SimplePractice vs TherapyNotes (2026): Which One Actually Fits Your Practice?

If you're choosing between SimplePractice and TherapyNotes, you're choosing between the two gravitational centers of the therapy-EHR market — and between two genuinely different philosophies of what practice software is for.

SimplePractice believes the product is the experience: yours and your clients'. Clean interface, slick portal, online booking, an app for everything. TherapyNotes believes the product is the infrastructure: claims that go out clean, denials you can chase, a phone number a human answers. Both beliefs are correct — for different practices.

Full disclosure before the referee blows the whistle: I founded a third EHR, Practice Harbor. I'll tell you when that matters at the end; the comparison itself stands on its own.

Where SimplePractice Wins

• The client-facing layer. Portal, online booking, intake paperwork, reminders, the client app — this is the best mainstream client experience in the category, and clients notice. If reducing scheduling friction and looking modern to prospective clients matters to your referral flow, this is SimplePractice's home turf.
• Breadth and ecosystem. Measurement-based care, a huge template library, Wiley planners, insurance add-ons, integrations, and a decade of tutorials, consultants, and Facebook groups. Whatever the edge case, someone has written a help article.
• Onboarding polish. It's the easiest of the two to set up without help. Solo practitioners get to functional fast.

Where TherapyNotes Wins

• Insurance billing, decisively. Claim scrubbing, payer connections, ERA posting, denial workflows — the billing engine is the product's soul, and insurance-heavy practices feel the difference weekly. Per-claim costs are low (around $0.14), and the workflow assumes you bill at volume rather than treating claims as an add-on.
• Support you can call. Phone support with short waits and staff who know billing. SimplePractice's support — chat and email queues — is its most-complained-about feature in every therapist forum. When a claim batch is stuck, this difference stops being abstract.
• Price stability. Around $69/month solo, and its pricing history is calmer than SimplePractice's steady upward creep ($49–99 depending on plan, plus add-ons that used to be included).

Where Both Lose

Documentation time. Both are fundamentally typing platforms: templates help you structure the note, but the note is still you, at a keyboard, after your last client. Both now sell AI note-taking as a paid add-on (roughly $25–40/month extra), and both add-ons are younger than the standalone scribes they're competing with. If notes are your bottleneck, neither default configuration solves it — you're buying the add-on either way, which changes the price math (the full AI note-taker comparison).

The Verdict, by Practice Type

• Insurance-heavy solo or group: TherapyNotes. The billing engine and phone support outweigh the dated interface, and your clients see their portal less than you see your claims queue.
• Private-pay practice competing on client experience: SimplePractice. The portal, booking, and polish are your storefront; the support risk stings less when you're not chasing payers.
• Mixed practice: decide by volume. Under a handful of claims a month, take SimplePractice's experience; past that, TherapyNotes' billing muscle compounds.

And the Question Behind the Question

Here's where my disclosure matters. This head-to-head assumes the 2015 framing: pick the least-bad typing platform and pay $50–100/month plus add-ons. If what actually drove you to compare EHRs is the hour of documentation after your last session, the honest answer might be neither — the newest generation of therapy EHRs treats AI documentation as the core of the product rather than an upsell. Ours is one ( the full shortlist comparison is here), it's $19/month licensed and free for pre-licensed clinicians, and the trade-off is youth: we don't have TherapyNotes' fifteen years of billing scar tissue or SimplePractice's ecosystem. You should weigh that honestly — the same way this article weighed them.

Albert Wong, PhD, is a clinical psychologist and the founder of Practice Harbor.