Best SimplePractice Alternatives for Private-Pay Therapists (2026)

Introduction: SimplePractice Isn't for Everyone

SimplePractice dominates the therapy EHR market with over 225,000 clinicians, but that doesn't make it the right choice for every practice. If you're a private-pay therapist searching for SimplePractice alternatives, you're not alone—and you likely have good reasons.

Common pain points driving the search include a March 2025 pricing restructure, payment processing fees of 3.15% + 30¢ per transaction, insurance-centric features that add complexity for cash-based practices, and AI documentation tools that fall short of newer purpose-built solutions.

The reality is that SimplePractice was designed to be everything for everyone. That's a strength for insurance-heavy practices juggling complex billing, but it means private-pay and cash-based therapists often pay for features they'll never use while missing specialized tools that could actually reduce their administrative burden.

This guide examines six SimplePractice alternatives through the lens of private-pay practice. We'll be honest about what each platform does well and where it falls short—because the best EHR for your practice depends entirely on how you practice.

Why Therapists Are Looking for SimplePractice Alternatives

Before diving into alternatives, it helps to understand what's driving the search. Based on user reviews and industry discussions, several themes emerge.

Price Increases Hit Private-Pay Harder

SimplePractice's three tiers—Starter ($49/mo), Essential ($79/mo), and Plus ($99/mo)—add up quickly when you factor in per-transaction processing fees of 3.15% + $0.30. A therapist seeing 25 private-pay clients weekly at $175/session loses roughly $150/month to processing fees alone—on top of the subscription cost.

For insurance-heavy practices, this fee structure is offset by the platform's robust billing tools. But private-pay therapists don't get that value exchange. And the Starter plan doesn't even include appointment reminders or client messaging—you need Essential ($79/mo) for those basics.

Features Built for Insurance Complexity

SimplePractice's strength in insurance billing becomes bloat for private-pay practices. Even the Starter plan charges $0.50 per electronic claim and $0.25 per manual insurance status check. Features like claims submission, ERA processing, and insurance verification take up interface real estate and add complexity without providing value. The Plus plan ($99/mo) dedicates significant functionality to group practice insurance workflows that solo private-pay therapists will never touch.

The trend toward private-pay practice is accelerating—one-third of psychologists don't accept insurance, according to the APA's 2024 data. Therapists making this transition often find that their EHR needs change significantly.

AI Note-Taking Falls Short

SimplePractice added AI Note Taker (powered by Anthropic's Claude), but user feedback suggests it's better suited for transcription than for the kind of intelligent clinical documentation that reduces administrative burden. Newer platforms have built AI into their core architecture rather than bolting it onto existing systems.

For therapists spending hours on documentation—and research shows clinicians spend roughly 50% of their workday on EHR work—the quality of AI assistance matters significantly.

Calendar and Technical Issues

User reviews frequently mention calendar sync problems. The Starter plan doesn't support calendar syncing at all, and even the Plus plan only syncs with Google Calendar—no Outlook, Apple Calendar, or iCal support. Double-bookings and missed sync updates create administrative headaches and client experience issues that compound over time. SimplePractice also faced a 2023 controversy over terms of service changes regarding data licensing provisions, which eroded trust among some users.

Quick Comparison Table

Platform	Best For	Monthly Pricing	Processing Fees	Key Strength	Key Limitation
CoralEHR	Private-pay solo/small practices	$79 flat	None	AI notes + private-pay focus	Not for insurance-heavy billing
TherapyNotes	Insurance + AI documentation	$69–79	3.1% + $0.30	TherapyFuel AI + robust billing	AI costs extra ($40/mo/clinician)
Jane App	Multidisciplinary practices	$54–99	2.85% + $0.25	Beautiful UI, 10K+ templates	Not therapy-specific
TheraPlatform	Telehealth-heavy practices	$39–79	2.9% + $0.30	40+ interactive therapy apps	No mobile app
CounSol.com	Client engagement focus	$49.95–69.95	Third-party	Client journal + dedicated account manager	Dated interface, weak telehealth
Carepatron	Budget-conscious new practices	Free–$29/user	Not published	Free tier with telehealth	Limited advanced features

6 Best SimplePractice Alternatives for Private-Pay Practices

1. CoralEHR — Best for Private-Pay Practices

Pricing: $79/month flat rate (no tiers, no per-transaction fees)

CoralEHR takes a different approach than most EHRs. Rather than building around insurance billing and adding clinical features as afterthoughts, it's designed specifically for the way private-pay therapists actually work—around clinical thinking, progress tracking, and treatment outcomes.

Key Differentiators:

• AI-Powered Clinical Notes: Unlike transcription-based AI tools, CoralEHR's AI understands clinical context. It generates progress notes that connect to assessments, treatment plans, and previous sessions—reducing documentation time while improving clinical utility.

• Outcome-Focused Design: The platform connects notes, standardized measures, and treatment plans into usable clinical insight. Instead of storing data in disconnected tabs, it helps you see patterns and track progress over time.

• Private-Pay Simplicity: No insurance billing modules cluttering the interface. Features are built for cash-based workflows: simple invoicing, superbill generation, and streamlined client management.

• Flat-Rate Pricing: One price, no tiers, no transaction fees. You know exactly what you're paying—unlike SimplePractice where the real monthly cost includes subscription + processing fees + add-ons.

Best For: Solo practitioners or small group practices focused entirely on private-pay who want powerful AI documentation without insurance billing complexity.

Limitations: If you bill insurance regularly, CoralEHR isn't designed for that workflow. Practices needing ERA processing, claims submission, or insurance verification should look elsewhere.

Try It: CoralEHR offers a free trial with full access to AI documentation features.

2. TherapyNotes — Best for Insurance Practices Wanting Better AI

Pricing: Solo $69/month, Group $79/month + $50/month per additional clinician

TherapyNotes was founded by Brad Pliner (tech) and Dr. Debra Pliner (clinical psychologist) and has been refined since 2010. Their addition of TherapyFuel AI makes them competitive for therapists who want both robust billing and modern documentation tools.

Key Features:

• TherapyFuel AI ($40/mo per clinician): Includes AI-generated SOAP fields, ambient listening via TherapyFuel Scribe, contact note generation from messages, and client history summaries. More sophisticated than SimplePractice's AI Note Taker, though the add-on cost adds up.

• Insurance Billing Strength: Electronic claims at $0.14/claim through CLAIM.MD (switched from Change Healthcare in April 2024), ERA/EOB processing, real-time eligibility checks, and support for 2,000+ payers. Dedicated billing roles (scheduler, biller, supervisor) are free.

• Comprehensive Telehealth: Free basic 1:1 sessions included. Premium telehealth ($15/mo/clinician) adds group sessions for up to 16 participants with HD video, closed captioning in English and Spanish, and custom backgrounds.

• ePrescribe Available: For psychiatrists and prescribers, electronic prescribing costs $65/month per prescriber—including controlled substances.

Best For: Therapists who bill insurance but want better AI documentation than SimplePractice provides. Also strong for practices that need ePrescribing.

Limitations: TherapyFuel AI costs $40/month per clinician on top of the base subscription, making the all-in cost $109/month for a solo practitioner with AI—higher than SimplePractice. SMS reminders cost $0.14 per message (not unlimited). The interface reflects its insurance-billing origins; pure private-pay practices may find themselves navigating around features they don't need.

3. Jane App — Best for Multidisciplinary Practices

Pricing: Balance $54/month (20 appts), Practice $79/month, Thrive $99/month

Jane App was co-founded by chiropractor Alison Taylor and developer Trevor Johnston in Vancouver, BC. Originally built for a multidisciplinary clinic, it serves physical therapists, dietitians, chiropractors, and mental health professionals. That breadth is both its strength and weakness.

Key Features:

• Beautiful Interface with 10,000+ Templates: Jane's community-shared template library is the largest among competitors. The charting system includes body charting for physical assessments, smart click-to-chart options, and ICD-10 integration.

• Competitive Payment Processing: Jane Payments charges 2.85% + $0.25 online and 2.6% + $0.10 for in-person terminal transactions—cheaper than SimplePractice's 3.15% + $0.30. In-person payment terminals are available for purchase directly in-app.

• Multi-Specialty Support: If your practice includes multiple provider types (therapy, nutrition counseling, bodywork), Jane handles them all in one system with unlimited admin profiles and multi-location support on all plans.

• AI Scribe ($15/mo per practitioner): Converts voice recordings to SOAP notes. Five free notes to try before committing. More affordable than TherapyNotes' TherapyFuel ($40/mo) but less feature-rich.

• Thrive Plan Extras: Waitlist automation, room/equipment management, packages and memberships, and Google Analytics integration—features that SimplePractice spreads across higher tiers.

Best For: Multidisciplinary wellness practices where therapists work alongside other provider types. Also a strong choice for practices that want lower payment processing fees.

Limitations: Jane isn't therapy-specific. Mental health features like treatment planning and outcome measures are more limited than purpose-built therapy EHRs. Insurance billing is a $20/month add-on using Claim.MD. The Balance plan caps appointments at 20/month. As a Canadian company, some US practices find support timezone differences frustrating.

4. TheraPlatform — Best for Telehealth-Heavy Practices

Pricing: Basic $39/month, Pro $69/month, Pro Plus $79/month

TheraPlatform stands out with the most feature-rich telehealth platform among all competitors, including 40+ interactive therapy apps and games designed specifically for child, teen, and speech therapy sessions.

Key Features:

• Superior Telehealth (All Plans): Every plan includes HIPAA-compliant video with built-in whiteboard, two-way screen sharing, in-session chat, video playback, session recording, and branded waiting rooms (custom logo, background music, greeting). No competitor matches this telehealth feature set at any price point.

• 40+ Interactive Therapy Apps (Pro Plus $79/mo): Reward games, sandbox environments, search-and-find games, social-emotional learning activities, speech therapy tools, and occupational therapy games—all usable in-person or via telehealth. This is entirely unique to TheraPlatform.

• Lower Processing Fees: Stripe-based at 2.9% + $0.30 per transaction, compared to SimplePractice's 3.15% + $0.30.

• White-Label Client Portal (All Plans): Custom logo and company name on the client portal at no extra cost—SimplePractice doesn't offer this level of branding on lower tiers.

• AI Notes (2025 Addition): Text-to-text, dictation, and telehealth AI note-taking in SOAP, DAP, and BIRP formats. Pricing details for AI features are still evolving.

• Insurance Billing (Pro+ Only): Electronic claims at $0.25/claim, eligibility checks at $0.10/check, ERA auto-posting, and access to 2,000+ insurance providers. However, billing is locked behind the $69/month Pro plan.

Best For: Practices heavily reliant on telehealth, especially those working with children, teens, or speech/occupational therapy clients. Also strong for practices that want branding customization without premium pricing.

Limitations: No dedicated mobile app—web-based only, which is a significant gap compared to SimplePractice's well-regarded iOS/Android apps. Calendar sync is Google Calendar only (Pro+ plans), with no Outlook or Apple Calendar support. Limited third-party integrations with no API available. Insurance billing requires the Pro plan ($69/mo). Wiley Treatment Planner is a $15/month/clinician add-on. Some users report inconsistent customer support quality and Medicaid billing issues.

5. CounSol.com — Best for Client Engagement Focus

Pricing: Standard $49.95/month, Standard Plus $59.95/month, Premium $64.95/month, Premium Plus $69.95/month

CounSol.com is built exclusively for mental health professionals and differentiates through client engagement features and a level of personal support that no other platform matches. With a 4.9/5 support rating and 96% overall user satisfaction, it earns loyalty through service rather than flashy features.

Key Features:

• Client Journal (All Plans): Clients write journal entries between sessions, choosing per entry whether to share with their counselor or keep private. This creates therapeutic touchpoints beyond scheduled appointments—a feature no competitor offers.

• Dedicated Personal Account Manager (All Plans): Every subscriber gets a named support contact regardless of plan tier. This isn't a help desk—it's someone who knows your practice setup and helps with onboarding, troubleshooting, and configuration. SimplePractice reserves premium phone support for Plus ($99/mo) users only.

• Modular Pricing: Insurance billing and telehealth are separate add-on tiers rather than bundled. The Standard plan ($49.95/mo) covers core practice management with unlimited clients and sessions. Add insurance billing for $10 more (Standard Plus, $59.95/mo) or telehealth for $15 more (Premium, $64.95/mo), or get both with Premium Plus ($69.95/mo). This means you don't pay for telehealth if you only see clients in-person, and you don't pay for billing if you're private-pay.

• No Per-Claim Fees: Unlike SimplePractice ($0.25–$0.50/claim) and TherapyNotes ($0.14/claim), CounSol.com charges no per-claim fees from their end. Office Ally clearinghouse may have its own fees for non-participating claims.

• Highly Customizable Client Portal: Portal colors match your practice branding, granular per-client permissions, and access for parents, guardians, sponsors, and PCPs.

Best For: Therapists who prioritize the therapeutic relationship and want a platform that extends engagement between sessions. Also ideal for those who value personal support over self-service documentation.

Limitations: The interface is widely described as looking like it's from the early 2000s—functional but visually dated. Telehealth is rated just 3.5/5 stars with reports of sync issues and random disconnections. No native mobile app (web-based only). Calendar sync is one-way iCalendar export only—no two-way sync with Google, Outlook, or Apple Calendar. Office Ally is the sole clearinghouse option with a smaller payer network than competitors. Limited template library compared to Jane's 10,000+ or SimplePractice's offerings. No API or third-party integrations. Not well-suited for couples or group therapy workflows.

6. Carepatron — Best Budget Option for New Practices

Pricing: Free forever, Essential $14–19/user/month, Plus $19–24/user/month, Advanced $24–29/user/month

Founded in 2019 by Jamie Frew and David Pene, Carepatron has grown to 100,000+ clinicians across 120+ countries. It's the only platform on this list with a permanently free tier that includes unlimited clients and telehealth.

Key Features:

• Genuinely Useful Free Tier: Unlimited clients, core scheduling, a client portal, HIPAA-compliant video calls with no time limits, access to the template library, and live chat support—all at $0/month. No competitor comes close at this price point. SimplePractice's cheapest option is $49/month.

• AI Documentation (Plus Plan, $19–24/user/month): Unlimited AI credits, AI transcription, AI note generation, and auto-coding for diagnoses. The AI detects any language and outputs in your selected language—useful for multilingual practices.

• Modern Interface: Clean, contemporary design that feels more like a modern SaaS product than a legacy EHR. Notably more polished than CounSol.com or pre-redesign TheraPlatform.

• Insurance Billing (Essential+): Electronic claims through ClaimMD with real-time eligibility checks—available from the $14/month Essential tier, making it the most affordable option for practices that need basic insurance billing.

• Two-Way Calendar Sync (Essential+): Syncs with Google Calendar, Outlook, and iCal—broader calendar support than SimplePractice (Google only) or TheraPlatform (Google only).

• Group Video Calls (Plus+): Up to 20 participants, integrated with Zoom, Google Meet, and Microsoft Teams.

Best For: New practices, side practices, therapists testing private-pay before fully committing, or international practices (supports 120+ countries).

Limitations: The free plan lacks appointment reminders, calendar sync, AI features, analytics, and custom branding. Storage is capped at 1 GB on the free plan and 5 GB on Essential. Advanced user roles and permissions require the $24–29/month Advanced plan. No dedicated account manager until the Advanced tier. The platform is relatively new compared to established options like TherapyNotes (2010) or SimplePractice (2012), which means fewer integrations and a smaller user community for peer support.

How to Choose the Right SimplePractice Alternative

The best choice depends on your practice model and priorities:

If You're Pure Private-Pay

First choice: CoralEHR — Purpose-built for cash-based practice with AI documentation that actually reduces admin time. Flat $79/month with no processing fees means predictable costs.

Budget alternative: Carepatron — Gets basics done at $0–19/month while you're establishing your practice. The free tier is genuinely functional for a new solo practice.

If You Bill Insurance Regularly

First choice: TherapyNotes — The most mature insurance billing platform with $0.14/claim through CLAIM.MD, ERA auto-posting, and real-time eligibility. Add TherapyFuel AI ($40/mo) for documentation support.

Budget alternative: Carepatron — Insurance billing from just $14/month through ClaimMD. Less refined than TherapyNotes but dramatically cheaper.

If You're a Growing Group Practice

First choice: TherapyNotes — Free billing and scheduling roles, plus $50/month per additional clinician with full feature access.

Budget alternative: TheraPlatform — Lower entry pricing at $39/month base. Contact them directly for group practice rates.

If You Run a Multidisciplinary Practice

First choice: Jane App — Multi-specialty support in a single platform with 10,000+ templates, excellent UX, and competitive processing fees (2.85% + $0.25).

Why not therapy-specific EHRs: Managing multiple systems for different provider types creates more problems than it solves.

If Telehealth Is Central to Your Practice

First choice: TheraPlatform — Unmatched telehealth features: whiteboard, screen sharing, session recording, 40+ interactive therapy apps, and branded waiting rooms—all included from $39/month.

Trade-off: No mobile app and limited integrations. You're choosing telehealth excellence over ecosystem breadth.

If Client Engagement Is Your Differentiator

First choice: CounSol.com — Unique client journal feature, dedicated personal account manager on every plan, and modular pricing so you only pay for what you use.

Trade-off: You're accepting a dated interface and weak telehealth (3.5/5 rating) for distinctive engagement tools and exceptional support.

Conclusion: Match Your EHR to Your Practice Model

SimplePractice built a strong EHR for insurance-based therapy practices. With 225,000+ users, HITRUST/SOC 2 certifications, and a comprehensive feature set at $49–99/month, it remains a solid choice for that use case. But the therapy landscape is evolving, and each alternative excels in specific areas where SimplePractice falls short.

The best SimplePractice alternative for you depends on how you practice:

• Private-pay focus: CoralEHR's purpose-built approach eliminates insurance bloat while providing sophisticated AI documentation at a flat $79/month.
• Insurance-heavy: TherapyNotes pairs the most mature billing platform with TherapyFuel AI, though the all-in cost ($69 + $40 AI) exceeds SimplePractice.
• Multidisciplinary: Jane App handles diverse provider types with 10,000+ templates and the lowest processing fees (2.85% + $0.25).
• Telehealth-focused: TheraPlatform's 40+ interactive therapy apps and feature-rich video platform are unmatched.
• Client engagement: CounSol.com's journal feature and dedicated account manager create relationship-building tools no competitor offers.
• Budget constraints: Carepatron's free tier with unlimited clients and telehealth gets new practices started with zero risk.

Take the time to trial your top choices. TherapyNotes and TheraPlatform offer 30-day free trials, CounSol.com offers 14 days, and Carepatron's free tier is permanent. Your EHR shapes how you spend your administrative time—choosing well matters.

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Take the Next Step

Building a private-pay practice means having the right clinical tools at your fingertips. Try our free assessment tools to streamline your intake and outcome tracking:

• SimplePractice vs CoralEHR — Detailed feature-by-feature comparison
• Compare All EHRs Side by Side — Interactive comparison of 11 EHR platforms
• PHQ-9 Depression Screening — The gold-standard 9-item depression questionnaire
• GAD-7 Anxiety Assessment — Quick, validated anxiety screening
• PCL-5 PTSD Checklist — Comprehensive PTSD assessment aligned with DSM-5
• DASS-21 Screening — Combined depression, anxiety, and stress assessment
• PC-PTSD-5 Screening — Quick 5-item PTSD screen developed by the VA

Ready to see how AI-powered documentation works for private-pay practice? Try CoralEHR free and experience the difference purpose-built makes.