SimplePractice vs TherapyNotes vs Practice Better: choosing the EHR for your first private practice
Your EHR holds your notes, calendar, billing and client portal, so switching later costs weeks. This guide narrows three common options to one in an evening, using only what each vendor publishes.
The short answer
Practice Better's free Sprout plan covers up to 3 clients, so you can start at $0 and move up when your caseload grows.
Practice Better Starter is $35/month and SimplePractice Starter is $49/month. Both are base tiers, so compare their feature lists before choosing on price.
TherapyNotes is $69/month for a solo user, with basic telehealth included. Electronic claims cost 25¢ each from December 2026.
Price the second clinician, not only the first: $74 more at SimplePractice Plus, $60 more at TherapyNotes (from December 2026); Practice Better's Team plan includes 2 practitioners.
Side by side
| Monthly billing | SimplePractice | TherapyNotes | Practice Better |
|---|---|---|---|
| Solo price | $49 / $79 / $99 (Starter, Essential, Plus) | $69 | $35 / $69 / $99 (Starter, Professional, Plus) |
| Free option | No free plan | No free plan | Sprout: free, up to 3 clients |
| Free trial | Up to 30 days | 30 days | 14 days (30 on Team) |
| Adding clinicians | Plus: $99 first, $74 each extra | Group: $89 first, $60 each extra (from 1 Dec 2026) | Team: $155 incl. 2 practitioners, $50 each extra |
| Telehealth | Group telehealth listed on Plus; check the plan page for one-to-one video | Basic free; Premium $15 per clinician | Not compared here |
| Paid extras | Note Taker $35; ePrescribe $49 + $89 setup | E-claims 25¢; ERA 9¢ per claim | Not compared here |
Prices and features as listed on each vendor's pricing page; nothing here goes beyond what they publish. Practice Better lists lower prices for annual billing. SimplePractice was also running a launch discount on 30 October 2026; promotions change, so it isn't used in the comparison. TherapyNotes' help centre still shows $59 for solo; its December 2026 pricing post says $69, so I use the newer figure.
What a real month costs
Subscription plus the per-use fees listed above, before payment processing and add-ons.
Solo, insurance-based, 60 claims a month
- TherapyNotes: $69 + 60 claims × 25¢ + 60 ERAs × 9¢
- $89.40
SimplePractice and Practice Better publish their insurance and claims pricing separately; check it against your claim volume before comparing.
Group of 3 clinicians
- SimplePractice Plus: $99 + 2 × $74
- $247
- TherapyNotes Group (from 1 Dec 2026): $89 + 2 × $60
- $209
- Practice Better Team: $155 (2 included) + 1 × $50
- $205
Five questions that decide it
- Insurance or private pay? If you'll file many claims, per-claim fees add up; price a typical month as above.
- How many clients in month one? Under 3, a free tier is enough while you set up.
- Solo for good, or hiring within a year? Compare what the second clinician costs, not only the first.
- Video sessions? Check whether the telehealth you need is included or an add-on.
- Do you need prescribing or an AI note tool? Both are paid add-ons at SimplePractice.
Then start a trial of your top pick and enter three fake clients. If the note template and calendar feel right by day three, keep it.
Check current pricing
What this guide can't tell you
I haven't run a US practice on these systems, so nothing here describes personal use. Before signing, confirm the vendor will sign a HIPAA Business Associate Agreement, and check your state board's record-keeping rules. This is software guidance, not clinical or legal advice.