TheraNest® vs SimplePractice
Which EHR fits your practice?
SimplePractice alternative for mental health practices that bill insurance
Choose TheraNest, by Ensora Health, if you bill insurance, whether you’re solo or preparing to hire. TheraNest Premier ($89 per therapist per month) automatically submits eligible claims and posts matching payments, with no per-claim fees. Plans start at $29 per therapist per month.
SimplePractice may fit better if you plan to stay solo and mostly private pay. It’s quicker to set up, has a polished mobile and client-facing experience, and has the largest community of therapists to learn from.
TheraNest vs SimplePractice:
where each one is stronger
| What you're comparing | Better fit | Why |
|---|---|---|
Starting price | TheraNest | TheraNest Essentials is $29 per therapist per month. SimplePractice Starter is $49 per month. |
Support and onboarding | TheraNest | TheraNest offers 24/7 phone support and live chat with a person from 8:00 AM to 8:00 PM CT, plus email support, training resources, and implementation help. SimplePractice offers phone support on weekdays from 7:00 AM to 5:00 PM PT and live chat seven days a week. |
Group practice and your first hire | TheraNest | Supervisor co-signatures, role-based permissions, shared scheduling, and group practice reporting help you add clinicians without rebuilding your workflows. SimplePractice supports more than one clinician only on its Plus plan. |
Admin and billing staff | TheraNest | Add as many admin users as you need at no extra cost on every plan. SimplePractice includes biller, scheduler, and supervisor roles on its Plus plan and charges $39 per month for each practice manager. |
Automated claims and follow-up | TheraNest | TheraNest Premier sends claims that pass its pre-check, posts payments that match your rules, and puts everything else in one review queue. SimplePractice can post insurance payments automatically, but you create and submit claims yourself, one at a time or in batches. |
A billing team when you want one | TheraNest | Ensora RCM Essentials adds a billing team that works alongside practices with 1 to 5 clinicians and is priced per practice. SimplePractice’s Managed Billing handles in-network |
Getting on insurance panels | TheraNest | TheraNest and SimplePractice both offer free credentialing to new customers. TheraNest covers up to 3 payers per therapist on an annual Premier plan and up to 2 on annual Advanced. SimplePractice covers up to 2 payer applications for your whole practice. |
Insurance billing and predictable claim costs | TheraNest | TheraNest Premier includes unlimited claims and eligibility checks, subject to its Fair Usage Policy (500 of each per clinician per month). As of October 1, 2026, SimplePractice charges for every claim, starting at $0.39, and Essential and Plus no longer include free claims. |
Shared treatment rooms | TheraNest | In TheraNest, you can book rooms, and the calendar blocks double booking, including for recurring appointments. In SimplePractice, you set up each room as an office location and check the calendar to avoid double booking. |
Waitlist and canceled-slot recovery | SimplePractice | When a client cancels, SimplePractice’s AutoFill offers the open time to up to the next 3 clients on your waitlist (Essential and Plus). TheraNest shows your real-time openings in the client portal so clients can request them. |
Quickest setup for a solo private-pay practice | SimplePractice | SimplePractice has less to configure if you won’t use insurance or team features. |
Mobile and client-facing experience | SimplePractice | SimplePractice offers mobile access, website and directory tools, and the largest community of therapists to learn from. A TheraNest mobile app is scheduled for fall 2026. |
Free trial length | SimplePractice | SimplePractice’s free trial is 30 days, with no credit card required. TheraNest’s is 21 days. |
AI scribe | Even | Ensai℠ Session Assistant and SimplePractice Note Taker each cost $35 per clinician per month. TheraNest also includes Ensai Notes Enhancement, which cleans up notes you’ve already written, on every plan at no cost. |
Verified October 15, 2026. Each row is an independent judgement, not a weighted score.
Why growth changes the decision
What your first hire adds to your week
Hiring a second clinician adds three things to your week:
- Twice the claims. At 80 claims a month per clinician, that’s 160 claims to submit and their payments to post.
- Someone else’s notes to review and sign, if your hire is pre-licensed.
- A shared calendar, shared rooms, and a cancellation policy that has to work the same way for both of you.
TheraNest Premier handles the routine billing steps: it creates invoices, submits eligibile claims, and posts payments from ERAs (the payment files payers send) that match your rules. Supervisor workflows, role-based permissions, and shared scheduling help your team stay organized, so you can focus on clients, clinical oversight, and the exceptions that need your attention.
Compare TheraNest vs SimplePractice
| TheraNest by Ensora Health | SimplePractice | |
|---|---|---|
Built for | Mental and behavioral health, solo through group practice | Health and wellness practitioners, solo and small practice |
Starting price | $29 per therapist per month ¹ | $49 per month ² |
Essentials $29, Advanced $59, Premier $89, per therapist per month | Starter $49, Essential $79, Plus $99 per month; $74 per additional clinician on Plus | |
Advanced: 50 claims and 50 eligibility checks per practice per month included, then $0.23 per claim and $0.25 per eligibility check. Premier: automated submission and ERA posting, unlimited under the Fair Usage Policy (500 claims and 500 eligibility checks per clinician per month). | As of October 1, 2026, claims start at $0.39 each on every plan, with lower rates at higher monthly volumes. Previously included claims on Essential and Plus ended on that date. | |
Free for new customers on Advanced and Premier: up to 3 payers per therapist on annual Premier and up to 2 on annual Advanced (2 and 1 on monthly plans). No commission. Starts once you’re on a paid plan. | Free for new customers: up to 2 payer applications per practice, handled by a partner, Medallion. Starts once you’re on a paid plan. | |
Admin and billing users | Unlimited, no extra cost, all plans | Plus only. Billers, schedulers, and supervisors included; practice managers $39 per month each |
Multi-clinician features
| Supervisor co-signature, role-based permissions, group practice reports, bookable rooms | Team members on Plus only; Starter and Essential support one clinician |
Waitlist and canceled slots
| No automatic waitlist fill. Clients can request your real-time openings in the client portal. Late-cancellation and no-show fees apply automatically by service type, and you can waive a fee. | Client waitlist on Essential and Plus. AutoFill offers a canceled time to up to the next 3 waitlist clients. |
AI notes | Ensai Notes Enhancement included on all plans; Ensai Session Assistant $35 per clinician per month. | Note Taker is a paid add-on that’s $35 per clinician per month. Care Aide (Note Taker plus Session Sidekick, Treatment Planner, and Client Summaries) $59 per month for the account owner and $49 per additional clinician. |
Unlimited individual and group telehealth included on Advanced and Premier; available on Essentials for $12 per therapist per month. | Included on all plans; group sessions on Plus, or $20 per month added to Essential. | |
E-prescribing
| Ensora eRx + PDMP add-on: $45 per therapist per month, plus a $135 one-time setup fee per practice. Includes electronic prescribing of controlled substances. | ePrescribe add-on, $49 per clinician per month plus an $89 one-time setup fee for each clinician. |
Billing team service | Ensora RCM Essentials is priced separately and adds a billing team that works alongside your practice on daily claim submission, ERA posting, and rejected-claim corrections. | Managed Billing: SimplePractice’s team handles in-network claims, rejections, denials, appeals, and resubmissions for practices on Plus, reportedly for 6% of insurance collections with a $750 monthly minimum. Out-of-network claims aren’t covered. Insurance Navigator ($1.79 per claim instead of $0.39) adds billing tools. |
Migration help
| Annual plans: the implementation team helps you export, format, and load client and staff data, then sets up your workflows. Monthly plans: import your data yourself at no cost, or have the migration team do it, from $199. Notes and billing data don’t transfer. | SimplePractice’s team creates client profiles from a template you fill in, usually within 1 to 3 business days. It moves basic client details only, with no appointments, notes, billing, or insurance information. |
21 days, no credit card required | 30 days, no credit card required | |
Contract | Monthly or annual; annual plans get 1 month free | Monthly; no contract required |
Other fees | $19.50 AMA CPT license fee per therapist per year, billed in December | $20 AMA CPT license fee per therapist per year. Manual insurance status checks $0.15 each on Starter and Essential as of October 1, 2026; included on Plus through March 31, 2027, then $0.15 on all plans. |
AI recording and transcripts | Recording stays off until you and the client agree to turn it on. Recordings are deleted within 48 hours of the note being finalized, and transcripts are deleted 8 hours after note finalization. | Transcripts kept up to 7 days or until the note is signed. Since June 17, 2026, de-identified transcripts may be retained to improve Note Taker unless you change the retention setting. |
Verified October 15, 2026 against each vendor's published pricing and product pages.
Which is cheaper, TheraNest or SimplePractice?
At a full-time insurance caseload of 80 claims per clinician per month, TheraNest Premier costs $41 to $103 less per month than SimplePractice Plus for practices of one to five clinicians, once SimplePractice’s claim fees are counted. TheraNest also has the lower starting price: Essentials is $29 per therapist per month, and SimplePractice Starter is $49 per month. Essentials covers scheduling, a client portal, basic forms and notes, and payments. Online booking, secure messaging, custom forms, and claims start at Advanced ($59 per therapist per month). As of October 1, 2026, SimplePractice charges for every submitted claim on every plan, and Essential and Plus no longer include free claims.
TheraNest pricing vs SimplePractice Pricing
| Practice size | TheraNest Premier | SimplePractice Plus with claim fees | TheraNest saves |
|---|---|---|---|
1 clinician | $89 per month | $130 per month | $41 per month |
2 clinicians | $178 per month | $235 per month | $57 per month |
5 clinicians | $445 per month | $548 per month | $103 per month |
Standard list prices, before add-ons. Illustrative only. Confirm current rates with both vendors.
If you also need practice manager seats on SimplePractice at $39 per month each (say one at two clinicians and two at five), TheraNest saves $96 and $181 per month instead. That’s $492 a year at one clinician, $1,152 at two, and $2,172 at five.
If you’re a solo and bill 50 or fewer claims a month, price TheraNest Advanced instead. Advanced ($59 per therapist per month) includes 50 claims and 50 eligibility checks per practice per month, with no per-claim fee unless you pass them. SimplePractice adds about $19.50 in claim fees for 50 claims on any plan.
Not included on either side: payment processing, TheraNest’s $19.50 annual AMA CPT license fee per therapist, SimplePractice’s $0.15 manual insurance status checks on Starter and Essential, SimplePractice’s $20 annual AMA license fee, AI add-ons ($35 per clinician per month on both), and e-prescribing.
Before you decide, add up the plan, the add-ons, and the fees you’d pay for your number of clinicians.
Does TheraNest or SimplePractice handle insurance billing better?
For a solo or growing practice that bills insurance, TheraNest Premier automates more of the billing work than SimplePractice, and it doesn’t charge per claim. Premier creates invoices, submits eligible claims, and posts payments from ERAs that match your rules.
As of October 1, 2026, SimplePractice charges for every submitted claim on every plan, and Essential and Plus no longer include free claims. SimplePractice can post insurance payments automatically, but you create and submit claims yourself, one at a time or in batches.
Payers change rules and reject claims for reasons outside your control; the question is how much of your week that takes. In TheraNest, a claim that fails the pre-check waits for you, a rejected claim shows its reason so you can fix and resubmit, and you can hold specific clinician and payer combinations for manual review. If you want help with the billing itself, Ensora RCM Essentials adds a billing team that works alongside your practice. It’s for practices with one to five clinicians, and pricing is quoted per practice.
SimplePractice’s closest option is Managed Billing, where its team handles in-network claims, denials, and appeals for practices on Plus. If you’d rather keep billing in-house, SimplePractice’s Insurance Navigator upgrade raises the claim fee from $0.39 to $1.79 and adds benefits checks, AI suggestions for fixing claims, payment entry from uploaded explanations of benefits (EOBs), and phone access to insurance specialists. You can also hire an independent billing company with either system. TheraNest lets you add your practice’s billers as free users on every plan, while SimplePractice includes billers on Plus only.
Is TheraNest or SimplePractice better for a group practice?
TheraNest is a better fit than SimplePractice for a group practice, whether you’re about to make your first hire or already have a team. You get supervisor co-signature, permissions set by role, shared schedules, and bookable rooms, and every plan includes unlimited admin users at no extra cost. SimplePractice only supports teams on its Plus plan, at $74 per month for each additional clinician and $39 per month for each practice manager.
If you employ pre-licensed clinicians, test the co-signature workflow in both trials: write a note, route it, and see what the supervisor sees and signs. Add a billing user too, and check what they can and can’t open. Then ask each vendor what supervisor and billing access cost at your number of clinicians, since that’s where the SimplePractice seat fees show up.
How do TheraNest and SimplePractice compare on AI documentation?
TheraNest and SimplePractice both offer AI notes at the same add-on price, $35 per clinician per month, and in both you review and sign before anything enters the record. TheraNest’s add-on is Ensai Session Assistant, which drafts a note from the session, and SimplePractice’s is Note Taker. SimplePractice also sells Care Aide, a bundle that adds Session Sidekick, Treatment Planner, and Client Summaries to Note Taker for $59 per month for the account owner and $49 for each additional clinician. TheraNest includes Ensai Notes Enhancement, which uses AI to clean up the wording, grammar, and abbreviations in a note you’ve already written, on every plan at no extra cost.
Ensai Session Assistant is consent-first: the client agrees before a session is recorded, recordings are deleted within 48 hours of the note being finalized, transcripts are deleted after 8 hours, and client data is never used to train AI models. Ensai Notes Enhancement records nothing; it only works on text you’ve already written. If AI notes are the reason you’re switching, price the add-on at your clinician count on both platforms, compare what each records and drafts during the trial, and ask each vendor to confirm in writing that its AI features are covered by its Business Associate Agreement (BAA).
TheraNest vs SimplePractice for AI notes
| Use case | TheraNest | SimplePractice |
|---|---|---|
Improve a note you typed yourself | Ensai Notes Enhancement. In any note field, click “Improve with AI.” Ensai cleans up the wording, fixes spelling and grammar, expands abbreviations, turns ICD-10 codes into written diagnoses, and turns bullet points into paragraphs. You accept or reject each suggestion. Included on every TheraNest plan. | No free equivalent. Note Taker, the $35 per clinician per month add-on, can draft a note from dictation or from an uploaded text or audio file. |
Note formats | Notes Enhancement works field by field in whatever TheraNest note template you use. Session Assistant drafts a SOAP-style summary (subjective, objective, mental status exam, interventions and modality, risk assessment, and plan) into the Session Summary field of your template, and you can copy sections into other formats. | Note Taker drafts SOAP, DAP, and BIRP notes and follows the format of your last note for that client. |
AI scribe: record the session and draft the note for you to review and sign | Ensai Session Assistant. $35 per clinician per month, 21-day trial. Records telehealth or in-person sessions with client consent and drafts the note for you to review, edit, and sign. Includes AI Case Summaries. Recordings are deleted within 48 hours of the note being finalized, transcripts are deleted after 8 hours, and client data is never used to train AI models. | Note Taker. $35 per clinician per month, 30-day trial. Transcribes SimplePractice telehealth sessions (up to 4 hours) or in-person sessions through the mobile app (up to 2.5 hours) and drafts a note for you to review and edit. Includes pre-session summaries. Transcripts stay for up to 7 days or until the note is signed. Since June 17, 2026, SimplePractice may keep de-identified transcripts to improve Note Taker unless you change the retention setting. |
When SimplePractice is the better choice
- You expect to stay solo and mostly private pay, and you want the quickest setup and a polished mobile and client-facing experience.
- You bill little or no insurance, so per-claim fees won’t add up and TheraNest’s billing automation won’t earn its price.
- You run a waitlist and want canceled hours refilled for you. On Essential and Plus, SimplePractice’s AutoFill offers a canceled time to up to the next three clients on your waitlist, so an opening can be filled without a phone call. TheraNest applies your cancellation fee automatically and lets clients request your open times through the portal, but it doesn’t offer a canceled slot to a waitlist for you.
- You want to learn from the largest community of therapists using the same software.
If neither TheraNest nor SimplePractice fits
Medicare clinicians who report MIPS
TherapyNotes sells a MIPS Reporting add-on ($359 per clinician per year) that sends quality measures for Medicare’s Merit-based Incentive Payment System to CMS through a behavioral health registry. TheraNest doesn’t offer MIPS reporting. Full comparison: TheraNest vs TherapyNotes.
Psychiatry and prescribing
Valant and ICANotes are built around medication management and electronic prescribing of controlled substances (EPCS), which TheraNest and SimplePractice offer as paid add-ons.
Substance use or residential programs
BestNotes supports ASAM Criteria (the American Society of Addiction Medicine’s level-of-care criteria) and 42 CFR Part 2, the federal confidentiality rule for substance use treatment records.
Is it hard to switch from SimplePractice to TheraNest?
No. Most practices move from SimplePractice to TheraNest in two to six weeks, though it can take longer if you have years of history to move. Your client list moves as data, your clinical history moves as files, and your SimplePractice website and Monarch listing (SimplePractice’s therapist directory) don’t move at all, so plan replacements before you cancel.
What moves as data. We help you import your client demographic records from SimplePractice: names, contact details, and the basics you need to schedule and bill. That import is included with an annual TheraNest plan. On a monthly plan, you can import the records yourself at no cost or have the migration team do it, from $199. Every plan includes a free 15-minute consultation with the migration team.
What moves as files. Progress notes, psychotherapy notes, treatment plans, intake questionnaires, invoices, superbills, and stored documents come out of SimplePractice in its complete data export as files, organized in folders. They don’t import into TheraNest as live records. You attach them to each client’s file in TheraNest so the history is there when you need it. Stored credit cards don’t transfer on any migration, so clients re-enter card details in the TheraNest client portal.
What has to be rebuilt. Future appointments, your intake forms, and your note templates. TheraNest includes standard intake forms on every plan and a custom form builder on Advanced and Premier, so you can rebuild your forms during setup.
How to switch from SimplePractice to TheraNest
- Run both SimplePractice exports before you touch anything else: the client list export and the complete data export. Only the account owner, or a practice manager with export permission, can do this. Open the files and check them.
- Start your TheraNest trial and send the client list to the migration team. Set your services, payers, and cancellation policy while the import runs.
- Pick a cutover date. Enter appointments from that date forward in TheraNest. Submit any claims that are ready in SimplePractice before the date, and work the rest from TheraNest.
- Attach the exported notes and documents to client files in TheraNest, and invite clients to the TheraNest client portal so they can re-enter payment details and complete anything outstanding.
- Don’t cancel SimplePractice until you’ve confirmed every open claim has been paid or resubmitted. Cancellation is immediate, and there’s no access afterward. If you want a bridge, SimplePractice’s help center notes you can drop to its Starter plan ($49 per month) to keep records accessible instead of canceling outright.
Your SimplePractice website and Monarch listing
If your website uses SimplePractice’s default domain, that address can’t move to another builder and goes away with the account. If you connected your own domain, disconnect it in SimplePractice and point it at a new site. Your Monarch directory profile is part of the SimplePractice account, so update your listings on the directories you’ll keep, such as Psychology Today, and put your TheraNest client portal and online booking link on your new site.
FAQ
Sources
TheraNest pricing, Ensora Health published rates. Verified October 14, 2026. https://ensorahealth.com/pricing/theranest-mental-health/
TheraNest Fair Usage Policy, Ensora Health. Verified October 14, 2026. ensorahealth.com/legal/fair-usage/
TheraNest automated billing, Ensora Health. Verified October 14, 2026. ensorahealth.com/product/theranest-mental-health/features/automated-billing/
Ensai data handling and consent, Ensora Health. Verified October 14, 2026. ensorahealth.com/ensai/
SimplePractice pricing, vendor published rates, and SimplePractice help center ("Subscription plan and pricing FAQs," "What's changing with insurance pricing?," "Insurance Essentials," "Note Taker FAQs," "Managing the client waitlist," "Scheduling and managing appointments"). Verified October 14, 2026. simplepractice.com/pricing
TherapyNotes pricing, vendor published rates. Verified October 14, 2026. therapynotes.com/pricing
Competitor pricing and feature details are sourced from the vendor's published materials on the verification date shown. Feature availability changes frequently and varies by plan tier – confirm current details directly with each vendor before deciding.
Revision history
October 14, 2026
Initial Publication