TherapyNotes vs SimplePractice 2026: Billing Comparison

Choosing between TherapyNotes and SimplePractice is one of the first decisions a therapist makes when setting up a private practice — and it is also one of the most argued about in online therapist communities. The honest answer is that both are excellent products. The right choice depends almost entirely on which workflow you prioritize: billing efficiency or client experience.

This comparison focuses specifically on the billing side: claim submission, ERA posting, denial workflow, pricing, and how each platform integrates with insurance credentialing. If you are still in the credentialing process, you will want to have your NPI number and CAQH profile set up before configuring billing in either platform.

Pricing Comparison 2026

TherapyNotes: Billing-First Design

TherapyNotes was built specifically for mental and behavioral health providers, and its billing module reflects that focus. The claim submission workflow is tightly integrated with the progress note — once you sign a note, a charge is automatically generated with the correct CPT code and session time. Claims submit to payers via the built-in Waystar connection with a few clicks.

For therapists who handle their own billing, this tight note-to-claim pipeline reduces errors significantly. The platform also has strong reporting: you can see outstanding claims, aging AR, and ERA breakdowns by payer. TherapyNotes’ billing team (available by phone) is consistently rated highly for support quality — a meaningful advantage when you have a denied claim and need a human to talk to.

SimplePractice: Client Experience First

SimplePractice is the market leader by user count, and for good reason: its client-facing features are genuinely best-in-class. The client portal allows online appointment requests, digital intake paperwork, secure messaging, and telehealth sessions all in one place. For practices where client experience and retention matter, SimplePractice’s ecosystem is hard to beat.

On the billing side, SimplePractice Essential and Plus include full insurance billing with ERA posting and superbill generation. The interface is cleaner than TherapyNotes and navigation is more intuitive for new users. The downside is that SimplePractice’s billing support is primarily chat and email — if you have a complex denial situation, you may not always get a knowledgeable human quickly. For a platform-specific comparison, see our Grow Therapy vs SimplePractice comparison.

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The Verdict: Which EHR Should You Choose?

What Neither Platform Replaces: Professional Billing

Both TherapyNotes and SimplePractice handle claim submission and ERA posting — but they do not handle denial management, credentialing, payer follow-up, or AR recovery. These are the tasks that actually determine how much revenue you collect per session, and they require a human who knows payer behavior and appeals procedures.

A professional billing service uses your EHR of choice as the submission vehicle while taking over every downstream billing task. For therapists seeing 10+ insurance clients per week, the revenue recovered from effective denial management typically exceeds the billing service cost. Our team works with both TherapyNotes and SimplePractice and can integrate with your existing setup without requiring a platform switch.

Before configuring billing in either platform, make sure your credentialing is current: check your Aetna panel status, verify your UnitedHealthcare contract, and ensure your BCBS rates are competitive for your market. An EHR cannot fix a credentialing gap or a below-market contracted rate.