting documentation content based on session context. Opus claims a 40% reduction in documentation time, which, if accurate, represents a substantial productivity gain for clinical staff who typically spend 30-50% of their working hours on documentation.

The Copilot is embedded in the clinical workflow rather than operating as a standalone tool. Clinicians interact with it during the documentation process itself -- as they complete assessments, enter session data, and finalize notes. This inline approach avoids the context-switching overhead that comes with third-party AI documentation tools that operate outside the EHR. The implementation is comparable to what Ease offers with its AI Scribe, though the two platforms take different approaches to the underlying AI architecture.

CRM and Admissions Pipeline

The integrated CRM module covers the full admissions lifecycle: lead capture, referral source tracking, insurance verification, contact management, and conversion analytics. For addiction treatment centers where the admissions pipeline directly drives revenue, having this data in the same system as clinical documentation and billing provides operational visibility that separate systems cannot match without expensive integrations.

The CRM tracks referral sources and their performance over time, giving admissions directors data on which relationships are producing admissions and which need cultivation. Lead-to-admission conversion tracking creates a measurable pipeline that treatment centers can use to optimize their marketing and referral development spend. This is the same architectural philosophy that Ease follows, and it is a meaningful advantage over platforms like AZZLY Rize that offer referral tracking but not a full CRM pipeline.

E-Prescribing with EPCS

Opus includes integrated e-prescribing with EPCS (Electronic Prescribing of Controlled Substances) that is fully DEA compliant. For SUD treatment programs -- particularly those running medication-assisted treatment (MAT) with buprenorphine, naltrexone, or methadone -- this is essential functionality. The e-prescribing module handles controlled and non-controlled medications, includes drug interaction checking, and maintains a medication history that is accessible across the clinical team.

Having EPCS natively in the EHR eliminates the need for standalone prescribing platforms like DrFirst or separate pharmacy integrations. For MAT-focused programs, this reduces both cost and the clinical risk that comes with managing medications across disconnected systems.

Integrated Telehealth

Opus provides built-in HIPAA-compliant telehealth that was specifically designed for SUD and behavioral health use cases. The telehealth module is integrated with scheduling, clinical documentation, and billing -- so a telehealth session follows the same workflow as an in-person encounter without requiring separate documentation or billing processes. This is table-stakes functionality in 2026, but the SUD-specific implementation matters: the platform supports group telehealth sessions, which are critical for IOP and outpatient SUD programs that deliver a significant portion of their services through group therapy.

Recovery Coaching Rounds Documentation

This is Opus EHR's most distinctive clinical feature. Recovery coaching rounds are a core operational workflow in residential treatment facilities -- recovery coaches and behavioral health technicians conduct regular check-ins with patients, document observations, flag clinical concerns, and track behavioral patterns. In most EHRs, this workflow is either unsupported (forcing facilities to use paper) or awkwardly shoehorned into progress note templates that were not designed for it.

Opus built dedicated rounds documentation tooling that allows recovery coaches to quickly log observations, track patient status across shifts, and escalate concerns to clinical staff through the platform. For residential SUD programs that rely on recovery coaches as a primary point of patient contact, this feature eliminates a significant documentation gap and improves the continuity of care between clinical sessions.

Assessment Tools

The platform includes 100+ customizable assessment tools covering the clinical assessments most commonly used in SUD and behavioral health treatment: ASAM criteria, PHQ-9, GAD-7, AUDIT, DAST, Columbia Suicide Severity Rating Scale, and many others. Assessments are built into the clinical workflow so that results feed directly into treatment planning and documentation. The assessment library is customizable, allowing organizations to add facility-specific instruments or modify existing ones to meet payer or accreditation requirements.

Dynamic Dashboards and Analytics

Opus provides dynamic dashboards that give clinical and administrative leaders real-time visibility into key operational metrics: census, admissions pipeline, revenue cycle performance, clinical outcomes, and staff productivity. The dashboards are configurable, allowing organizations to surface the metrics that matter most to their operations. For multi-facility organizations, the analytics provide roll-up views across locations alongside facility-level detail.

Outcomes Measurement

The outcomes measurement module tracks patient progress over time using standardized instruments, with visual graphs that make outcome trends accessible to both clinicians and patients. This is increasingly important as payers, accreditors, and referral sources demand evidence of treatment effectiveness. The visual presentation makes outcomes data useful in clinical sessions (showing patients their progress) and in reporting to external stakeholders.

Lab Integration

Opus supports lab integration for ordering and receiving lab results within the platform. For SUD programs that rely heavily on drug screening and toxicology testing, having lab results flow directly into the clinical record eliminates manual data entry and ensures that screening results are immediately available for clinical decision-making.

Billing and Revenue Cycle Management

The integrated RCM module covers claims generation, submission, tracking, ERA/EOB processing, and denial management. Claims are generated from clinical encounters, reducing the documentation-to-billing gap that causes revenue leakage in many treatment centers. Insurance eligibility verification is built into the admissions workflow, and the platform supports the complex billing scenarios common in SUD treatment -- multiple levels of care, per-diem residential billing, and the varying payer rules that make behavioral health billing notoriously difficult.

Compliance and Security

The platform is ONC certified and HIPAA compliant, with role-based access control and audit trails. For SUD treatment providers, 42 CFR Part 2 compliance for substance use disorder records is supported. The cloud-based architecture provides automatic updates, data backup, and disaster recovery without on-premise infrastructure requirements.

Pros

Cons

Pricing

Opus EHR uses a tiered pricing model that is unusual in the behavioral health EHR market. The entry point is a free complimentary user that includes basic scheduling and billing functionality. This allows organizations to get started with the platform without financial commitment -- a rare offering in a market where most vendors require a demo-to-quote sales cycle before you can access the software.

Full platform access -- including clinical documentation, CRM, Copilot AI, e-prescribing, telehealth, outcomes measurement, and advanced analytics -- requires a custom quote based on organization size, number of users, and feature requirements. Exact pricing is not publicly disclosed, which is standard practice among behavioral health EHR vendors in this segment.

The key pricing consideration is the all-in-one value proposition. Because Opus bundles CRM, clinical EHR, billing/RCM, e-prescribing, telehealth, and AI documentation into a single platform, organizations should compare the total cost against the combined expense of separate systems for each function. A treatment center running a standalone CRM, a separate EHR, and an outsourced billing service is likely spending more in aggregate -- before accounting for the cost and complexity of integrating those systems.

The free tier is a smart evaluation strategy: organizations can onboard a scheduling/billing user at zero cost, assess the platform's interface and basic functionality, and then make an informed decision about upgrading to full access. This is a lower-risk entry path than many competitors offer.

For a broader comparison of EHR pricing models across the industry, see our EHR cost guide.

Who Should Use Opus EHR

Opus EHR is designed for organizations whose clinical work centers on addiction treatment and behavioral health, and who need a unified system that covers admissions through billing. Specifically:

• Substance use disorder treatment centers -- residential, PHP, IOP, and outpatient programs that need SUD-specific documentation, recovery coaching rounds, MAT workflows, and specialized billing for addiction treatment.
• Residential treatment facilities with recovery coaching staff -- programs that rely on recovery coaches and behavioral health technicians for patient monitoring will benefit from the dedicated rounds documentation feature that no other major EHR offers.
• Mid-size treatment organizations looking to consolidate their tech stack -- facilities currently running separate systems for admissions CRM, clinical documentation, and billing that want to unify operations under a single platform without the enterprise pricing of Netsmart.
• MAT programs -- clinics prescribing buprenorphine, naltrexone, or other controlled substances that need DEA-compliant EPCS e-prescribing integrated with clinical documentation and billing.
• Organizations that want to try before they buy -- the free complimentary user tier allows organizations to evaluate the platform's scheduling and billing capabilities before committing to a full subscription.
• Treatment centers with active referral pipelines -- organizations where admissions volume is a key business driver and where having CRM and lead conversion data in the same system as clinical operations provides measurable value.
• Programs focused on outcomes measurement -- treatment centers that need to demonstrate clinical effectiveness to payers, accreditors, or referral sources will benefit from the built-in outcomes tracking with visual graphs.

Who Should NOT Use Opus EHR

No EHR is the right fit for every organization. Opus EHR is not the best match for:

• Solo therapists and very small outpatient practices. Individual practitioners with straightforward documentation and billing needs will find platforms like TherapyNotes or SimplePractice simpler, cheaper, and faster to set up. Opus's CRM, recovery coaching, and enterprise features are unnecessary overhead at this scale.
• General medical and hospital practices. Opus is a behavioral health and SUD platform. Primary care, urgent care, surgical, or multi-specialty medical groups need a general ambulatory or hospital EHR. See our vendor directory for broader options.
• Organizations that require rock-solid customer support. If responsive vendor support is your top priority -- and for clinical systems it should be high on the list -- the reported 2+ week support delays are a red flag. Organizations that cannot tolerate slow support turnaround should evaluate AZZLY Rize (known for strong customer support) or verify that Opus has addressed these issues before committing.
• Large enterprise organizations with complex state reporting requirements. While Opus serves enterprise customers, organizations with extensive state reporting, HIE, and interoperability requirements may find that Netsmart offers deeper capabilities in these areas, particularly for community behavioral health organizations with Medicaid reporting mandates.
• Psychiatry-only practices without SUD treatment. Standalone psychiatric practices that focus on medication management and therapy without a SUD component may find Opus's SUD-specific features (recovery coaching, MAT workflows, residential census) to be unnecessary complexity. Valant or TherapyNotes may be a better fit.

Implementation

Opus EHR's cloud-based architecture simplifies deployment compared to on-premise systems, but the breadth of the platform means that implementation requires thoughtful planning across multiple operational domains. Key factors that influence the implementation experience:

• Cloud-based deployment. There is no on-premise hardware to procure or maintain. The platform is accessed through a web browser, which simplifies rollout across multiple locations and eliminates infrastructure overhead.
• CRM configuration matters. Organizations that plan to use the CRM module need to configure referral source categories, pipeline stages, and lead routing rules that match their admissions workflow. This is not plug-and-play -- it requires input from the admissions team to set up correctly.
• Assessment library customization. While Opus includes 100+ assessments out of the box, most organizations will need to customize or add assessments to match their specific payer requirements, accreditation standards, and clinical protocols. Plan for this as a configuration phase, not a post-go-live activity.
• Recovery coaching rounds setup. Residential programs should involve recovery coaching supervisors in the implementation process to configure rounds documentation workflows, shift schedules, and escalation protocols. This is a feature that other platforms do not offer, so there is no legacy workflow to migrate -- but it needs to be designed intentionally.
• Data migration. Moving clinical records, patient demographics, and billing data from a prior system requires planning and validation. Organizations migrating from Kipu, AZZLY Rize, or other SUD EHRs should discuss data migration scope and timelines early in the sales process.
• Training investment. Given the reported learning curve, organizations should plan for dedicated training sessions for each user role -- clinical staff, billing, admissions/CRM, and administrative users. The breadth of the platform means that a single training session will not be sufficient.

The free complimentary user can serve as an informal pilot: organizations can onboard a scheduling/billing user to test the platform's interface and basic workflows before committing to a full implementation. This is a practical risk-mitigation strategy that few competitors offer.

For a comprehensive overview of what to expect during any EHR implementation, see our EHR implementation checklist.

Frequently Asked Questions

Verdict

Opus EHR occupies a well-defined position in the SUD treatment EHR market: it is a purpose-built addiction treatment platform that goes deeper into the operational workflow than most competitors by integrating CRM, clinical EHR, and RCM into a single system with genuinely unique features like recovery coaching rounds documentation. For residential SUD treatment centers that need more than clinical documentation -- that need a system spanning from first-contact admissions through recovery coaching through final billing -- Opus delivers a compelling unified experience.

The Copilot AI and recovery coaching rounds are the two features that most clearly differentiate Opus from the competitive field. The AI documentation capabilities put it in the same conversation as Ease (which also ships with native AI), while the recovery coaching tooling addresses a workflow that no other major SUD EHR has productized. For residential programs that employ recovery coaches, this alone may justify a serious evaluation.

The free complimentary user is a smart go-to-market strategy that gives prospective customers a genuine try-before-you-buy path. In a market where vendor demos and sales conversations are the only way to evaluate most platforms, the ability to actually use the software -- even in a limited capacity -- is a meaningful differentiator.

The trade-off is support responsiveness. The reported 2+ week support delays are a serious concern for any clinical system. EHR issues can directly impact patient care, billing revenue, and regulatory compliance -- waiting two weeks for a support response is not acceptable in a clinical environment. Organizations evaluating Opus should make support SLAs a contractual negotiation point and verify that the company has addressed this issue before committing.

The learning curve is the other consideration. Opus is a feature-rich platform, and that richness comes with complexity. Organizations should budget for adequate training and expect a ramp-up period. That said, the complexity exists because the platform does a lot -- and for organizations that are currently stitching together three or four separate systems, the consolidation benefit outweighs the learning investment.

Evaluating multiple options? See our behavioral health EHR comparison for a side-by-side look at the leading platforms, or read our EHR selection guide for a structured evaluation framework.