EHR Pricing Is Confusing on Purpose
Every EHR markets a low starting price. Few of them tell you what you'll actually pay.
Base price. Per-clinician fees. Telehealth add-ons. AI notes add-ons. Per-claim charges. Payment processing markups. Wiley Treatment Planner licenses. It adds up fast, and the math is deliberately hard to do before you're locked into a contract.
This guide does the math for you. We pulled real pricing data for 8 EHR platforms popular with therapists in 2026 and calculated the true annual cost for a solo private-pay practice. No affiliate links, no sponsored rankings — just numbers.
The Full Cost Breakdown: 8 EHRs Compared
Here's what each platform charges across the categories that actually matter to your bank account.
| EHR | Base Price | Add-On Costs | Payment Processing | Total Cost (Solo, Private-Pay) |
|---|---|---|---|---|
| CoralEHR | Free pilot (projected $79/mo) | None — telehealth, AI notes, scheduling included | Stripe: 2.9% + $0.30 | $0/mo during pilot (projected ~$79/mo) |
| SimplePractice | $29–$99/mo | AI Scribe add-on; Wiley $15/mo; telehealth only on Essential+ ($69+) | Stripe: 2.9% + $0.30; claims $0.25 each | $69–$139/mo (most need Essential+) |
| TherapyNotes | $49/mo solo | Wiley $15/mo; no AI notes available | Built-in processing; claims $0.14 each | $49–$64/mo + processing fees |
| Jane App | $54/mo (CAD) | Jane AI charting (beta); no Wiley; telehealth included | Stripe: 2.9% + $0.30; claims $0.25 each | $54/mo CAD (~$40 USD) + processing |
| Upheal | $19–$69/mo | AI notes included in all plans; no Wiley; telehealth included | Stripe: 2.9% + $0.30 | $19–$69/mo (AI-first, no insurance billing) |
| CounSol.com | $49.95/mo | Telehealth on Premium+ ($64.95+); Wiley $20/mo; no AI notes | Third-party processor | $64.95–$84.95/mo for telehealth + Wiley |
| TheraPlatform | $39/mo | AI notes included; Wiley $15/mo; telehealth included; claims $0.25 each | Stripe: 2.9% + $0.30 | $39–$54/mo + processing fees |
| TherapyAppointment | $10–$59/mo | Telehealth $15/mo add-on; no AI notes; no Wiley | 2.9% + $0.30; claims $0.15 each | $25–$74/mo (telehealth adds up) |
A note on base prices: The lowest advertised price is rarely the price you'll pay. SimplePractice's $29/mo Starter plan, for example, doesn't include telehealth — the feature most therapists consider non-negotiable in 2026. TherapyAppointment's $10/mo tier covers only 10 sessions per month. Always check what's included at the tier you'll actually use.
Hidden Costs Most Therapists Miss
The comparison table above covers the obvious costs. Here are the ones that show up on your credit card statement three months in.
Telehealth Add-Ons: $10–15/mo
In 2026, telehealth isn't optional — it's baseline. Yet several EHRs still charge extra for it:
- TherapyAppointment: $15/mo add-on
- CounSol.com: Only on Premium plans ($64.95+)
- ICANotes: $10/mo add-on
- TheraNest: $12/mo add-on
- TherapyZen: $9.99/mo add-on
CoralEHR, Upheal, Jane App, and TheraPlatform include telehealth on all plans. TherapyNotes includes it too.
AI Notes Add-Ons: $15–40/mo
AI-powered clinical notes save 15–30 minutes per session. But not every EHR includes them, and the ones that offer them as add-ons charge accordingly:
- SimplePractice: AI Scribe is a separate add-on (pricing varies)
- TherapyNotes: No AI notes available
- CounSol.com: No AI notes available
- TherapyAppointment: No AI notes available
CoralEHR and Upheal include AI notes as a core feature at no extra charge. TheraPlatform includes AI dictation and telehealth AI on all plans.
Per-Claim Fees: $0.14–0.25 Each
If you bill insurance even occasionally, per-claim fees stack up:
- TherapyNotes: $0.14/claim (lowest)
- TherapyAppointment: $0.15/claim
- SimplePractice: $0.25/claim
- Jane App: $0.25/claim
- TheraPlatform: $0.25/claim
- TherapyZen: $0.25/claim
For a therapist submitting 80 claims/month, that's $11.20–$20.00/month — or $134–$240/year — just in claim fees. Private-pay therapists avoid this entirely.
Payment Processing Fees: 2.9–3.15% + $0.25–0.55
Every EHR that processes payments takes a cut. Most use Stripe at standard rates, but transaction fees vary:
- Standard Stripe: 2.9% + $0.30 per transaction (CoralEHR, SimplePractice, Jane App, TheraPlatform)
- TherapyZen: 2.9% + $0.55 per transaction (higher per-transaction fee)
- TherapyAppointment: 2.9% + $0.30
On a $150 session, that's $4.65–$4.90 per payment. Over 80 sessions/month, you're paying $372–$392/month in processing fees alone. This cost exists regardless of which EHR you choose, but the per-transaction markup matters.
Wiley Treatment Planners: $15–25/mo
If your practice uses Wiley Treatment Planners for evidence-based treatment planning:
- SimplePractice: $15/mo
- TherapyNotes: $15/mo
- TheraPlatform: $15/mo
- CounSol.com: $20/mo
- TheraNest: $25/mo
CoralEHR, Upheal, Jane App, and TherapyAppointment don't offer Wiley integration. If you need it, factor this into your comparison.
The Real Math: Annual Cost for a Solo Private-Pay Therapist
Let's get specific. Here's the scenario:
- Solo therapist, private-pay only
- 20 clients per week, 48 weeks per year (960 sessions/year)
- Needs telehealth + clinical notes
- $150 average session rate
- No insurance billing
Annual EHR Software Cost (Before Payment Processing)
| EHR | Monthly Cost | Annual Cost | What's Included |
|---|---|---|---|
| CoralEHR (pilot) | $0 | $0 | Telehealth, AI notes, scheduling, portal |
| CoralEHR (projected) | $79 | $948 | Telehealth, AI notes, scheduling, portal |
| Upheal (Starter) | $19 | $228 | Telehealth, AI notes, scheduling |
| Upheal (Professional) | $69 | $828 | Everything + unlimited sessions |
| TheraPlatform | $39 | $468 | Telehealth, AI notes, scheduling |
| TherapyAppointment | $59 + $15 | $888 | $59 unlimited tier + telehealth add-on; no AI notes |
| TherapyNotes | $49 | $588 | Telehealth included; no AI notes |
| Jane App | ~$40 USD | ~$480 | Telehealth, AI charting (beta); CAD pricing |
| CounSol.com | $64.95 | $779 | Premium plan for telehealth; no AI notes |
| SimplePractice (Essential) | $69 | $828 | Telehealth included; AI Scribe extra |
| SimplePractice (Plus) | $99 | $1,188 | Everything + waitlist, add-on codes |
Add Payment Processing (Stripe Standard)
At $150/session and 960 sessions/year:
- Per-transaction fee: 2.9% + $0.30 = $4.65 per session
- Annual processing cost: $4,464
This cost is roughly the same across all EHRs using Stripe. TherapyZen's higher per-transaction fee ($0.55 vs. $0.30) adds an extra $240/year.
True Annual Cost (Software + Processing)
| EHR | Software | Processing | Total Annual |
|---|---|---|---|
| CoralEHR (pilot) | $0 | $4,464 | $4,464 |
| Upheal (Starter) | $228 | $4,464 | $4,692 |
| TheraPlatform | $468 | $4,464 | $4,932 |
| Jane App | ~$480 | $4,464 | ~$4,944 |
| TherapyNotes | $588 | $4,464 | $5,052 |
| CounSol.com | $779 | $4,464 | $5,243 |
| SimplePractice (Essential) | $828 | $4,464 | $5,292 |
| Upheal (Professional) | $828 | $4,464 | $5,292 |
| CoralEHR (projected) | $948 | $4,464 | $5,412 |
| TherapyAppointment | $888 | $4,464 | $5,352 |
| SimplePractice (Plus) | $1,188 | $4,464 | $5,652 |
The difference between the cheapest and most expensive option is over $1,100/year in software costs alone. That's real money — roughly 7–8 therapy sessions worth of income.
When Cheap Isn't Actually Cheaper
A $10/mo EHR sounds great until you realize you're spending 45 minutes per session on documentation because there's no AI notes feature. Or you're paying $15/mo for a telehealth add-on that should be included. Or you're manually sending invoices because the client portal is limited.
Here's what false economy looks like in practice:
Time cost of manual notes: If you spend an extra 15 minutes per session writing notes without AI assistance, that's 240 hours/year (960 sessions x 15 minutes). At your effective hourly rate, that's thousands in lost productivity. An EHR with AI notes at $39–79/mo pays for itself in the first week.
Client no-shows without automated reminders: Practices without robust scheduling and reminder systems see 10–20% higher no-show rates. On a 960-session practice, even a 5% improvement means 48 additional kept appointments — $7,200 in revenue at $150/session.
Switching costs: Migrating EHRs takes 20–40 hours of setup, data transfer, and retraining. Choosing the cheapest option now and upgrading later costs more than choosing the right tool from the start.
The real question isn't "which EHR has the lowest price?" It's "which EHR delivers the most value per dollar for how I actually practice?"
Our Take: Best Value for Private-Pay in 2026
After analyzing the real costs, here's how the landscape breaks down for solo private-pay therapists:
Best overall value: CoralEHR — The free pilot includes everything a private-pay therapist needs: telehealth, AI-powered notes, scheduling, client portal, and Stripe payments. No add-ons, no per-claim fees, no tier restrictions. The projected $79/mo post-pilot price is competitive given that comparable feature sets from other EHRs cost $69–139/mo after add-ons.
Best budget option: Upheal at $19/mo — AI notes and telehealth included from the jump. The $1-per-session pricing (capped at $69/mo) is clever for therapists still building their caseload. No insurance billing, which is fine if you're fully private-pay.
Best if you need insurance billing too: TheraPlatform at $39/mo — Telehealth and AI notes included, with insurance billing available on Pro+ plans. Per-claim fees apply ($0.25 each), but the base price is competitive.
Best for the feature-complete crowd: SimplePractice Essential at $69/mo — The industry standard for a reason. Comprehensive feature set, strong integrations, large community. Just budget for the add-ons you'll inevitably want.
Pricing data sourced from public EHR pricing pages and verified against our comparison matrix. Last updated April 2026. All prices in USD unless noted otherwise. Payment processing fees assume Stripe standard rates.
Compare and Calculate
- Best EHR for Private-Pay Therapists in 2026 — Full feature-by-feature comparison
- SimplePractice Alternatives — Side-by-side with CoralEHR
- Jane App Comparison — How Jane stacks up for therapy practices
- Upheal vs CoralEHR — AI-native EHR showdown
- Practice Savings Calculator — See your personalized annual cost breakdown
Frequently Asked Questions
CoralEHR Team
CoralEHR Team
