SimplePractice vs TherapyNotes: The 2026 EHR Showdown for Growing Practices

You’ve been running your private practice for a year or two. Maybe you're still on paper notes, or you've outgrown that spreadsheet-based scheduling system. Now you're staring at two names that dominate every search: SimplePractice and TherapyNotes.

Quick answer: SimplePractice wins for solo practitioners and small groups that want an all-in-one business platform with sleek client-facing tools. TherapyNotes wins for group practices, especially those that see high daily volume and want the most efficient clinical documentation workflow on the market.

I’ve spent the last three weeks digging through both platforms — testing trial accounts, interviewing practice owners, and running my own workflow simulations. Here’s what I found.

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# Why This Choice Matters More Than You Think

The EHR you pick isn’t just a database for progress notes. It’s the backbone of your revenue cycle, your scheduling operations, and your client communication. You’ll live in this software for 30-40 hours per week. Switching later is painful — data migration, retraining staff, reconfiguring billing rules.

In 2026, the landscape has shifted. Both platforms have matured considerably. SimplePractice has invested heavily in its telehealth and client engagement features. TherapyNotes has doubled down on clinical efficiency and group practice management. The gap between them isn’t as wide as it was five years ago — but key differences remain.

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# Quick Comparison Table

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# Feature-by-Feature Deep Dive

1. Scheduling and Calendar Management

SimplePractice does this: Offers a clean, modern calendar view with drag-and-drop appointment adjustments. You can set custom appointment durations per client, create recurring appointments with ease, and color-code by appointment type. The booking widget embeds directly into your website, letting clients self-schedule in real-time — no double-booking risk. Automated email and text reminders go out based on your preferred schedule (24-hour, 48-hour, etc.).

One standout feature: the Waiting Room dashboard view shows all upcoming appointments in a list format, which makes your morning check-in workflow faster.

TherapyNotes does this: The calendar feels clinical — dense and information-packed. Each appointment block displays client name, insurance carrier, and session type at a glance. The Multi-View option shows a weekly grid plus a daily breakdown simultaneously, which is useful if you’re managing several clinicians. Group scheduling is more robust — you can block multiple clinicians at once, and the room scheduling feature helps if you rent space from other providers.

However, the client-facing booking widget lacks polish. You can’t customize available appointment lengths as flexibly, and the self-scheduling flow takes more clicks. No built-in waitlist feature either — you have to manually track open slots.

Which wins: It’s a tie, but for different reasons. If you want a client-facing experience that feels modern and converts website visitors into booked clients, SimplePractice wins. If you’re managing a team of clinicians and need a calendar that gives you maximum operational visibility, TherapyNotes wins.

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2. Clinical Documentation and Note-Taking

This is the kill zone — where these platforms separate themselves dramatically.

SimplePractice does this: Offers three note formats: free-text, template-based, and a structured Intake Wizard. The template library is extensive — you get access to hundreds of pre-built formats covering CBT, DBT, trauma-focused, couples counseling, and more. Customization is straightforward: you can drag-and-drop form fields to build your own note template in about 10 minutes.

The Auto-Save feature means you never lose work mid-note. Timers let you track how long you spend per patient on documentation. The mobile app is genuinely usable for quick progress notes between sessions.

But here’s the limitation: progress notes aren’t tied to the DC (Diagnosis Code) in a way that prevents you from submitting a claim prematurely. You need to manually match the diagnosis to the claim, which can create errors.

TherapyNotes does this: The Quick Note system is the fastest documentation workflow I’ve tested — period. It auto-populates the date, service code, diagnosis, and billing code based on the scheduled appointment. You can create a complete progress note with five clicks and under 60 seconds. The To-Do List automatically generates documentation tasks for every completed appointment, so if you miss a note, it nags you until it’s done.

Structured note templates are the default, not an option. You pick a format (SOAP, DAP, BIRP), click through structured prompts, and the system writes your narrative. This works great if you prefer a guided flow. For clinicians who want free-form narrative control, the system feel restrictive.

Custom note templates require HTML knowledge — there’s no drag-and-drop builder like SimplePractice. For most therapists, this is a dealbreaker.

Which wins: TherapyNotes, hands down, for speed and accuracy. The billing-code auto-population eliminates a full class of errors. SimplePractice wins for note flexibility and template customization. If you write long, narrative-style progress notes, you’ll feel cramped in TherapyNotes.

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3. Insurance Billing and Claims Management

SimplePractice does this: The claims submission flow takes about two minutes per client. You can batch-submit multiple clients with one click. ERA (Electronic Remittance Advice) posting is semi-automated — the system reads the PDF from the clearinghouse and suggests matching payments. You approve each one.

The Claim Status Checker lets you submit a claim and instantly see the status with major payers — no portal login needed. This saves real time.

But the learning curve here is real. First-time users get confused about when to bill the client vs. the insurance carrier. The system assumes you understand how co-pays, deductibles, and secondary insurance work. There’s no integrated clearinghouse step where simpler tools hold your hand through the whole flow.

TherapyNotes does this: Billing is built in as a first-class citizen. Running a batch claim submission takes under a minute. The Billing Dashboard shows all outstanding claims, with aging filters and a status summary that insurance carriers’ portals actually respect — so claims get rejected less often.

The Practice Performance Dashboard is a killer feature. It shows revenue per clinician, payer mix, and outstanding claims balance — all updated in real-time. You can spot a payer who hasn’t paid in 45 days faster than with any other EHR. For group practice owners, this is the single most valuable screen in the entire platform.

Which wins: TherapyNotes. Its billing accuracy (the lower rejection rate) and data visibility for group owners are unmatched. SimplePractice’s EUA posting feels smoother for solo practitioners, but that’s a narrow win.

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4. Client Portal and Communication

SimplePractice does this: The client portal is gorgeous. Clients can pay invoices, complete intake forms, access documents, message you, and schedule appointments — all from one clean interface. The Mobile App for clients (iOS and Android) is well-designed and actually functions — clients can check their upcoming appointments and pay from their phone.

Video telehealth is built into the same portal. Clients click a link in their calendar confirmation and land directly in a video call that works reliably. You get a virtual waiting room with audio/video check, screen sharing, and an interactive whiteboard.

TherapyNotes does this: The client portal is functional but uninspired. Clients can complete forms and pay invoices, but the mobile experience is limited — there’s no true native app; it’s a web view that feels slow. The messaging system works but lacks read receipts, which drives therapists crazy when you need a client to respond to a critical update.

Telehealth calls feel like zoom-before-zoom: stable call quality, but no waiting room, and no integrated chat during the session. On a 2026 product, this feels dated.

Which wins: SimplePractice, emphatically. If client experience matters to you — and it should — the portal differences are significant enough to sway the purchase decision on their own.

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5. Reporting and Analytics

SimplePractice does this: Basic reports are available — monthly visit counts, revenue totals, no-show rates. Export to CSV works fine. But there’s a catch: you can only generate reports on data points the system tracks, and some metrics (like client acquisition source, claim status changes) aren’t captured at all. You can’t build custom reports. You’re stuck with what they give you.

TherapyNotes does this: Offers one of the most robust reporting engines in all of EHR software. 14 pre-built report categories, including revenue by payer, clinical hour breakdowns, claims aging, outstanding balances, average reimbursement rates per service code, and client discharge summaries.

The Custom Report Builder lets you combine any saved data fields and export with filters. Group practice owners use this to track profitability per clinician. Solo practitioners who want metrics beyond “how much did I bill this month” will appreciate the depth.

Which wins: TherapyNotes. No contest. SimplePractice’s reporting feels like a toy compared to TherapyNotes’ business intelligence suite.

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6. Mobile App

SimplePractice does this: Has a native iOS and Android app that handles notes, scheduling, billing, messaging, and telehealth. The app is genuinely functional — not just a wrapper around a webpage. You can write a full progress note on your phone during a no-show slot. Calendar updates sync instantly.

TherapyNotes does this: Offers mobile apps for providers, but they’re restricted to specific functions. The iOS app supports appointment lookup and client messaging; the Android app lacks parity. Neither supports documentation. You must return to a desktop or laptop for notes or billing.

Which wins: SimplePractice. No question. For therapists who see clients in multiple locations or work from home, the mobile experience isn’t a nice-to-have — it defines your workflow. SimplePractice respects your time with a true mobile experience.

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7. Intake Forms and Documentation

SimplePractice does this: The Form Builder is a drag-and-drop interface that takes under 10 minutes to create a custom intake packet. You can duplicate forms, set conditional logic (show different fields based on prior answers), and assign different forms to different appointment types.

The Client Portal does the heavy lifting here: clients complete forms in their portal, which populates the client record automatically. No re-entry, no scanning PDFs.

TherapyNotes does this: Features a solid library of pre-built intake forms, and you can import PDFs and make them fillable. But building custom forms requires HTML editing. For most therapists (and especially non-technical practice managers), this is a non-starter. Pre-built forms work fine if you use a standard template, but any deviation from the norm requires developer-level skills.

Which wins: SimplePractice — hugely. If you work with specific intake requirements (addiction treatment, children’s assent forms, pain management contracts), the form builder alone justifies the monthly cost.

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# Pricing Face-Off

Scenario: Solo Practitioner (1 Clinician)

• SimplePractice (Plus Plan): $69/month
• TherapyNotes: $65/month

TherapyNotes edges out on paper, but you’ll likely spend more time on documentation with TherapyNotes’ rigid structure — unless you need their fast billing workflow. If you write narrative notes, SimplePractice’s flexibility saves you time, which, honestly, is worth more than the $4 monthly difference.

Scenario: Small Group Practice (5 Clinicians)

• SimplePractice (Group Plan): $99/month for the first 2 + $55 each additional = $264/month
• TherapyNotes: $65 × 5 = $325/month

SimplePractice is $61 cheaper per month. You get the better client portal and form builder. But you lose the per-clinician revenue dashboards and the automated billing-queue features.

Scenario: Large Group (50 Clinicians)

• SimplePractice (Custom): ~$1,500-$2,500/month (negotiated)
• TherapyNotes (Custom): ~$3,000-$3,750/month (negotiated)

TherapyNotes’ per-clinician pricing doesn’t scale as aggressively. If you’re running a large group, you’ll want to negotiate both — but SimplePractice has more room to move in their enterprise pricing.

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# Integration Ecosystem

SimplePractice has: Zapier integration (this alone puts it in a different category). You can connect to automation tools like Mailchimp, Google Sheets, and accounting software. Direct integrations exist for Stripe (payment processing), Zoom (if you prefer outside video), and Luma Health (patient communication platform).

TherapyNotes has: No Zapier support. They offer a few native integrations — Veradigm for e-prescribing, Xero/QuickBooks for accounting, and MediScripts for lab orders. That’s the entire list. They intentionally keep the ecosystem closed, arguing it’s a HIPAA-compliance move.

Here’s my honest take: the closed ecosystem hurts TherapyNotes. Solo and small group practices increasingly rely on automation tools to keep their overhead low. If you use separate marketing tools or want to trigger workflows based on appointment status, TherapyNotes forces you to do that manually. SimplePractice’s Zapier connection opens the entire automation world — but you sacrifice native accounting integration. It’s a trade-off.

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# User Experience and Learning Curve

SimplePractice:

• Learning curve: 3-5 hours to feel comfortable with core workflows; 1-2 weeks to master billing.
• Interface: Modern, clean, airy. Everything is where you expect it to be — intuitive navigation that doesn’t require a manual.
• Setup: Takes about 2 hours to configure your account — create forms, set appointment types, import client data. The import tool works well with CSV files.
• Training: Free onboarding sessions (recorded and live) plus a robust learning center with videos and articles.

TherapyNotes:

• Learning curve: 5-8 hours to feel barely functional; 2-3 weeks to feel fast.
• Interface: Dense and utilitarian. The dashboard shows so much information that it feels overwhelming at first. But once you learn where everything lives, the workflow speed is unmatched — the efficiency game is strong.
• Setup: Takes 4-6 hours on average. The import tool accepts CSV, TSV, and XML files, but mapping fields takes longer. You’ll also need to create procedure codes manually and assign them to payers.
• Training: Live sessions available, but less comprehensive. Their help center is good but written for more technical users.

Which wins: SimplePractice gets you productive faster. TherapyNotes rewards you with greater long-term efficiency if you spend the upfront hours mastering it. If you have a staff person dedicated to billing and scheduling, TherapyNotes is worth the learning curve. If you run the practice solo, SimplePractice’s gentle approach wins.

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# Who Should Pick SimplePractice?

You’re building a client-facing practice. Your clients touch your software every single day — scheduling, messaging, paying invoices. Their experience matters to you, and it should. SimplePractice’s portal and mobile app set the bar for what clients expect in 2026.

You’re a solo practitioner who handles everything yourself. The lower learning curve means you’re not spending your weekend learning a system. The form builder, the mobile app, the clean interface — these translate directly to saved hours per week.

You rely on automation. If you use Mailchimp for newsletters, a CRM for leads, or want to trigger automatic text messages when a client books, the Zapier integration makes this possible. The closed ecosystem of TherapyNotes will hold you back.

You supervise or delegate to admin staff. SimplePractice’s roles and permissions make it easy to give your admin limited access — they can schedule, bill, and message without seeing clinical notes. The interface is non-threatening for staff with less technical experience.

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# Who Should Pick TherapyNotes?

You run a group practice. The Practice Performance Dashboard alone justifies the higher cost per clinician. You get real-time insight into each clinician’s productivity, revenue generation, and payer mix — this is business intelligence that SimplePractice simply doesn’t give you.

You process high insurance volume. If your practice submits 50+ claims per week, the accuracy of the auto-populated billing codes and the smooth flow from note to claim mean fewer rejections, faster payment, and less time on the phone with insurance carriers.

You hate re-entering data. TherapyNotes’ notes-to-claim pipeline is the smoothest in the industry. If you can tolerate the steeper learning curve, the long-term efficiency gain is measurable.

You prefer guided clinical documentation. If you like structured intake prompts and consistent progress note formats across all clinicians, TherapyNotes enforces a standardization that SimplePractice can’t match. This helps group practice owners maintain quality control.

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# The Verdict

For solo practitioners and small groups (1-5 clinicians) focused on client experience: Pick SimplePractice. The portal quality, the mobile app, the form builder, and the automation integrations make it the better investment for your practice. It’s also cheaper at this scale.

For group practices (5+ clinicians) that generate high insurance volume: Pick TherapyNotes. The billing accuracy, the business intelligence dashboards, and the clinical automation features will save you 3-5 hours per week — that’s 150-250 hours per year. Over $10,000 in time saved annually per clinician on admin tasks. That’s worth the higher monthly cost.

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# FAQ

Q: Can I switch between them later without data loss?

A: Both platforms offer free data import tools that handle client demographics, progress notes, and appointment history. The transition takes time (plan for 2-4 weeks of parallel use), but it’s manageable. Prepare to manually map fields — CSV exports from either platform don’t include attachment files.

Q: Do either work with psychology today or other directories?

A: Not natively. Both support manual appointment URL embedding, but neither offers a one-click integration with Psychology Today or directory sites. Practice owners typically paste their booking link manually into their directory listings.

Q: Which handles HIPAA compliance better for telehealth?

A: Both are HIPAA-compliant platforms with BAA agreements signed automatically at signup. SimplePractice has a built-in virtual waiting room and encryption; TherapyNotes’ telehealth is more basic but stable and compliant. If telehealth is your primary care delivery mode, SimplePractice’s integrated telehealth experience wins.

Q: Can I use my own payment processor with these tools?

A: SimplePractice requires using their integrated Stripe-based processing (no external processor option). TherapyNotes offers native Integration with Stripe, Square, and PayPal, allowing you to keep your existing merchant account and avoid transaction fees. This is a hidden advantage — practice owners with high transaction volumes can save thousands per year.

Q: Is there a contract — or can I pay month-to-month?

A: Both offer month-to-month plans without contracts. SimplePractice’s annual prepayment offers a 20% discount (effectively two months free). TherapyNotes offers a 10% discount on annual prepayment. There are no cancellation fees on either platform, though you’ll lose access to your data immediately upon cancellation — so back up your records before you disconnect.