SimplePractice vs TherapyNotes: An Honest Comparison for 2026

Short answer: SimplePractice is the better product for solo therapists and very small practices: more polished, better mobile app, broader practitioner support. TherapyNotes is the better product for insurance-heavy practices that want ONC certification, structured documentation, and support that its long-tenured users defend without being asked. Both start to strain for the same reason around the same point: they're priced per user and built around one clinician's caseload.

We build a competing product, so read this with that in mind. What we've done here is report what practices actually told us, many of them current customers of one or the other, rather than argue for ourselves. Our own take is at the end, clearly labeled, and you can skip it.

Head to head

On pricing. SimplePractice publishes Starter at $49, Essential at $79 and Plus at $99 a month. Group practices need Plus, with additional clinicians tiered at $74 each for two to five, $72 for six to fifteen, and $69 for sixteen or more. TherapyNotes is $69 a month solo, or $79 for the first clinician plus $50 for each additional one in a group. Claims, ERAs and text reminders are 14 cents each. Verified 30 July 2026; confirm before you sign anything.

What practices say about SimplePractice

The good. Polished, mature, genuinely pleasant to use. The mobile app is the best in the category. Broad support for practitioner types beyond mental health, and an ecosystem of templates and community knowledge a newer platform can't match. For a solo therapist, it's an easy recommendation.

The friction, at scale. The most consistent sentence we hear:

"It works quite well for a solo provider, but then really when you start growing, that's when it falls apart."

Specifics practices raised:

• Supervision doesn't distinguish credential status. Sign-off is required for all

supervisees, including provisionally licensed clinicians who are independently credentialed with payers and don't legally need a co-signature. One practice asked directly: "if it's a supervisee, you have to sign off on everything. Is there a way to differentiate that?"

• Interns cost what clinicians cost. *"It's the same cost for a clinician versus an

intern. That also kind of sucks."*

• Couples and family records don't link. One client completed intake individually,

then needed a couples appointment: "we couldn't link them. And so they had to redo all the paperwork."

• Verification of benefits described as "barely functional," with staff checking payer

portals by hand.

• No API, so no connecting analytics or ad attribution.
• Change cadence is itself a complaint: *"every day it's a different change. So my

life is hell."*

One practice hit a rendering-provider bug that caused every Medicaid claim to be rejected by their payer: "every Medicaid claim now requires manual editing. Not sustainable."

What practices say about TherapyNotes

The good, and it's genuinely good. We hear more unprompted praise for TherapyNotes than for any other incumbent. A practice the better part of a decade in with a couple of dozen providers:

"In many ways it has been an exceptional product. They have exceptional customer service. I gauge them as a high integrity organization."

Another established practice: "The utility has been invaluable. I would not have been able to grow and scale without it." And on the record itself: "TherapyNotes probably has a really nice clinical record."

The friction.

• It feels dated. *"It's fine. It does what it needs, but it does feel a little clunky

and a little bit (whatever the opposite of intuitive is) at times."*

• Per-transaction fees add up. One group practice read their invoice aloud, a four-figure monthly total assembled from claims, ERAs, eligibility checks, telehealth minutes, and

text reminders billed at 14 cents each.

• No enterprise tier. *"There's a point where it's going to get too expensive, because

it's a cost per user, and they don't offer an enterprise package."*

• Limited integrations. A practice running a separate assessments tool: *"It doesn't

integrate, and so they have to pull the assessment reports and feed that back into the EHR. And I can guarantee you some of them aren't even doing that."*

• Audit trail gap. Practices report that revised signed notes don't produce a full

change history: a real exposure during payer audits. (Oasys records the amendment in full, who unlocked the note, why, and the content before and after. Other platforms vary.)

• Eligibility checks aren't trusted; at least one billing specialist bypasses them for

insurer portals.

• Getting data out is hard. *"TherapyNotes doesn't have a straight migration out of

the record."*

Pricing: compare invoices, not pricing pages

Both platforms price per user, and both have costs that don't appear on the pricing page. Real monthly totals practices reported to us:

• A mid-sized group practice on TherapyNotes: four figures a month
• SimplePractice card processing flagged at roughly 3.25%, on top of platform fees

The honest answer to "which is cheaper" is that base rates are close enough that your transaction volume decides it. A practice submitting 200+ claims a month with heavy text reminders will feel TherapyNotes' per-transaction model. A practice on SimplePractice needing group features will feel the plan-tier requirement and the per-clinician add-on.

Neither platform's headline price is what a group practice pays.

The thing both share

They're both built around one clinician and one client, with group functionality added on top. That's not a criticism of either team, it's a product-history fact, and it shows up in the same places:

• supervision that treats every supervisee identically
• per-seat pricing that charges full rate for unlicensed trainees
• payroll that isn't modeled at all, so practices rebuild it in spreadsheets
• billing that becomes manual as claim volume grows

The largest number we've encountered in this category isn't on any invoice. It's this, from a practice with a couple of dozen clinicians:

"About 20 hours a week of our billing manager goes into converting the information in [our EHR] into a payroll ledger."

Half a full-time role, permanently, because the software has no model for a contractor revenue split, or a salaried arrangement with an hourly minimum plus commission.

Which should you choose?

Choose SimplePractice if you're solo or under about five clinicians, you want the best mobile experience, you work across practitioner types beyond mental health, or you value a large ecosystem.

Choose TherapyNotes if ONC certification matters, you're insurance-heavy, you prefer structured template-driven documentation, or support responsiveness is your top criterion.

Consider neither if you're past roughly 20 clinicians, you supervise a mix of interns and provisionally licensed clinicians, or you're rebuilding payroll in a spreadsheet every month. At that point you're not choosing between these two, you're choosing whether to keep absorbing the operational cost.

Our position, clearly labeled

We make Oasys, an EHR for mental health group practices. We built it because of the pattern above: supervision configured per role, role-based permissions, native payroll modeling, and billing designed for volume, at $80 per clinician per month on an annual contract with no add-ons.

Migration is the question we are asked about most. Rather than make promises in a blog post, ask us directly what moving your particular system would involve, what comes across, and what happens to appointments already booked.

If you're solo, we'd genuinely point you at SimplePractice.