TherapyNotes Pricing in 2026: What It Actually Costs (Fees Included)

TherapyNotes prices itself the way an old harbor prices moorage: a modest flat fee to tie up, and then a little charge every time you use the dock. Fourteen cents to send a claim. Fourteen cents when the remittance comes back. Fourteen cents to remind a client they have a session tomorrow. None of these numbers will scare anyone — that's the point of pricing things in cents — but they compound quietly, per claim and per text, until the bill at the end of the month is a different animal than the one on the pricing page. This post does the arithmetic out loud.

One disclosure before the numbers: I'm a clinical psychologist, and I also built Practice Harbor, an EHR that competes with TherapyNotes. That's a bias worth naming. So the ground rules are the same as in our SimplePractice pricing breakdown: every figure below comes from TherapyNotes' own public pricing page, support documentation, and announcements, as of July 2026, and anything I couldn't verify stays qualitative. This is arithmetic, not attack — TherapyNotes is a product I respect.

The base plans, plainly

Two things deserve credit right away. First, the base plan is honest — telehealth, the client portal, and the full billing engine are in the box, not sold back to you tier by tier. There's no "Starter" plan missing the features you came for. Second, free non-clinical seats matter more than they sound: a group practice can add a biller and a front-desk person without the subscription growing, which is not how most of the category works.

The number to watch is the trend line. The solo rate was $59/month as recently as the fall of 2025; effective December 1, 2025, TherapyNotes raised every base plan by $10 — solo to $69, group to $79 plus $50 per additional clinician. One increase with notice is not a scandal, and TherapyNotes said plainly that the per-use fees weren't changing. But if you're doing multi-year budgeting, price the trend, not the snapshot.

A few practicalities worth knowing before you commit: there's a 30-day free trial with no credit card required, billing is month to month rather than an annual contract, and there's no free tier — the trial ends and the meter starts. That's a fair, old-fashioned arrangement. It's also worth saying that "solo" here means one clinician, full stop: the moment you bring on an associate, you're on group pricing, and every licensed hire adds $50/month to the base before anyone files a claim.

The meter: where the bill actually grows

Here's the part the pricing page states honestly but quietly. The base plan is the berth; everything that moves costs per use:

• Electronic claims: 14 cents each. Every claim you file through the built-in clearinghouse. Cheaper than a stamp, as their own docs like to point out — and true. But it's a meter, and a full insurance caseload keeps it spinning.
• ERAs: 14 cents per claim. The electronic remittance — the payer's answer to your claim — is billed per claim on the ERA. In practice, a claim's round trip costs you roughly 28 cents: once going out, once coming back.
• Text and phone reminders: 14 cents per message. Email reminders are free. But most clients live on their phones, and if you send each of them one text per session, every appointment on your calendar carries its own small toll.
• AI notes (TherapyFuel): $40/month per clinician. TherapyNotes' AI documentation is an add-on, not a plan feature — and at $40 it costs more than half of the base plan itself. If AI notes are the reason you're shopping, this is the line item to price first. (How these tools differ is its own topic — see our AI note taker comparison.)
• Premium telehealth: $15/month per clinician. Standard one-on-one video is included; the premium tier is the upsell.
• ePrescribe: $65/month per prescriber. Only relevant if you prescribe — but if you do, it's the biggest add-on on the sheet.
• Card processing fees on client payments, at industry-typical percentage-plus-cents rates — not unique to TherapyNotes, but part of the real monthly total.

Notice what's not on the meter: there's no claim allotment to exceed, no cap on clients, no per-note charge, and the portal doesn't cost extra. The metered fees are real money, but they're small, disclosed, and proportional to use. As nickel-and-diming goes, this is the polite version.

To estimate your own bill, you only need three numbers: sessions per week, the share billed to insurance, and whether you want the AI. Multiply your monthly insurance sessions by roughly 28 cents for the claim-plus-ERA round trip, add 14 cents per texted reminder, add $40 if you want TherapyFuel, and put it all on top of the $69 base. Do that math before the demo call, not after — it's five minutes with a calculator, and it's the difference between budgeting for the sticker and budgeting for the boat you'll actually be sailing.

What you get for it

Credit where it's due, because it's due. TherapyNotes' insurance billing is the best-regarded in the category — claim scrubbing, denial workflows, ERA auto-posting — and it comes standard rather than as a premium tier. The product is famously stable; their support answers the phone with actual humans who know the software. They've been at this for well over a decade, and it shows in the way a steady ship shows: nothing flashy, nothing loose on deck. If your week is dominated by claims, the $69 buys you a billing department's worth of infrastructure, and that's a fair trade.

The honest criticisms aren't about price. They're about age — the interface, the manual note-writing unless you pay for the AI add-on, the thinner client-facing features. We wrote those up separately in our full TherapyNotes comparison, and none of them change the arithmetic here.

How it compares

Against SimplePractice, TherapyNotes' sticker is higher ($69 vs. $49 Starter) but its middle is stronger: SimplePractice's usable tiers run $79–99 before add-ons, meters claims on lower tiers, and charges $20/month extra for group appointments on Essential — the full math is in our SimplePractice pricing breakdown. For a solo insurance practice, comparable configurations of the two land within a few dollars of each other; TherapyNotes tends to win on billing depth, SimplePractice on polish. Since I build a competitor, here's our side stated plainly rather than smuggled in: Practice Harbor is free for pre-licensed clinicians, $19/month licensed, $39/month for a group practice — with AI notes, claims, and reminders included instead of metered. And if budget is the whole question, start with our guide to free EHRs for therapists.

Who this pricing suits — and who feels the meter

TherapyNotes' pricing fits practices whose gravity is insurance: heavy claim volume, a biller on staff (free seat), denials worth real money. For them, the per-claim pennies are rounding error against what the billing engine saves, and the flat, complete base plan is a better deal than the tiered competition. It also quietly favors group practices that need front-office staff, because those seats cost nothing.

The meter is felt most by three groups. High-volume, low-fee practices — lots of sessions, lots of reminders, lots of claims — pay the per-use fees on every one. Clinicians who want AI documentation pay $109/month before a single text goes out, because the AI is an add-on priced like a second subscription. And pre-licensed clinicians running on intern income are paying real money for an engine — the billing department — they mostly can't use yet. If you're in that third group especially, run the numbers before you sign; dead reckoning is no way to navigate a budget.