SimplePractice Alternatives for Billing Companies

Short answer

SimplePractice is a well-built behavioral-health EHR for solo and small-group therapy practices that run their own scheduling, charting, telehealth, and billing. It is the wrong shape for a third-party billing company: it prices per clinician per month and structures each practice as a separate account, so a book of ten clients means ten logins with no shared denial queue, no cross-practice ERA review, and no aggregate A/R. For most billing companies the move is not to pull clients off SimplePractice at all. It is to leave SimplePractice for clinical work and run the billing layer on a platform built for it.

If your clients keep their EHR and you need the billing operator layer, a per-practice platform fits: Medi ($20 per client practice, no per-clinician fee) or CollaborateMD. If a client wants a behavioral-health EHR alternative for its own self-billing, TherapyNotes is the closest like-for-like. Office Ally covers the low-cost clearinghouse layer. No single platform wins every comparison, and this page names where each one earns the look.

Sources: G2 Medical Billing · Capterra Medical Billing Software · Software Advice Medical Billing

Why billing companies leave SimplePractice

SimplePractice is built for the practice, not the company that bills on its behalf. The mismatch shows up as the book grows.

• **Per-clinician pricing scales the wrong way.** Per SimplePractice's published pricing, Essential is $79 a month and Plus is $99, with added Plus seats at $74 each (seats 2-5), $72 (6-15), and $69 (16+). Your software cost rises every time a client hires a provider, whether or not that hire changes your workload.
• **No multi-practice operator view.** Each practice is a separate account. Ten clients means ten contexts, with denial work, ERA review, and follow-up siloed per account. There is no shared queue, aggregate denial trend, or single-screen A/R across the book.
• **Wrong fit for multi-specialty books.** SimplePractice is tuned for behavioral health: SOAP and DAP templates, mental-health intake, telehealth, a therapy-relationship client portal. A book spanning primary care, orthopedics, and physical therapy needs a platform that does not assume one specialty.
• **PE ownership and pricing trajectory.** Parent company EngageSmart was taken private by Vista Equity Partners for $4 billion in January 2024. Reviewers on G2 and Capterra have noted price increases since. Not disqualifying, but worth modeling into a multi-year cost projection.
• **Open client-portal privacy question.** In 2023, class action attorneys alleged SimplePractice embedded Meta, Google, and TikTok tracking pixels in its authenticated client portal, which combined with login state could transmit what HHS guidance treats as PHI. No public denial or resolution has been located as of March 2026. Billing companies whose clients use that portal should know this is unresolved.

None of this means moving every client off SimplePractice. Practices that do their own billing on it should keep it if it works. The question is narrower: whether SimplePractice should be the billing company's own operating layer. For that job, the architecture is the wrong fit.

The main options

SimplePractice

Worth saying plainly before the alternatives: SimplePractice is the right tool for a solo therapist or small behavioral-health practice that does its own billing. Starter at $49 a month covers scheduling, clinical notes, client portal, and telehealth; Essential at $79 adds insurance billing at $0.35 per claim; Plus at $99 drops the per-claim rate to $0.25 (above 250 claims per month it falls to $0.23). A billing company should not push a client off a clinical system that works just to simplify its own workflow.

The seat structure and per-account isolation are not flaws. They reflect what the product is: an EHR for practices, not an RCM platform for the companies that bill on their behalf. So the common path is for each client to keep SimplePractice for clinical work while the billing company runs the billing layer somewhere built for it. Medi has no EHR and does not try to replace those clinical tools, so the two coexist.

Compare Medi vs SimplePractice in detail

Medi

Medi is built for the billing company that bills across practices it does not own. The billing company is the primary tenant and each client practice is a scoped workspace inside one operator view, so denial queues, ERA review, follow-up, and A/R aging work across the full book by default, with practice filters to narrow when needed. That is the surface SimplePractice does not have, because a per-practice EHR is not designed to provide it.

Pricing is $20 per client practice per month, with volume pricing available, no per-clinician fee, and no contract. Claims route through Stedi at $0.70 each, flat, with ERA included, no separate remittance fee. The per-claim rate steps down to $0.65 from 501 to 5,000 claims a month and $0.55 beyond 5,000. Eligibility runs $0.25 per inquiry, claim status $0.20, and COB, insurance discovery, or claim attachments $1.50 each. 277CA acknowledgments and PDFs are included. Migration is free with a 12-month commitment or $100 per practice (capped at $3,000) month-to-month, data export is always free, and there is no termination fee.

Where Medi loses: it is not an EHR and does not chart, schedule, or run a patient portal. It is the wrong recommendation for a solo therapist doing their own billing, and it should never be positioned as a SimplePractice replacement for that buyer. The calculator models per-practice cost across volume tiers, the demo walks the cross-practice denial, ERA, and A/R surfaces, and the best medical billing software for billing companies roundup covers the wider field.

See full Medi pricing · Try the pricing calculator · Book a demo

TherapyNotes

TherapyNotes is the alternative most billing companies hear about when a behavioral-health client asks what else it could use instead of SimplePractice. It is a behavioral-health PM and EHR with SOAP and DAP templates, treatment plans, telehealth, scheduling, and a patient portal, comparable to SimplePractice in clinical scope.

Pricing is published: $69 a month solo, or $79 for the first clinician plus $50 per additional clinician for groups, with claims at $0.14 each versus SimplePractice's $0.25. At the same clinician count it often comes out cheaper, and reviewers consistently rate the behavioral-health workflows well. The caveat matches SimplePractice exactly: it is built for practices doing their own billing, with no multi-client workspace. Recommend it to behavioral-health clients who want a SimplePractice alternative for their own operations, not as your operating platform.

Tebra

Tebra, formed from the Kareo and PatientPop merger, is a PM and EHR aimed at independent medical practices outside behavioral health: primary care, urgent care, and specialty. For a book that mixes those with behavioral health, it comes up more naturally than TherapyNotes.

Tebra publishes its billing-tier pricing: Billing Starter runs $99 to $199 per provider per month at Tebra's pricing page, with fuller EHR bundles at $399 to $799. The per-provider model creates the same scaling pressure as SimplePractice. Tebra does have a Central Billing Office concept aimed at multi-practice billing, a real structural edge over SimplePractice and TherapyNotes, though how well it holds up at a billing company's scale is worth walking in a demo. Owners who used Kareo report the merger introduced workflow disruptions, so read current reviews first.

Compare Medi vs Tebra

Office Ally

Office Ally is a clearinghouse with a free basic PM, not a billing-company platform. It earns a mention because billing companies leaving SimplePractice often reach for it as a low-cost submission path while they evaluate full replacements.

Claim submission is free for in-network (par) payers; non-par enrollment is $44.95 per Tax-ID and NPI combination, the main cost to plan for. Practice Mate, the companion PM, is free and covers basic scheduling, demographics, and claim tracking for one practice. Cost and accessibility are where it genuinely wins, and it has real longevity in the market. What it lacks is the cross-practice operator view, denial depth, and ERA review a growing book needs. It never claimed to be an EHR or a full platform, so it will not disappoint on features it never had.

Compare Medi vs Office Ally

CollaborateMD

CollaborateMD is one of the few options here actually designed for the same buyer as Medi: a PM with an explicit billing-company offering, client-level access controls, claim tracking, and ERA posting across a book.

CollaborateMD does not publish pricing on its own site. A BestNotes partner price sheet lists about $0.38 per claim (declining with volume) and about $54 per provider (declining); the full billing-company tier is quote-required. You are comparing Medi's published schedule at /pricing against an estimate until you talk to their sales team. Probe the same things in a demo that you would anywhere: how granular the cross-practice denial and ERA workflows are, what the operator view looks like at 20 or 30 practices, and what migration on and off costs. Long market tenure gives it payer-connection depth and a support team that knows billing companies. The question is whether its architecture and pricing still fit the book you expect in two to three years.

Compare Medi vs CollaborateMD

How to choose your SimplePractice replacement

• **Who is replacing what?** If a client keeps SimplePractice for clinical work, that is separate from your choice of operating layer. You may not need to replace SimplePractice at all, just add a billing-company platform beside it.
• **Does the bill scale with providers or with client practices?** Per-provider pricing (SimplePractice, TherapyNotes, Tebra) grows every time a client hires a clinician. Per-practice pricing (Medi) grows only when you add a client. At higher provider counts the gap is large.
• **Can you see the whole book in one view, or one practice at a time?** Cross-practice denial queues, shared ERA review, and aggregate A/R are features, not defaults. Ask for a live demo of those exact surfaces.
• **Does specialty fit your book?** A behavioral-health platform (TherapyNotes) can create friction for primary care, orthopedics, or PT clients. Evaluate against your real client mix.
• **What does leaving cost?** Export fees, migration timelines, and termination clauses vary widely. Confirm them before signing.
• **What is the pricing history?** PE-owned platforms have a track record of post-acquisition increases. Not disqualifying, but model it into a three-year projection.

Frequently asked questions

Is SimplePractice ever the right choice for a billing company?

For the billing company's own operating platform, no. It is built for practices doing their own billing, not for third parties managing many clients. But your clients can keep SimplePractice for clinical work while you run billing on Medi: the practice holds the EHR, you hold the billing layer. Often the right call is not to force a clinical-tool migration at all.

What is the best SimplePractice alternative for a behavioral health billing company?

It depends on the buyer. If you are advising small behavioral-health practices on what to run themselves, TherapyNotes is the most direct SimplePractice alternative on clinical and pricing grounds. If you are the third-party billing company billing for those practices, Medi is built for that operator role and TherapyNotes is not. The split between "the practice's tool" and "the billing company's tool" is the deciding variable.

How much does SimplePractice cost for a billing company managing multiple practices?

There is no billing-company tier. If you log into each client's account, your cost is whatever each practice pays for its own plan, because you are not SimplePractice's customer in that arrangement, and running one account across multiple clients is not supported. Per SimplePractice's published pricing, Plus is $99 a month base with added clinician seats from $74. At ten clinicians the seat fees alone clear $700 a month, and that is one practice, not a book.

What is the SimplePractice tracking pixel issue and does it affect billing companies?

In 2023, class action attorneys alleged SimplePractice embedded Meta, Google, and TikTok pixels in its authenticated client portal, where login state plus those pixels could transmit what HHS guidance treats as PHI. No public resolution or denial has been located as of March 2026. The exposure for a billing company is mostly reputational: if you recommended that portal and a client asks how you vetted the tools their patients use, the open question becomes yours too. The compare page covers the security comparison in full.

Does Medi work for solo therapists or small behavioral health practices?

No. Medi is for third-party billing companies, not practices doing their own billing. A solo therapist who wants one platform for scheduling, notes, telehealth, and billing should look at SimplePractice, TherapyNotes, or TheraNest depending on price and feature priorities. Medi has none of those clinical tools and would be the wrong recommendation for a self-billing practice at any size.

How we sourced these prices

Pricing for other vendors comes from their public pricing pages where they publish one, and from third-party aggregators, reseller materials, and customer reports where they do not. Gated figures are approximate, may not reflect negotiated or current rates, and can change without notice, so confirm with each vendor directly. Where a vendor does not publish pricing, this page says so rather than presenting an estimate as fact. Medi's own pricing is published in full at /pricing.

Sources: SimplePractice Pricing · TherapyNotes Pricing · G2 Medical Billing · Capterra Medical Billing Software · SimplePractice HITRUST Press Release · Tracking pixel analysis