Built for outpatient PT & multi-service clinics

A full initial evaluation
in six minutes.

Note, assessment, goals, and codes, billing-ready in about six minutes of documentation time, against roughly twenty on a legacy system. Your therapist reviews and signs every note.

Book a Demo See the real product
~6 minFull initial eval, our clinic
9Documentation suites
+4%Billing done for you, on top of your plan
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01 The real product

No mockups.
This is the EHR.

Screens from the live Cowboy Systems EHR, shown on a test patient. Everything you see here ships today.

ehr.cowboy-systems.com
Patient chart in Cowboy Systems showing a signed Lower Extremity Initial Evaluation for a test patient
A signed Lower Extremity Initial Evaluation on the patient chart: diagnoses, history, and every section of the exam.Test patient · demo data
02 How it works

From exam to
claim in four steps.

The AI does the typing. Your therapist stays in charge: nothing is final until they review and sign it.

01

Examine as usual

Run the visit the way you already do. Findings, special tests, and outcome scores like LEFS go straight into the chart.

Nothing new to learn
02

AI drafts the note

The SOAP note is built from the visit and the chart, not a blank template.

No after-hours charting
03

Assessment and goals

An assessment grounded in chart findings, special tests, and outcome scores, with timed short- and long-term goals.

Clinically specific
04

Sign once, done

CPT and ICD codes like 97162 and 97110 are suggested. When the therapist signs, the claim, the home exercise program and the flow sheet are built from the note.

Claim, HEP and flow sheet ready
03 The platform

One system that
actually does the work.

Not a note-taker with integrations bolted on. Documentation, the front office, and the revenue cycle share one patient record.

AI Documentation · Live
Recording

The note writes itself.

Speak naturally. The AI builds the SOAP note and picks the codes as you go.

S: O: A: P:
CPT 97110 CPT 97140 ICD M75.41
Scheduling

A calendar that stays full.

A shared waitlist books into an open slot in one click.

Mon
Tue
Wed
Thu
Fri
● Wed 10:00 opening, booked from waitlist
Revenue Cycle

We run your billing.

4% of collections, on top of your plan
Aetna · 97110Paid
BCBS · 97140Scrubbed
Medicare · 97530Paid
Clinics pay legacy systems $3,000+/mo just to bill. We do it for 4% of collections on top of your plan, right inside the EHR you already use.
The difference
6 min

A full initial evaluation, versus about 20 on a legacy system.

At our own clinic, Cowboy Healthcare
Nine documentation suites

Depth, by region.

Lower extremityUpper extremitySpine NeuroCardiacPelvic VestibularBariatricWound
Pre-visit AI calls

It calls ahead.

Hi Marcus, confirming your PT eval Thursday at 2. Any change to your insurance?
Nope, same Aetna plan.
Verified, you are all set. See you then.

Everything in one system.

Clinical, front office, and billing, sharing one patient record.

Clinical
  • AI notes and intakeEvals, daily notes, re-evals, and discharges drafted from the visit.
  • Assessment and goalsGrounded in findings, special tests, and outcome scores like LEFS.
  • Nine documentation suitesLower and upper extremity, spine, neuro, cardiac, pelvic, vestibular, bariatric, wound.
  • Home exercise programs and flowsheetsBuilt from the plan of care and tracked visit to visit.
Front office
  • AI receptionist and pre-visit callsAnswers, books, confirms visits, and checks insurance before the patient arrives.
  • Intake and faxesReferral faxes parsed straight into the patient record.
  • Scheduling and waitlistRecurring visits, double-booking checks, and a shared waitlist that books in one click.
  • PT plus wellness, and telehealthRun PT, Yoga, and studio services, plus video visits, from one schedule and record.
Revenue
  • Coding supportCPT and ICD codes suggested from the note and checked before the claim.
  • Prior auth and appeal lettersDrafted from the chart, so they are ready when payers ask.
  • Eligibility and claimsEligibility checks, claim scrubbing, and submission through Availity.
  • Full billing at 4%Optional add-on on top of your plan: we run your entire revenue cycle, ERA posting and denials included.
04 Services

What each part
does for you.

Every service, what it takes off your plate, and how it stacks up. Competitor details come from their own public websites, checked September 2026, with the source linked.

AI documentation

Finish the note before the next patient.

The AI drafts the note from the visit and the chart. Your therapist reviews and signs, so charting stops following them home.

  • Sign the initial eval and the home exercise program, flow sheet and claim are already built from it
  • Evals, daily notes, re-evals and discharges with carry-forward
  • AI assessment and goals grounded in chart findings
  • AI check for goals met on re-evaluations, marked for review
  • Text snippets that expand anywhere in a note
CheaperAI notes come in the base plan: 100 a month on Starter, unlimited on Growth. SimplePractice sells its AI Care Aide as a $59/month add-on, and Jane charges $15/month per practitioner for unlimited AI Scribe. SimplePractice Jane
Clinical and plan of care

Never miss a recert or a progress report.

The chart tells you what is due, so nothing slips and no visit goes unbillable.

  • Nine region suites and 42 ready-made templates
  • Alerts for recertification, physician certification, progress reports every 10 visits and the Medicare therapy threshold
  • Outcome measures scored against MCID, printed as scorecards
  • PTA co-sign, and home exercise programs and flow sheets that fill in from signed notes
Better valueTemplate depth on par with enterprise PT systems (TheraOffice lists 40+ templates), with a flat price published on this page. WebPT, Raintree, Prompt, Net Health and TheraOffice list no prices on the pages we checked. TheraOffice WebPT
Scheduling and reminders

Fewer no-shows. Fewer phone calls.

Patients confirm by text, and the schedule shows who is coming without anyone picking up the phone.

  • Reminder texts 24 hours ahead; a YES or NO reply shows as Confirmed or Wants to reschedule
  • Recurring series booked in one step, with provider hours and double-booking checks
  • Shared waitlist that books into an opening in one click
  • Online booking straight into your schedule
More includedText reminders are on the Starter plan. Jane's entry Balance plan sends email reminders only; unlimited SMS reminders start on its Practice plan. Jane
Billing and claims software

Clean claims without a billing department.

Claims are filled in from the chart and checked before they go, so fewer come back.

  • Real-time eligibility and authorization checks through Availity
  • Diagnosis, GP modifier and units checked against documented minutes
  • Batch submit, ERA posting, and denials sent to the Inbox with the fix
  • The right Medicare contractor and payer IDs for your state
More includedClaims tools are part of every plan. Jane's insurance billing is a $20/month add-on, plus $5 for each added full-time practitioner. Jane
Full-service billing

Hand us the whole revenue cycle.

We work the claims inside the EHR your team already uses. You treat patients; we chase the money.

  • Eligibility, coding review and claim scrubbing
  • Submission, ERA posting, denials and appeals
  • One monthly statement showing exactly what was collected
Cheaper4% of collections, on top of your monthly plan. SPRY publishes 4 to 6% for its billing service, and a WebPT article puts typical RCM services at 6 to 12% of collections. SPRY WebPT
AI front office

The phone gets answered while you treat.

Routine calls and insurance details are handled before the patient reaches the front desk.

  • AI receptionist answers FAQs, books visits and takes messages
  • AI pre-visit calls confirm the visit and check insurance
  • Scan an insurance card and the payer, member ID and plan fill in
Pay for what you usePre-visit calls come in packs from $49 for 50 calls, not another front-desk salary.
Intake, fax and referrals

Referrals into charts, not piles.

Faxes and referrals land in one inbox and get filed to the right patient in a few clicks.

  • eFax inbox with a full-screen viewer and filing to the chart
  • Referral hub and digital intake forms
  • Batch fax to referring providers, with opt-outs handled
One inboxFaxes arrive and get filed inside the chart, with no separate fax portal to check.
Provider mobile app

The clinic in your pocket.

Check the day, sign a note, or text a patient from your phone, without opening a laptop.

  • Today's schedule, charts, and notes written and signed with the web forms
  • Book visits, add patients, and text patients from the clinic number
  • Unsigned notes, plan-of-care and authorization alerts in one list
  • Face ID lock and access logging
More includedThe provider app comes with Cowboy. SPRY puts its companion mobile app in its higher SPRY Plus tier. SPRY
Patient app and portal

Patients handle the small stuff themselves.

Fewer calls to reschedule, fewer paper handouts, and balances paid from home.

  • Book, message the clinic and pay a balance
  • Home exercises with demo videos and check-offs
  • Progress screen with the patient's real scores and visits
Your brandYour clinic's own app on the App Store and Google Play for $99/month.
Telehealth

Video visits without another subscription.

Book, see and document a video visit from the same schedule and chart.

  • Built-in video visits with private, random room links
  • 50 sessions a month on Starter
One loginNo separate video tool to buy, sign a BAA for, or train staff on.
Payments

Get paid at the desk and from home.

Card and cash payments are tied to the chart with a receipt, so the day closes out cleanly.

  • Card payments go straight to your own bank through Stripe
  • Cash with change due, and patient portal payments
No markupCowboy takes no platform fee on card payments.
Security and compliance

Ready when the auditor calls.

The records an auditor asks for are already kept, and you can check them yourself.

  • Signed BAA, two-step sign-in and sign-in lockout
  • Tamper-evident audit log with a one-click integrity check
  • Your clinic's own trail of who opened, printed, faxed or exported records
See it yourselfOne button confirms the audit log has not been edited.
Growth and marketing

Turn discharges into reviews and referrals.

The follow-ups that bring patients back happen without a marketing hire.

  • Google review request texted and emailed at discharge
  • Birthday and 6- and 12-month follow-up reminders on the chart
  • Marketing studio, plus a custom website with booking built in
No monthly website billA custom website with online booking for $599, one time.

Watch it work.

Short clips of the real product on a test patient.

Coming soon
Initial evaluation, exam to signed noteAbout 90 seconds
Coming soon
From signed note to submitted claimAbout 60 seconds
Coming soon
Sign a note on your phoneAbout 60 seconds
Coming soon
Reminder texts and confirmationsAbout 45 seconds
We time it in our own clinic. Documentation time from start to signed note.
~6 minInitial evaluationTimed, our clinic
~5 minRe-evaluationTimed, our clinic
~3.5 minProgress noteTimed, our clinic
What that adds up to. Per full-time provider.
~7 hrsBack every weekAbout 340 hours a year
~8More visits a week, if you fill the timeAbout 380 a year
~$840More revenue a weekAbout $40,000 a year

How we got there: a full-time therapist seeing 12 patients a day, 5 days a week, 48 weeks a year, where 10% of visits are initial evaluations and 5% are re-evaluations. Cowboy times are what we timed in our clinic (6:00, 5:00 and 3:38). The before times are 17 minutes for an initial evaluation, the pre-AI time Raintree reports for a client (source), and our estimates of 15 minutes for a re-evaluation and 10 minutes for a progress note. That saves about 421 minutes a week. Each extra visit is counted as a 45-minute session plus its note, rounded down to whole visits, at $105.33 net revenue per visit, the rate U.S. Physical Therapy reported for the second quarter of 2025 (source). A 5-provider clinic gets about 35 hours back and room for about 40 more visits a week. Your numbers will differ with your caseload and payer mix. Building the home exercise program and flow sheet by hand is not counted.

05 Billing, done for you

Get your billing
off your desk.

Most clinics pay a legacy vendor for the EHR, then pay a billing company on top. We do both, for less.

The legacy way
$3,000+/mo

A legacy EHR subscription plus a separate billing service taking 5 to 6% of collections.

The Cowboy way
4% of collections

On top of your monthly plan. Full revenue cycle run for you, inside the EHR you already use. One team, one platform.

We run eligibility, coding review, claim scrubbing, submission through Availity, ERA posting, and denial appeals, on the same platform your clinicians already document in.

See what we would charge you
Live revenue cycle

Claims that clear themselves.

Aetna · Eval 97161Paid · 2d
UHC · 97110 x3Paid · 3d
BCBS · 97140Scrubbed
Medicare · 97530Paid · 2d
Cigna · Re-eval 97164Eligibility ✓
06 Them vs. Cowboy

Howdy. Here's how
the other guys stack up.

Every "other guys" fact below comes straight from that company's own website, linked on the card. We didn't make anything up. We didn't have to.

 The other guysCowboy
What does it cost? The other guysWebPT, Raintree, Prompt, Net Health and TheraOffice show no prices on the pages linked below. You book a demo to find out what you will pay.Source: WebPT Raintree Prompt Net Health TheraOffice Cowboy$249 a month for 2 providers. $499 for 5. No sales call just to see a number. No "let me check with my manager."
The AI upcharge The other guysSimplePractice charges $59 a month for its AI Care Aide, plus $49 for each added clinician. Jane charges $15 a month per practitioner for unlimited AI Scribe. SPRY keeps its AI Scribe in the higher Plus tier.Source: SimplePractice Jane SPRY CowboyIn the plan. 100 AI notes a month on Starter, unlimited on Growth. We don't charge extra for the robot to do your homework.
The initial eval The other guysTheraOffice says its initial evals are done in under 7 minutes.Source: TheraOffice CowboyAbout 6 minutes, timed in our clinic. Sign it and the HEP, flow sheet and claim show up on their own. Like magic, but with a BAA.
Someone else does the billing The other guysSPRY charges 4 to 6% of collections. WebPT does not publish its rate. A WebPT article puts typical billing services at 6 to 12%.Source: SPRY WebPT article Cowboy4% of collections, on top of your plan. Keep the other 96. You treated the patients.
Getting paid by insurance The other guysJane's insurance billing is a $20 a month add-on, plus $5 for each added full-time practitioner, and not available on its Balance plan.Source: Jane CowboyOn every plan, with eligibility checks and batch submission through Availity. Getting paid shouldn't be an add-on.
Reminder texts The other guysJane's Balance plan sends email reminders only. SimplePractice lists appointment reminders starting on its $79 Essential plan, not its $49 Starter.Source: Jane SimplePractice CowboyTexts on Starter. Patients reply YES, the schedule says Confirmed, and your front desk drinks their coffee while it's still hot.
The phone in your pocket The other guysSPRY's therapist app is only in its higher Plus tier.Source: SPRY CowboyIncluded. Write and sign notes, book visits, text patients and block your day off. Sign that last note from the couch. We won't tell.
Your evenings The other guysWebPT says "Document 3x faster." Prompt says "75% less documentation time."Source: WebPT Prompt CowboyAbout 7 hours back a week per full-time therapist. That's basically a whole workday, or room for about 8 more visits. See the math.

The receipts.

Swipe the table to see every system.

 Cowboy SystemsWebPTPrompt HealthRaintreeNet HealthSPRYJaneSimplePracticeTheraOffice
Published pricingYes. Starter $249/mo for up to 2 providers; Growth $499/mo for up to 5No. Set up per provider per month or per visitNoNoNoNo. Based on visits per full-time providerYes. $54, $79 or $99/mo, plus fees per added practitionerYes. Solo $49, $79 or $99/mo; group Plus $99/mo plus $74 per added practitionerNo
Documentation time (each company's claim)Timed at our clinic: initial evaluation about 6 min, re-evaluation about 5, progress note about 3.5. Signing also builds the HEP, flow sheet and claim"Document 3x faster""75% less documentation time"Evaluation note time cut "from 17 min to 90 sec"Cuts documentation time "by 20-30 minutes"AI Scribe drafts SOAP notes "within a few minutes"Not statedAI Note Taker drafts progress notes "in moments"Initial evals "done in under 7" minutes; daily notes 1 to 2 minutes
AI documentationIncluded. 100 AI notes/mo on Starter, unlimited on GrowthAI note generation and coding guidanceAI scribe with ambient listening and real-time CPT codingNoteIQ AI documentationNative ambient AI documentation in ReDocAI Scribe in the SPRY Plus tierUnlimited AI Scribe add-on, $15/mo per practitionerCare Aide add-on, $59/mo plus $49 per added clinicianAI speech-to-text documentation
Insurance billing softwareIncluded on every plan, with Availity eligibility and claim checksBilling software in the Enhanced and Ultimate plansBuilt-in billing with clearinghouse integrationTherapy-specific billing and RCMBilling safeguards in ReDocClaim scrubbing, clearinghouse and ERA auto-posting in EssentialsAdd-on on Practice and Thrive: $20/mo plus $5 per added full-time practitionerInsurance Essentials in every planIntegrated ERA and denial organizer
Billing done for youOptional add-on, 4% of collections on top of your planRCM service offered; rate not publishedNot statedManaged RCM services; rate not publishedNot stated4 to 6% of collectionsNot statedNot statedNot stated
RemindersText reminders with YES or NO confirmation on the scheduleAutomated appointment remindersAutomated reminders to bookNot statedNot statedAppointment reminders; two-way messaging is an add-onEmail on Balance; unlimited SMS from PracticeAppointment reminders from the $79 Essential planNot stated
Mobile appsProvider app included; branded patient app $99/moNot statedCustom patient app (Engage) and kiosk check-inNot statedNot statedTherapist companion app in SPRY PlusNot statedEHR mobile app and client portal app in every planTouchless mobile check-in
Worth knowingBuilt and used in our own PT clinicSupports over 20,000 clinicsResults based on over 1,000 practices3,500+ locationsBuilt for hospital outpatient rehabG2 rating 4.8 out of 5Multi-discipline clinic softwarePrivate practice EHRONC-certified; 175+ built-in reports
SourceThis pagePricingRCM serviceHomepageHomepageReDoc pagePricingPricing (US)PricingProduct page

Checked and double-checked September 17, 2026 on each company's public website. Documentation times are each company's own claim, not our measurement. "Not stated" means the page we checked does not say; it does not mean the product lacks it. Products and prices change; if something here is out of date, tell us and we will fix it. Company names are trademarks of their owners and are used here only to identify their products.

07 We care about the family

The small things that get your evenings back.

We run our own clinic, so we built the little details that save a text, a phone call, or a trip back to the office. Your team, and the families waiting at home, notice.

Your schedule in your Google CalendarEach provider sends their visits to their own Google Calendar with one click, without patient names, next to school pickups and family plans.
Time off, blocked in secondsBlock a provider's time off from the web or the phone, or close the whole clinic for a holiday in one step. No one gets booked on a day off.
Patients confirm by textReminders go out 24 hours ahead. A YES or NO reply shows on the schedule, so no one spends the morning calling to confirm.
Text patients from the clinic numberStaff text a patient from the chart or the app. It comes from the clinic's number, never a therapist's personal phone.
Sign the last note from the couchThe provider app opens the same note forms as the web. Sign on your phone and the claim and appointment update on their own.
Reach a colleague fastCall, text or email anyone on staff from the app's staff list, without hunting for a number.
Book the whole plan of care at oncePick the days and the number of weeks, and every visit is booked with conflicts checked.
Remembering the peopleBirthday and 6- and 12-month follow-ups show on each chart, and discharged patients are asked for a Google review automatically.
08 Pricing

Flat plans. No
per-seat games.

Start with a 3-month minimum, billed monthly, or save 15% on a 12-month term. Every paid plan includes a signed BAA and onboarding.

Software
Your plan, flat monthly

The full EHR, including billing and claims tools. Your own team submits and works the claims.

Software + full billing
Your plan + 4% of collections

We run all of your billing: eligibility, coding review, claim scrubbing, submission, ERA posting, and denials and appeals. 6-month minimum.

Starter
$249 / mo
or $211/mo on a 12-month term
One flat price for up to 2 providers. Everything to run a modern practice.
Get started
  • AI SOAP notes (100/mo)
  • Scheduling and patient records
  • Waitlist, reminders, eligibility
  • Referral intake and analytics
  • Telehealth (50 sessions/mo)
  • Basic billing and claims
  • Signed BAA included
Most popular
Growth
$499 / mo
or $424/mo on a 12-month term
One flat price for up to 5 providers, with higher AI limits.
Get started
  • Everything in Starter
  • Up to 5 providers
  • Unlimited AI SOAP notes
Enterprise
Custom
Multi-location practices and health systems.
Contact sales
  • Everything in Growth
  • Marketing and website builder
  • Custom integrations and API
  • Dedicated account manager
  • Staff training and onboarding

Start with a plan, then add what you need: full-service billing at 4% of collections on top of your plan, a custom website, a branded patient app, and more. Prices in USD, excluding applicable taxes.

09 Trust and compliance

Compliant by default.
Clinician in control.

Built for HIPAA from the first line of code. Read our HIPAA statement.

HIPAA and signed BAAA signed BAA comes with every paid plan.
256-bit encryptionPatient data encrypted at rest and in transit.
Audit logsEvery access recorded, with role-based permissions.
Daily encrypted backupsAutomated, every day.
Therapist signs offThe AI drafts. Nothing is final until your therapist reviews and signs.
10 See it live

Twenty minutes.
Then you will get it.

Book a 20-minute live demo on a real note type. Watch an initial evaluation go from exam to a signed, coded note, ready to bill.

Pick a time below View pricing

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