Medi vs SimplePractice

Short answer

SimplePractice and Medi are not direct competitors, so the choice comes down to who the buyer is. SimplePractice is a behavioral-health and therapy EHR priced per clinician (Starter $49, Essential $79, Plus $99 per month), built for the solo or group therapy practice that runs its own scheduling, charting, telehealth, client portal, and billing in one place. Medi is a billing-company-first revenue cycle platform priced per client practice, with no EHR layer and a flat per-practice fee. Both companies publish their pricing. Pick SimplePractice if the practice does its own billing; pick Medi if you are the billing company billing on behalf of practices you do not own. Cost tracks that split: on SimplePractice, multi-clinician practices need the Plus plan and seat fees climb with headcount (a ten-clinician group is $99 base plus nine added seats, $755 a month before any claim charges), while the same providers spread across a billing company's book run $20 per practice plus per-claim EDI.

Sources: simplepractice.com/pricing · Medi pricing

Choose Medi if billing is your business

• You are a third-party billing company running revenue cycle for practices you do not own.
• Your clients keep their own EHR, scheduling, and charting and do not expect those from you.
• You need cross-practice denial queues, all-practices A/R, and ERA review across your full book on one screen.
• You want a fee that does not move when a client hires another provider.
• You need practice-scoped and role-scoped permissions so an offshore posting team reaches the right clients and no others.
• Your clients span specialties beyond behavioral health (primary care, orthopedics, physical therapy) and you want one system that covers all of them.
• You want EDI pricing you can verify: $0.70 per claim submitted (flat, line-blind, ERA included), with volume steps at $0.65 and $0.55; $0.25 per eligibility check; $0.20 per claim status check; $1.50 per COB, discovery, or attachment transaction. Published at /pricing.

Choose SimplePractice if the practice does its own billing

SimplePractice is well-built for the job it is designed for. It is the right choice in several real situations.

• The buyer is a therapy or behavioral health practice that runs its own front desk and insurance billing and wants scheduling, notes, telehealth, client portal, and claims in one system.
• The practice is solo or a small group of one to fifteen clinicians, where the per-clinician fee stays manageable.
• The practice values clinical workflows built for mental health: specialized intake forms, SOAP and DAP note templates, treatment plans.
• Telehealth is a core delivery channel the practice wants native, not bolted on through a third party.
• The practice wants a client portal where patients schedule, complete intake, and pay balances without calling the front desk.
• The buyer needs a certified platform: SimplePractice holds HITRUST CSF certification and markets HIPAA-compliant infrastructure to practices and clients.

Pricing model

The arithmetic for a ten-clinician behavioral health group on SimplePractice Plus: $99 base plus nine added seats, four at $74 (seats 2-5) and five at $72 (seats 6-10), is $755 a month in plan fees, before claim fees, credit card processing, or the annual AMA CPT fee. Medi for those same ten providers spread across five client practices (a common billing-company shape) is $100 a month in practice fees plus EDI usage, typically $400 to $600 for a book that size at standard volume. Hiring more clinicians inside any client practice never adds to the bill. The gap widens with every seat, because SimplePractice's fee scales with headcount and Medi's does not.

This is not SimplePractice doing anything wrong. It prices like a practice EHR because that is what it is.

Billing-company architecture vs. practice-first design

SimplePractice treats the individual practice as the tenant. Each account has its own calendar, client list, notes, portal, and billing configuration. A billing company managing ten client practices runs ten separate SimplePractice accounts, or asks each practice to grant external-user access to its own. SimplePractice has no cross-client work queue: denial routing and A/R live inside each separate account, never aggregated across unrelated practices. A biller working denials for five clients cycles through five logins, five client lists, five claim histories.

Medi inverts that. The billing company is the primary tenant, and each client practice is a scoped workspace inside it. Denial queues, ERA review, follow-up tasks, and A/R aging span the full book by default, with practice filters to narrow when needed. The owner sees every client in one place, and access controls limit what each team member or subcontractor sees by practice and by role.

The difference shows up in daily questions a demo should answer:

• Where does a denial specialist work all fifteen clients' denials in one sitting, without switching accounts?
• How does the owner see A/R aging for the whole book instead of fifteen separate dashboards?
• When a new client is onboarded, does it become another isolated silo or join the shared operator view?
• How are permissions set when one contractor should see four practices and not the other eleven?

SimplePractice has no answer because this is not its problem. Its problem is helping a therapy practice run clean from one login, and it does that well. For a billing company, the architecture is the wrong shape.

Claims, ERA posting, and denial management

SimplePractice handles insurance billing through a built-in clearinghouse. Essential plan practices submit claims at $0.35 each (after 10 included per month); Plus plan practices pay $0.25 each (after 35 included, dropping to $0.23 above 250 per month). The platform tracks statuses, supports secondary claims, and posts ERA remittances. For a solo therapist or small group billing twenty to fifty claims a month, that is more than enough.

At billing-company scale the gaps are different. SimplePractice does not publish ERA line-item pricing, PLB segment handling, or held-line exception policy. There is no described workflow for routing a contested ERA line to a denial specialist separate from the original poster. The posting controls visible in review-site screenshots reflect a practice workflow, per-session payment entry and insurance allocation, not a bulk ERA review pass.

Medi's ERA surface is built for that volume. The 835 comes in, the BPR footer shows the check total, each service line is held or auto-accepted by configurable policy, CARC and RARC codes are translated to plain English, and PLB and recoupment segments appear as discrete entries instead of being absorbed into the payment total. A biller clears exceptions across every client practice in one pass.

For a single practice billing its own claims, SimplePractice's workflow is adequate. For a posting team working 40 to 400 ERAs a month across diverse payers and clients, the depth of exception handling and the audit trail matter in ways a per-practice EHR is not built to provide. Worth probing in either demo:

• Where does a held ERA line go, and who decides the resolution?
• How is write-off tolerance set per practice and per payer, and who can change it?
• How is every posting decision logged: who posted what, when, at what authority level?
• How does the system tell a denial from an underpayment from a payer adjustment at the line level?

Data portability and migration

SimplePractice's export outputs client demographics and appointment history as CSV and clinical records as per-client PDFs. It is all-or-nothing: you cannot filter to a date range or a clinician set. Custom note templates, assessment forms, and future scheduled appointments do not export and must be rebuilt in the destination system, and billing and payment records require a separate export step.

After cancellation, SimplePractice support documentation states a retention period of no more than 64 days, after which data is no longer accessible. The guidance is to run a full export before canceling. See the SimplePractice cancellation article for current terms.

Medi publishes its migration pricing. Migration is free with a 12-month commitment, or $100 per practice as a one-time fee (capped at $3,000) month-to-month. Export from Medi is always free, and there is no early-termination fee. The standard pattern is a legacy A/R closeout: leave the last 60 to 90 days of active claim work in the source system, start Medi forward-only, and import historical claim ledgers as reference-only records that preserve balance context without entering work queues unless an action promotes them. The continuity challenge of open denial investigations, in-flight appeals, and unposted ERAs applies to any migration, not just moves to Medi, and no export format resolves it cleanly.

If your clients each have their own SimplePractice account, the real question is narrower: their clinical data can stay in SimplePractice while billing operations move to Medi. Medi has no EHR and does not need that data. That is the common shape, where practices keep their EHR and the billing company changes its operating layer. The two do not have to move together.

Security and audit posture

The tracking-pixel allegation matters for billing companies whose clients ask about patient privacy. Class action attorneys at ClassAction.org alleged that Meta, Google, and TikTok pixels on the authenticated client portal transmitted identifiers that, combined with device login state, constitute PHI under HHS Office for Civil Rights guidance. As of March 2026 no public response from SimplePractice has been found. If you advise clients who use the SimplePractice portal, treat the question as open.

On certifications the picture inverts: SimplePractice holds HITRUST while Medi claims neither HITRUST nor SOC 2 Type II. For a billing company that must answer client security questionnaires requiring HITRUST, that difference is real. Neither platform wins the full security picture; the profiles are simply different.

Is Medi always a better fit than SimplePractice?

No. In most situations these products do not compete for the same buyer.

The comparison gets real when a behavioral health client asks whether the billing company can "just use SimplePractice for the billing part." The billing features work, but they live inside a per-practice, per-seat product that has no shared workspace across multiple clients. Accessing a client's account does not hand the billing company a cross-client view, shared denial routing, or permissions scoped to its own team.

Medi loses outright when the practice wants one system for both clinical and billing work, when HITRUST is a procurement requirement, or when telehealth and client-portal workflows need to stay tightly bound to billing data.

Other comparisons billing companies look at

• Medi vs Tebra: another per-provider practice-management platform, more common in primary care and specialty medical than behavioral health.
• Medi vs DrChrono: EHR-plus-billing with mobile-first design and per-clinician pricing structured much like SimplePractice.
• Medi vs athenahealth: cloud EHR and RCM for larger groups, with higher cost and a deeper payer network.
• Medi vs AdvancedMD: per-provider PM platform with a Central Billing Office option for multi-client billing companies.
• Billing company software evaluation guide: the criteria that matter most when choosing operating software, independent of any shortlist.
• Best SimplePractice alternatives for billing companies — the full field of options beyond the head-to-head pages.

Frequently asked questions

Can a billing company use SimplePractice to manage multiple client practices?

Technically yes, but with real friction. SimplePractice is structured around individual practice accounts. You can take access credentials from each client and log in to manage that practice's billing, but there is no native workspace where all clients appear in a shared view. Denial routing, ERA review, and follow-up tasks are siloed per account, so ten behavioral health clients mean ten separate contexts. Past two or three practices, the missing operator layer creates daily overhead that compounds as the book grows.

Does SimplePractice support billing companies as a customer type?

SimplePractice is built for practices, not for the billing companies that service them. There is no published billing-company tier, partner program, or multi-client workspace. Some billing companies do use it on behalf of a client that requires it, typically by logging into the client's own account. That is a client-driven requirement, not a SimplePractice strategy for billing companies.

How does SimplePractice handle insurance claim submission and ERA posting?

Insurance billing is available on Essential ($79/month) and Plus ($99/month) only. Essential charges $0.35 per claim after 10 included; Plus charges $0.25 per claim after 35 included, with the rate dropping to $0.23 above 250 claims a month. SimplePractice uses a built-in clearinghouse you cannot swap out. ERA 835 posting works inside the practice account, with payment allocated per session. Separate ERA line-item pricing, PLB segment handling, and held-line exception workflows are not described in its public support documentation. For the volume and posting complexity a billing company runs, verify these directly before assuming the workflow fits your team.

What happens to SimplePractice data if a practice cancels the account?

SimplePractice support documentation specifies a retention period of no more than 64 days after cancellation, after which data is no longer accessible through the platform. The guidance is to complete a full export first. That export gives you client demographics as CSV and clinical records as per-client PDFs, but custom note templates, future scheduled appointments, and some billing detail need separate handling. See the SimplePractice data export article and cancellation article for current policy. If you are helping a client migrate off SimplePractice, plan the export and clinical handoff well before the cancellation date.

What is the SimplePractice tracking pixel concern about?

In 2023, class action attorneys at ClassAction.org alleged that SimplePractice embedded third-party tracking pixels from Meta, Google, and TikTok in its client portal, the authenticated area where clients book appointments, complete intake forms, and message their therapists. The allegation is that those pixels, combined with device login state, transmitted information the HHS Office for Civil Rights has described as potentially constituting protected health information. Parent company EngageSmart was acquired by Vista Equity Partners in a deal that closed in January 2024. As of March 2026 no public denial or resolution from SimplePractice has been located. See the therapist-facing analysis for a detailed timeline. If you advise behavioral health clients who use the SimplePractice portal, know that this question is not publicly resolved.

Does SimplePractice hold HITRUST certification?

Yes. SimplePractice has achieved HITRUST CSF certification, which it lists alongside HIPAA and PCI on its public pricing materials. HITRUST CSF folds in requirements from HIPAA, ISO 27001, PCI, and NIST CSF. Medi claims neither HITRUST nor SOC 2 Type II. If your client contracts or procurement require HITRUST from vendors in the workflow, that is a real difference to account for.

How current is this comparison?

Last reviewed 2026-06-07. SimplePractice's pricing, plan structure, and feature availability change. The primary sources for current product and pricing are simplepractice.com/pricing/ and simplepractice.com/pricing/compare-plans/. The per-claim fee structure was cross-referenced with third-party pricing analysis, and ownership context comes from public reporting. Get current rates and contract terms directly from SimplePractice before any purchasing decision.

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For how Medi runs multi-practice operations, see billing company operations and the software evaluation guide. To model your own book, use the pricing calculator or book a demo.