SimplePractice vs. TherapyNotes: Which One Actually Fits Your Mental Health Counseling Practice?
These two quote the identical 1-30 employee range, so the usual 'pick based on team size' logic doesn't apply here. The real fork is whether telehealth, payments, and e-signature are built in — or something you configure, and pay for, separately.
SimplePractice $600/mo vs. TherapyNotes $500/mo — both serve 1-30 employees, so bundling is what actually decides it
Both platforms are priced for 1-30 employees — the decision comes down to what's included, not headcount.
SimplePractice and TherapyNotes both quote the same 1-30 employee range, which means the usual "pick the cheaper one until you outgrow it" logic doesn't apply — an 8-person practice fits either platform equally well on paper. The question that actually separates them is what's included in the monthly price versus what you'll be configuring, or paying for, on the side.
Monthly cost comparison
SimplePractice: $600/mo — telehealth, payments, and e-signature bundled in
SimplePractice's EHR, scheduling, and progress-notes platform includes built-in telehealth, and per the current integration data it connects natively to Zoom Healthcare (for practices that still want a dedicated video tool), Tebra (insurance billing), the Psychology Today directory, and — notably — Stripe and DocuSign directly. That last part matters: payments and e-signature aren't add-ons you have to wire up yourself. The failure mode we see with SimplePractice isn't cost, it's underuse — practices pay for the full client-portal and telehealth tier while a newly hired clinician keeps re-entering notes into a template from their previous EHR out of habit, instead of actually working in the platform they're paying for.
TherapyNotes: $500/mo — built around psychiatric and medication-management workflows
TherapyNotes is $100/mo cheaper and, per the vertical's clinical positioning, stronger for practices doing active medication management — a real differentiator if you have a psychiatric nurse practitioner or prescriber on staff. But its documented integrations are narrower: only Tebra and the Psychology Today profile. It doesn't list a native Stripe or DocuSign connection, which means practices relying on either need to confirm how payments and consent actually flow — manually, or through a workaround — before assuming they "integrate." A lot of TherapyNotes practices also keep a separate video platform running because telehealth isn't emphasized the same way it is in SimplePractice.
TherapyNotes' $100/mo sticker-price saving disappears the moment you add a $200/mo Zoom Healthcare subscription for telehealth — a fair comparison has to price in what SimplePractice bundles for free.
Feature comparison
| Feature | SimplePractice | TherapyNotes |
|---|---|---|
| Built-in telehealth | ||
| Native Stripe payment sync | ||
| Native DocuSign e-signature sync | ||
| Psychiatric/medication-management workflows | ||
| Tebra insurance billing integration |
The actual decision rule
Clinical mix and what you're already paying for elsewhere matter more here than headcount.
- No prescriber on staff, and you'd otherwise pay separately for video and e-signature: SimplePractice's $600/mo all-in price usually beats TherapyNotes plus a $200/mo video add-on and a standalone e-signature tool.
- A psychiatric nurse practitioner or prescriber is part of the practice, regardless of size: TherapyNotes' medication-management workflows are worth paying per-clinician for even without bundled telehealth.
- Growing group practices adding clinicians and expecting to lean on integrated payments and consent workflows at scale: SimplePractice's native Stripe and DocuSign connections avoid building that plumbing yourself later.
If your practice doesn't do active medication management, price SimplePractice against TherapyNotes plus whatever video and e-signature tools you'd actually need to add — not against TherapyNotes' sticker price alone.
One thing worth naming directly: a lot of "best EHR for therapists" content online is written by, or paid by, whichever platform has the bigger affiliate budget. That's exactly the incentive our engine is built to be blind to; it ranks purely on your clinical mix and integration needs, not on which vendor pays the biggest bounty.
Run the free audit with your real headcount and clinical mix to see which one — plus the rest of your stack — actually fits.
- What Should an 8-Person Mental Health Counseling Practice Actually Pay for Software?
- Google Workspace vs. Microsoft 365 Business Premium: Which One Actually Fits Your Mental Health Counseling Practice?
- Signs Your Mental Health Counseling Practice Has SaaS Sprawl (And What It's Costing You)
- Software Integration Guide for Mental Health Counseling Practices