Best Software for Independent Therapists Running Their Own Practice

For an independent therapist in private practice, the decision is not which EHR has the nicest website, it is which tool keeps the calendar, the notes, the insurance claims, and the payments straight for one clinician who is also the front desk, and at what monthly bill once the per-claim fees, telehealth add-ons, AI note takers, and card processing are counted. EHR comparison pages mostly list features side by side. The products actually separate on pricing models, what counts as an add-on, and what the clinical record export looks like when you leave, which matters more here than anywhere else because therapy records carry legal retention obligations.

SimplePractice, TherapyNotes, Sessions Health, and Carepatron are the shortlist a solo therapist or small group practice actually meets. Each is a real product with a real identity, and the marketing pages make all of them look interchangeable. They are not.

Large platforms and payer-side networks such as Alma or Headway solve a different problem: they bundle credentialing and insurer panels but take a slice of the session fee or reshape the practice around their network, and course-style wellness sites were never designed to run daily progress notes and claims. White-label clinic buildouts are projects, not tools you run this afternoon.

The short version

• The pricing model is the product. SimplePractice sells per-practitioner plan tiers, TherapyNotes sells a solo flat rate plus per-clinician group pricing, Sessions Health sells one flat plan with a small free tier, and Carepatron sells per-user plans with a genuinely usable free tier. The sticker price tells you almost nothing until you model claims volume, telehealth, and documentation AI.
• TherapyNotes is the insurance-heavy default: Solo at $69 per month for one user, Group at $79 for the first clinician plus $50 per additional clinician, with free non-clinical staff. The catches are the per-use billing layer: 14 cents per electronic claim, ERA claim, and eligibility request, 14 cents per text or voice reminder (email reminders free), a 3.1 percent plus 30 cents processing fee per card transaction, telehealth at $15 per clinician per month for Premium, and e-prescribing at $65 per prescriber per month.
• SimplePractice is the all-in-one market leader: Starter $49, Essential $79, and Plus $99 per month for a solo practice, with additional practitioners at $74 per clinician for small groups and lower tiers or custom pricing at 6 or more. Payment processing runs about 3.15 percent plus 30 cents per transaction, and the add-on stack is real: the Note Taker AI is $35 per month, the Care Aide suite is $59 per month for the account owner ($49 per additional clinician), and ePrescribe is $49 per month plus a one-time $89 setup fee. And since October 1, 2026, insurance billing is metered on every plan: claims start at $0.39 each with no free claims on any tier, and the optional Insurance Navigator upgrade files at $1.79 per claim.
• Sessions Health is the flat-and-transparent option: free for up to 3 active clients, Professional at $39 per month for the first practitioner and $29 per additional practitioner with every core feature included. The honest catches are the usage fees layered on top: $10 per practitioner per month for integrated telehealth, $0.25 per electronic claim at typical volume (volume discounts start at 200 claims a month and only reach $0.19 at 1,000 or more, with automated ERA posting included in every submitted claim), $0.15 per eligibility report, and $35 per practitioner per month for the AI Assist suite.
• Carepatron is the free-start wildcard: a real free tier with unlimited clients, telehealth, and an AI scribe and note taker (scoped to 1GB of storage, 1 million AI tokens, and 1,000 tasks), Plus at $31 per month and Advanced at $39 per month (20 percent off annual billing, a current 50-percent-off-for-6-months promotion, and a 14-day free trial). Insurance claim filing starts at $0.25 per claim, eligibility checks are $0.15 each, e-prescribe is $39 per prescriber per month, and CMS-1500 forms and claim filing arrive only on paid plans.
• Do not decide on the sticker. Decide on the tier that covers your real caseload and payer mix, the add-ons your workflow actually needs, the per-claim and transaction fees, and what the export looks like when you leave, because clinical records are not optional to keep.
• Every tool here can schedule a session and take a card. The differences that matter are the claims math, what is an add-on versus included, the e-prescribe and telehealth fees, and the exit.

What a private practice actually requires

Before comparing vendors, write the requirement list, because the tool for a fully cash-pay therapist seeing fifteen clients a week is a different product from the tool for a therapist billing three insurance panels a hundred claims a month.

• Notes and documentation. Progress note templates, treatment plans, and a workflow that gets the note signed and locked the same day. This is the daily surface and the clinical heart of the product.
• Insurance billing. Claim creation, electronic claims submission, ERAs, eligibility checks, and clearinghouse access. This is where the fine print lives: per-claim fees, eligibility fees, and whether CMS-1500 claim filing is locked behind a paid tier at all.
• Payments and superbills. Card processing, AutoPay, and automated superbills for clients who self-submit. Transaction fees compound quietly on every session.
• Telehealth. Integrated HIPAA-compliant video is now a base expectation, but on several platforms it is a paid add-on or a premium tier, and group telehealth is a higher-tier feature.
• Client experience. A client portal with paperless intake, e-signature, secure messaging, and online scheduling. Portals are how clients meet their treatment, and the gap between the best and worst portal in this category is bigger than any backend difference.
• AI documentation, carefully. Note takers and scribes are the fastest-growing add-on in the category at $35 to $59 per month, with Carepatron the exception that bundles an AI scribe into every plan including Free, and they involve recording a clinical session: consent, state law, and who stores the audio belong in the checklist, not just the price.
• Compliance and exit. HIPAA compliance with a signed BAA, encryption, audit trails, and a full export of the clinical record when you leave. Therapy records carry legal retention duties, so data you cannot leave with is not just a liability, it is a compliance problem.
• Reporting. Revenue summaries, caseload counts, and claim status so the practice is a business you can read at a glance.

Keep that list next to you while reading. Every tool here can schedule an appointment. The list is what separates them.

The shortlist

SimplePractice

SimplePractice is the most established name in the category and the closest thing to a default for solo private practice in North America. Pricing is per practitioner and scales by tier: Starter at $49 per month, Essential at $79, and Plus at $99, with a 30-day free trial and a current promotion of 50 percent off for the first 3 months if you begin a paid account within 7 days. Group practices run on the Plus plan at $99 per month for the first practitioner plus $74 per additional clinician for small groups, with the support docs listing $72 per clinician at 6 to 15 and $69 at 16 or more while the pricing page invites groups of 6 or more to talk to sales about custom pricing; group telehealth is on Plus only.

The honest catch is the add-on and fee layer. Card processing runs about 3.15 percent plus 30 cents per transaction on top of the plan, the Note Taker AI is $35 per month per clinician, the Care Aide suite wraps Note Taker with session support and treatment planning at $59 per month for the account owner and $49 per additional clinician, and ePrescribe is $49 per month plus a one-time $89 setup fee, so a therapist who wants notes, prescribing, and card payment pays meaningfully more than the $79 headline. The claims side changed on October 1, 2026: claim fees no longer depend on your plan. The default Insurance Essentials billing starts at $0.39 per submitted claim on every tier, no plan includes free claims anymore, and manual insurance status checks cost $0.15 each on Starter and Essential (Plus keeps them free through March 31, 2027). The optional Insurance Navigator upgrade, still labeled coming soon on the pricing page, files claims at $1.79 each, but it is not the same service at five times the price: it bundles a human insurance specialist, a claim assistant that catches and corrects errors, and automatic benefits verification. Community reporting on price increases at renewal is real enough to budget for. What keeps it winning is the widest client-experience surface in the group: a polished client portal and mobile app, paperless intake, reminders, calendar sync, and the largest practice-tool ecosystem.

• The strength: the most complete client-facing experience and ecosystem in the category, a real 30-day trial, and polished mobile apps for clinician and client.
• The catch: processing fees, AI add-ons, and e-prescribing stack on top of a plan that already prices above the category median, and renewal price moves are a documented pattern in the community.
• Best for: a solo therapist or small group that values the client portal and all-in-one polish and will model the full add-on bill before committing.

TherapyNotes

TherapyNotes is the insurance-workflow specialist and the crossover favorite for therapists who convert to insurance panels: to-do-list-driven documentation, claim scrubbing, ERA tracking, and eligibility workflows that read like they were designed by a biller. Pricing is per account by clinician count: Solo at $69 per month for one user, and the Group plan at $79 per month for the first clinician plus $50 per additional clinician, with free non-clinical staff and an Enterprise tier for 30 or more users that adds a dedicated account manager at the same rates.

The honest catch is the per-use billing layer: every electronic claim, ERA claim, and eligibility request costs 14 cents, so a claim's round trip runs about 28 cents once the payer response comes back on an ERA; text or voice reminders cost 14 cents each (email reminders are free), card processing is 3.1 percent plus 30 cents, Premium telehealth is $15 per clinician per month, e-prescribing is $65 per prescriber per month, and the TherapyFuel AI documentation suite is $40 per clinician per month. A high-volume billing practice runs a small meter alongside the base bill. What offsets that is the operational bedrock: unlimited clients and notes, unlimited file storage, a custom client portal, free client data import from another EMR, and 24/7 phone and email support that reviewers consistently rate the best in the category, plus a 30-day free trial with no credit card.

• The strength: the strongest claims-and-billing workflow in the group, the best-documented support desk, and a data-import offer that respects the migration you are dreading.
• The catch: usage metering adds a second bill on top of the base price, e-prescribing is priced per prescriber, and the interface is functional rather than delightful.
• Best for: a therapist or small practice built around insurance panels who wants claims handled like a billing service and support that answers at 2 a.m.

Sessions Health

Sessions Health is the flat, transparent option, and the one that reads like it was priced by someone who has run a billing spreadsheet: a genuinely usable free plan for up to 3 active clients, then Professional at $39 per month for the first practitioner and $29 per month per additional practitioner, with unlimited administrators free and core features (scheduling, documentation, client portal, billing tools, unlimited clients, unlimited storage) all included in the base plan.

The optional features are listed openly rather than bundled into tiers: integrated telehealth at $10 per practitioner per month, electronic claims at $0.25 per claim for the first 199 claims a month with volume discounts that only reach $0.19 at 1,000 or more claims ($0.23 at 200 to 499, $0.21 at 500 to 799, $0.20 at 800 to 999), eligibility reports at $0.15, and the AI Assist suite (notes from telehealth or audio, pre-session summaries) at $35 per practitioner per month. Every submitted claim includes automated ERA posting once you enroll with the payer, which is the same remittance step TherapyNotes meters at 14 cents a claim. Card processing goes through Stripe at 2.9 percent plus 30 cents with no platform fee on top, which is the cleanest processing arrangement in this comparison. The catches are the newer feature set and the smaller ecosystem: report depth, integrations, and some AI features are still maturing, and a practice that wants a large marketplace of templates and wearables connections will find it thinner here.

• The strength: the clearest pricing in the category, a real free tier, no platform fee on card processing, and customer service that reviewers single out consistently.
• The catch: the feature surface is younger, per-claim and telehealth fees still layer on for a heavy insurance practice, and integrations are narrower than SimplePractice or TherapyNotes.
• Best for: a solo therapist or small group that wants one predictable bill with every core feature included and will read the add-on list line by line.

Carepatron

Carepatron is the free-start wildcard and the one built as a general clinical workspace rather than a mental-health-only EHR: a real free tier with unlimited clients, telehealth, a client portal, automated payments, and an AI scribe and note taker, then Plus at $31 per month and Advanced at $39 per month per user, with 20 percent off annual billing, a current 50-percent-off-for-6-months promotion, and a 14-day free trial. Plus adds unlimited storage, group telehealth, a shared inbox, custom branding, and advanced workflows; Advanced adds roles and permissions, white labeling, a Google Analytics integration, 90-day deleted-data retention, a 1:1 onboarding manager, and premium support.

The honest catches are the billing and add-on seams. Appointment reminders and CMS-1500 claim filing only arrive on paid plans, electronic claims start at $0.25 each, eligibility checks are $0.15, e-prescribing is $39 per prescriber per month, and the managed insurance billing service (credentialing, claims, denials under your own NPI) is 3.9 percent of collected amounts plus $79 per month for the first provider. Card processing runs through Stripe at 2.9 percent plus 60 cents per transaction, the steepest fixed fee in this comparison, though Carepatron covers processing on your first $1,000. The free tier also meters data (1GB), AI tokens (1 million), and tasks (1,000), so it is a real workspace but not unlimited. What makes it interesting is modern polish: a fast interface, an AI scribe on every plan, and per-user pricing that undercuts the big names by roughly half for a solo clinician on annual billing.

• The strength: the lowest paid entry price in the category on a capable Free tier, plus contemporary tooling that fits a therapist who also wants one workspace for forms, notes, and payments.
• The catch: insurance billing is shallower and metered, e-prescribing and claims add back much of the savings, and free-tier limits (storage, AI, reminders) push working therapists toward Plus quickly.
• Best for: a cash-pay therapist, new practice, or side caseload starting at zero cost who values modern software and keeps billing simple.

What to check before you sign

• The billing-math scenario. Convert everything to your real week: a therapist filing 100 claims a month pays about $25 in claim fees on Sessions Health, about $39 through SimplePractice's default Insurance Essentials at $0.39 per claim (the bill only approaches $179 if you buy the Navigator upgrade), and $14 in claim fees on TherapyNotes, or about $28 once each claim comes back on a metered ERA. That is a real spread, not the tenfold one the Navigator sticker implies, and Navigator is not the same service: it bundles a human insurance specialist and claim-correction tools. Model your own numbers, not the checkout example.
• What is an add-on versus included. TherapyNotes prices claims, ERAs, premium telehealth, AI notes, and e-prescribing as line items; SimplePractice now meters every claim at $0.39 regardless of plan and prices AI and e-prescribing as add-ons; Sessions Health lists every optional fee openly on the pricing page and includes ERA posting; Carepatron gates reminders and claim filing behind paid plans. Make the add-on list part of the evaluation, not a footnote.
• Transaction fees under the payment layer. All four run card processing on Stripe-class rates near 3 percent, but the fine print differs: Sessions Health passes Stripe through untouched at 2.9 percent plus 30 cents with no platform fee, TherapyNotes is 3.1 percent plus 30 cents, SimplePractice about 3.15 percent plus 30 cents, and Carepatron 2.9 percent plus a steep 60 cents, waived on your first $1,000 of volume. Compute the fee on your average session, then multiply by your no-show and late-payment patterns.
• The BAA and the audit trail. Confirm HIPAA compliance with a signed business associate agreement, encryption at rest, and role-based access before anything else. This is table stakes, and the vendors all offer it, but the paperwork is part of the checklist.
• The AI consent question. Three of the four shortlist tools sell an AI note taker, at $35 per month (SimplePractice's Note Taker, Sessions Health's AI Assist) to $59 (SimplePractice's Care Aide); Carepatron instead includes an AI scribe and note taker on every plan, Free included. Before buying, settle your consent language and your state's recording rules, and check where the audio is stored and whether you can delete it. The cheapest AI add-on is the one you do not have to unpick from a consent dispute.
• The export test, with a retention asterisk. Export the full clinical record, including notes, assessments, and payment history, during the trial and open it somewhere else. TherapyNotes ships free client data import, which signals they understand the other side too. Because records must be retained by law, the export you run today is the archive you may need years from now.

The honest recommendation

• Insurance-panel therapist or small group where claims are the daily grind: TherapyNotes, with the Solo $69 plan and the 14-cent claim-and-ERA meter, and the honest warning that the support desk is better than the interface.
• Solo therapist who values the client portal, mobile apps, and the widest ecosystem: SimplePractice Essential at $79, plus the Note Taker if AI notes pay for themselves, and model the processing fee and the $0.39 claim meter before believing the $79 headline.
• Therapist who wants one predictable bill and transparent fees: Sessions Health Professional at $39, paying $10 for telehealth and cents per claim only as actually used, with the cleanest processing arrangement in the group.
• Cash-pay therapist, new practice, or side caseload starting at zero: Carepatron's free tier, upgrading to Plus when reminders and unlimited storage matter, as long as insurance billing stays out of scope or moves to their managed service knowingly.
• A two-clinician group is the crossover point: SimplePractice Plus at $99 plus $74 per clinician and TherapyNotes at $79 plus $50 make TherapyNotes the cheaper group bill, and Sessions Health ($39 plus $29) undercuts both while offering a different feature philosophy.
• The platform is the floor, not the ceiling. Practice software earns its keep when the note gets written, the claim gets paid, the client portal works, the export is clean enough for your retention obligations, and the price you pay is the price of the tier and the fees you actually incur.

Official sources

All prices in this article are USD list prices, checked against these official pricing pages and support docs in October 2026.

• SimplePractice pricing: https://www.simplepractice.com/pricing/
• SimplePractice subscription plan and pricing FAQs: https://support.simplepractice.com/hc/en-us/articles/115005956266-Subscription-plan-and-pricing-FAQs
• SimplePractice, What's changing with insurance pricing: https://support.simplepractice.com/hc/en-us/articles/48468642804237-What-s-changing-with-insurance-pricing
• TherapyNotes pricing and subscription options: https://support.therapynotes.com/hc/en-us/articles/30661380110747-TherapyNotes-Pricing-and-Subscription-Options
• TherapyNotes pricing: https://www.therapynotes.com/pricing/
• Sessions Health pricing: https://www.sessionshealth.com/pricing/
• Carepatron pricing: https://www.carepatron.com/pricing/
• Carepatron online payments and processing rates: https://help.carepatron.com/en/articles/6381761-online-payments-with-carepatron
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Are you a therapist running SimplePractice, TherapyNotes, Sessions Health, Carepatron, or a patchwork of scheduler, note writer, and claims portals? What did the claims math or the export test teach you? Drop it in the comments.

Until next time, keep your systems thoughtful.