TherapyNotes or SimplePractice, and the $31 a year nobody counts

Where you probably are right now

You are somewhere in a 30-day trial with a decision to make, or you are three years into SimplePractice, you saw the $20 AMA line on the December invoice, and you went looking to see what else exists. Either way the search that brought you here was some version of TherapyNotes or SimplePractice, and every answer you found was a feature grid written by somebody who has never billed Anthem Blue Cross in California.

This page is the sibling to the SimplePractice page on this site. That page carries an affiliate link. This one does not, because TherapyNotes has no affiliate program this site is part of, which is exactly why it needed writing — a software section with one product in it, and that product the one that pays, is not a resource. The disclosure is in the verdict section below and links to the full disclosure page.

Two things are worth knowing before the detail. First, the headline price gap between these two is much smaller than it looks, because each one includes things the other meters, and the metering runs in both directions. Second, the places where they genuinely diverge are not the places the review sites talk about: supervisor co-signature, Good Faith Estimates, and what happens to your records for the seven years after you stop practicing.

Everything below was checked against each vendor’s own pricing page, help center and terms of service in August 2026, plus the California code sections that create the obligations. Where a figure is a computation, the arithmetic is shown.

What each one charges, and what that works out to

TherapyNotes sells one product with two price points and meters the plumbing. SimplePractice sells three tiers and includes the plumbing. That single structural difference explains almost every surprise in the bills.^[1][2]

Two smaller things a California reader should notice. TherapyNotes names its clearinghouse — CLAIM.MD — on a public support page.^[8] SimplePractice says only that it “works with a variety of clearinghouses” and will not name them, which means you cannot check in advance whether a particular Medi-Cal managed-care plan is reachable electronically.^[9] And California is not on the list of states where TherapyNotes collects sales tax, so the $69 is $69.^[10]

Now the part almost nobody runs. The claim you will see repeated everywhere is that TherapyNotes files claims at 14¢ against SimplePractice’s 25¢ to 50¢, and that this makes TherapyNotes dramatically cheaper for an insurance practice. It is true about claims and wrong about bills, because TherapyNotes also charges 14¢ for every payment report and 14¢ for every text reminder, and SimplePractice charges nothing for either.^[1][2][7]

Take a California LMFT on panels seeing 80 sessions a month, filing one claim per session, receiving one electronic payment report per claim, and sending one text reminder per appointment. Card processing is left out of this table because the two rates are within half a percentage point of each other; it is priced separately below.

Switch that practice to email reminders, which TherapyNotes gives away and most clients accept, and TherapyNotes drops to $91.40 a month and the gap becomes $13.77 a month, or $165 a year. That is the honest size of the claims advantage for one clinician: real, worth having, not transformative.

There is an awkward third column nobody puts in these comparisons. SimplePractice Starter at $49 with 80 claims at 50¢ each comes to $90.67 a month — cheaper than either of the above. Starter is genuinely crippled: no secure messaging, no reminders except for telehealth appointments, and no template customisation, which as you will see below is a live problem in California. But if you are claims-heavy, disciplined and unbothered by any of that, the cheapest insurance-billing option of the three is the one nobody recommends.

On the private-pay side the ranking flips and the money moves to a different line entirely. At 80 sessions a month at $180, all paid by card, the subscription is a rounding error next to the processing fee.^[5][4]

$18.87 a month, $226 a year, and about 86% of each bill is the card processor. TherapyNotes discloses incidental charges SimplePractice does not publish: a $35 chargeback fee, a $29.95 penalty if you do not complete the PCI questionnaire within three months of merchant approval, and unspecified “credit card network fees”.^[4] Neither vendor’s processing rate is competitive with taking payment outside the platform; that argument is made in full on the SimplePractice page and is not repeated here.

If you are an associate, or you supervise one

This is where the two products are furthest apart, and it affects a large share of this site’s readers, because an AMFT, ASW or APCC cannot sign a note that stands on its own.

On SimplePractice, team members exist only on the Plus plan. The supervisor seat itself is free once you are there, along with practice biller and practice scheduler, but the floor for any account with two people in it is $99 a month.^[2] The co-signature workflow is properly built — pending queue, request-edits loop, both signatures on the finished note — and once the supervisor signs, the note is locked.^[14]

On TherapyNotes the arithmetic is different because the plan boundary is different. Solo pricing is defined as “$69/month for a single user”, so the moment a supervisor has a login you are on group pricing: $79 for the first clinician, $50 for each additional clinician, and unlimited non-clinical users.^[1] The question is therefore whether a supervisor counts as a clinician.

TherapyNotes defines a Clinician as “any person who provides services to a client”, and lists Supervisor as a separate role.^[12] A separate support page states plainly that the $50 monthly charge attaches to the Clinician role.^[13] A supervisor who reviews notes but does not see clients in your account therefore falls under “unlimited non-clinical users”. One caveat, stated because it is the honest one: the pricing page’s examples of non-clinical users are Practice Administrators, Practice Schedulers and Practice Billers, and it does not name Supervisor. Ring sales and get it in writing before you switch on the strength of $20 a month.

Read the last two rows carefully, because they are the point of this page. The subscription gap for a supervisor plus one associate is $44 a month. Once you add the claims, the payment reports and the reminders that TherapyNotes meters and SimplePractice includes, that $44 collapses to $11.38. Choose email reminders and it recovers to $33.78. The metering, not the sticker price, decides the answer — and it depends on how you run your practice, not on which logo you prefer. If you are working out whether an associate pays for themselves at all, that is a separate and much larger calculation.

The workflows differ in ways that matter for a BBS audit trail. TherapyNotes lets you assign more than one supervisor to a supervisee and choose per note which one signs, sets supervision at three levels (access only, must approve, must co-sign), and lets you set incident-to billing per payer — rendering provider only, both, or supervisor only.^[11] It also lets the supervisee edit a progress note after the supervisor has signed it, which re-triggers the co-signature. SimplePractice permits one supervisor per supervisee and locks the note on signature. Which of those you prefer is a clinical-governance question, not a price one; if your relationship with your supervisor is remote and asynchronous, the TherapyNotes model creates fewer emails and more chances to re-open a signed record. Neither vendor’s software counts your hours — that is still yours to track.

The California questions

Six things a California therapist needs from practice software that a generic comparison will not tell you.

Good Faith Estimates. Federal law requires you to give an uninsured or self-pay client a written estimate of expected charges — within one business day of scheduling if the appointment is at least three business days out, three business days if it is at least ten days out, and three business days on request.^[15] SimplePractice ships a No Surprises Act template that auto-populates from the client’s chart and your fee schedule and is signed in the client portal, on every plan including the $49 one.^[16] TherapyNotes ships nothing. Its published help center carried 243 English-language articles when checked in August 2026 and not one of them mentions a Good Faith Estimate or the No Surprises Act.^[1] You can build one yourself with its custom form builder and send it for signature through TherapyPortal, but you will be typing the fee, the codes and the dates by hand, every time, for every self-pay client.^[17] For a private-pay California practice this is the single strongest argument for SimplePractice, and what a compliant estimate has to contain is set out separately on this site.

Superbills. Both produce them. SimplePractice can generate them automatically on a monthly schedule once a diagnosis and your Type 1 NPI are on file.^[19] TherapyNotes requires the Practice Biller role, requires the date of service to be set to Insurance — Out of Network — Paper with coverage at zero and the client’s payment recorded in full, and then you tick each date of service you want on the bill.^[18] It is per-batch and manual, and the signature is optional in the software although, as TherapyNotes itself notes, “most payers require a signature from the clinician to accept a superbill for reimbursement.” TherapyNotes also pushes you toward a better answer than a superbill: submitting the out-of-network claim electronically on the client’s behalf, at 14¢, so the reimbursement check goes to them without them having to file anything.^[18] If most of your caseload is out-of-network, that is worth more than the superbill formatting.

Telehealth consent. California requires that before delivering care by telehealth you inform the patient, obtain verbal or written consent, and that “the consent shall be documented”. Failure is unprofessional conduct, and the section expressly covers associate MFTs, associate clinical social workers and associate professional clinical counselors, not just the licensed.^[20] Neither vendor ships a California-specific §2290.5 consent. The difference is what it costs you to make one. TherapyNotes puts a Consent for Services form in every practice’s library, covering telehealth among other things, and will not let you share it until you have edited it — a forcing function, on the only plan there is.^[21] SimplePractice gates template customisation above Starter, so a California telehealth practice cannot properly paper itself on the $49 plan.^[3] On this narrow question TherapyNotes at $69 beats SimplePractice at $49 and ties it at $79.

The BAA. Both, at every tier, at no charge, with no separate request. SimplePractice agrees it by checkbox at signup and does not require re-agreement when you convert from trial. TherapyNotes folded its Business Associate Agreement directly into its Terms of Service effective 23 April 2026, in connection with HITRUST certification; there is now nothing to sign, download or return, and it applies automatically to any customer who is a Covered Entity.^[22] Neither is a differentiator. It is worth knowing only because some cheaper alternatives will not sign one at all.

Couples and families over video. This one catches MFTs specifically. TherapyNotes’ free Basic Telehealth is a standard-definition peer-to-peer connection capped at two participants; the $15/month Premium tier is what gets you sixteen participants, HD, screen sharing and captions.^[1] If you see couples and the two partners join from different addresses — which is common, and often the reason they are in couples therapy — that is three participants and you need Premium. SimplePractice publishes no participant cap on an ordinary telehealth call and includes video on every tier; its 15-client limit applies to group appointments, which are a Plus feature or a $20/month add-on.^[3][36] For a relational practice, add $15 to the TherapyNotes column.

Anything else California. SimplePractice ships a handful of California documents in its template library and documents the fact that California has two Blue Cross payers whose claims are rejected if sent to the wrong one. The word “California” does not appear in any of TherapyNotes’ 243 published help articles, and neither does “Medi-Cal”. That is not evidence that TherapyNotes cannot bill a California payer — it names CLAIM.MD as its clearinghouse and publishes a supported-payer list inside the product — but it does mean you get no state-specific hand-holding. If you are still deciding which panels to join, check your intended payers against that list during the trial rather than after.

Seven years after your last session, and how to get out

California requires a marriage and family therapist, clinical social worker or professional clinical counselor to retain a client’s health service records for a minimum of seven years from the date therapy is terminated, and for a minor, seven years from the date they turn 18. Records may be kept electronically.^[23] The obligation does not end when your practice does. Neither does it end when your subscription does.

TherapyNotes sells the answer to this and SimplePractice does not. TherapyNotes storage mode costs $9 a month for the first user and $3 a month for each additional one. The account stops being a practice — no new appointments, notes or patients, and claims, eligibility, payment reports, reminders and the client portal are all switched off — but every existing record and the whole billing history stay accessible according to each user’s role, and nothing is altered or deleted. A Practice Administrator switches it on from the subscription settings page, and it takes effect from the next billing cycle.^[1] TherapyNotes says so plainly in its own documentation: “If you are closing your practice or retiring, you do not need to download your notes.”^[24]

SimplePractice publishes no archive-only plan. Your published options are to keep paying for Starter, or to export everything and take custody of it yourself. Seven years of each:

Run the same arithmetic for a child client. If you terminate with a six-year-old, the clock runs to their twenty-fifth birthday: nineteen years, $2,052 of TherapyNotes storage, and a filing cabinet problem you would rather not have in a garage. The self-storage column is free and is what most retiring therapists actually do, but it is not free of duty — you remain the custodian, and TherapyNotes says so explicitly: after its retention period expires, “Customer will solely be responsible for complying with all records retention requirements.”^[25]

Getting your data out. SimplePractice is the better of the two here and it is not close. It has a self-serve account-level export at Settings, then Practice, then Data export, in three flavors — Complete, Sessions and Contacts — delivered as a password-protected ZIP organized into folders per client, containing progress notes, psychotherapy notes, treatment plans, chart notes, intakes, claims, invoices, statements, superbills, secure messages and stored documents.^[26] Three traps: appointments are not included, contact information cannot be had in CSV through the export, and the download link and its password expire after one week with no way to recover them.

TherapyNotes publishes no equivalent. Across all 243 of its public help articles there is no self-serve bulk export; notes come out per client, selected by tick box, as a single combined PDF, and reports come out as spreadsheets one report at a time.^[24] Its termination FAQ tells you four separate times to “initiate a data export” without saying where the button is.^[25] The clearest evidence of how this works in practice comes from SimplePractice’s own migration documentation, which for every other EHR links to a self-serve export guide and for TherapyNotes says only: “Contact TherapyNotes directly to request an export.”^[27]

Getting your data in. Both offer a free assisted import of your client list and neither publishes a fee for it. Neither will move clinical notes, appointments or billing history — TherapyNotes states that outright, SimplePractice states that its system “can’t import clinical notes, billing documentation, and appointments”.^[28][27] The difference is how much of the client record survives the trip. TherapyNotes accepts an .xlsx or .vcf and imports names, email, four phone types, full address, account ID, Social Security number, date of birth, marital status, sex, employment status, billing comments and both insurance policies; turnaround is one to five business days.^[28] SimplePractice’s template has eight columns — active flag, first name, last name, preferred name, primary clinician, mobile phone, home email, email consent — and everything else is collected afterwards through an intake request; turnaround is one to three business days.^[29]

So the migration is asymmetric in an unhelpful way. Moving to TherapyNotes preserves far more of the client record but requires you to get a spreadsheet out of SimplePractice first, which its export will not give you directly. Moving to SimplePractice is a phone call to TherapyNotes support followed by eight columns of retyping. In both directions your notes arrive as PDFs uploaded one client at a time, or not at all. Budget a weekend, and do it in a quiet month.

What is wrong with each of them

Both of these are good products with real complaints against them. The complaints are different in kind, and it is worth knowing which kind you mind.

TherapyNotes, sourced. The most serious documented complaint concerns silent claim failures. A verified Capterra reviewer, a therapist writing on 20 March 2026, reported that “claims were marked as successfully sent within the system, creating the impression they had been properly transmitted when they had not”, and that “multiple claims were never received by the payer, resulting in over $2,000 in lost reimbursements”.^[32] That is one reviewer, not a pattern, but it is the failure mode a claims-first product should not have and it is worth reading the electronic claim history page weekly rather than trusting a green tick. Video reliability comes up too: a licensed professional counselor, 26 March 2026, wrote that “the program can be glitchy for the video conferencing, so I do have to have a back up alternative link”. Professional reviewers add fewer automation features than competitors, limited form customisation, limited reporting, and rescheduling that is not drag-and-drop.^[34] One item on that list is now out of date and should not be held against it — TherapyNotes shipped a native iOS and Android app, free with any subscription.^[35]

TherapyNotes, in the contract. Its Terms of Service grant it a “non-exclusive, worldwide, royalty-free, sublicensable, and transferable license” to your User Data, to be used “non-publicly and internally” for providing, troubleshooting, testing and developing the service — and that license “will survive the termination of Your Account”. Disputes go to binding arbitration in Philadelphia under Pennsylvania law, with an express waiver of any class, consolidated, collective or private attorney general action, and no opt-out is offered.^[30] The terms also reserve the right to “at any time and without notice… prospectively amend fees and charges for existing services”.

SimplePractice, sourced. Its equivalent clause is broader in the way that matters: the license it takes covers marketing as well as development, and is described as perpetual and irrevocable. The most careful public write-up of it is by Miranda Palmer of ZynnyMe, first published June 2023.^[31] Price increases are the most consistent user complaint, and the company has been owned by Vista Equity Partners since January 2024. Its export link expiring after a week and its no-refund, no-proration, immediate-deletion cancelation are documented on its own support pages.^[2][26] The full account, including the privacy investigation that appears to have gone nowhere, is on the SimplePractice page, stated as found.

Aggregate scores, for what little they are worth. On Capterra TherapyNotes holds 4.7 from 969 reviews; SimplePractice holds 4.6 from 2,827. On G2 the same two are 4.4 from 99 and 4.1 from 129.^[32][33] TherapyNotes is ahead on both, by a margin small enough that it should not decide anything, from sample sizes small enough that the G2 figures in particular are close to anecdote.

One asymmetry is worth naming because it cuts against the product this site earns from. SimplePractice has a $20 charge that appears once a year, in December, cannot be opted out of, and applies whether or not you have ever billed a CPT code. If you cancel in January, you have just paid a full year’s AMA royalty for one month of use, and you will not get it back, because SimplePractice does not refund and does not prorate.^[6][2] TherapyNotes has no equivalent charge in its published pricing.

The verdict

Down the side is your situation. Across the top is the answer. There are rows here where TherapyNotes wins, rows where SimplePractice wins, and rows where the answer is that you should not be buying either.

Disclosure. This site earns a commission if you subscribe to SimplePractice through the link on its page here. It earns nothing from TherapyNotes, which has no affiliate arrangement with this site, and nothing from Google Workspace, Ivy Pay or Spruce. This page was written because a software section containing only the product that pays is an advertisement wearing a resource’s clothes. Where TherapyNotes is cheaper it is said so, in numbers; where the answer is that you should buy neither, that row is in the table above. Every paid link on this site, and how the money works, is set out on the affiliate disclosure page.

What to do on Monday

Do not switch on the strength of a comparison table, this one included. Do this instead, in this order.

• Count your claims and your reminders for one month. Open last month’s invoice and your reminder settings. If you file fewer than about 60 claims a month and send text reminders, the two products are within $3 a month of each other and price is not your reason to move.
• Decide the associate question first. If anybody co-signs your notes now or will within a year, that single fact is worth more than every other line on this page. Price the two-user configuration, not the one-user configuration.
• Take both 30-day trials, at the same time. They are both free and both 30 days, and nothing in either terms of service stops you running them in parallel. Put three real clients in each.
• During the trial, ask each one two questions in writing. Ask TherapyNotes whether a Supervisor-role user with no Clinician role is billed as a clinician. Ask SimplePractice whether it has any archive or record-retention plan for a closed practice. Note how long each takes to answer — TherapyNotes advertises 24/7 phone and email support on every plan, SimplePractice puts its phone line behind the $99 tier.
• Check your payers before you check the interface. On TherapyNotes, search the supported-payer list for the plans you actually bill. On SimplePractice, ask support directly, since it will not name its clearinghouses.
• Write down your exit before you sign in. On SimplePractice, that means knowing the export link dies after a week and appointments are not in it. On TherapyNotes, it means knowing that you will have to ring them.

And one thing that is true of both: the subscription is not the expensive part of your practice. At 80 private-pay sessions a month the card processor takes roughly $478 and the software takes $79. Put your own rate, your own volume and your own expenses into the simulator below before you spend an evening choosing between $69 and $79.