Medi vs SimplePractice

Short answer

SimplePractice is a behavioral-health and therapy EHR priced per clinician per month (Starter at $49, Essential at $79, Plus at $99), built for solo and group therapy practices that run their own scheduling, charting, telehealth, client portal, and billing in one place. It is owned by EngageSmart, taken private by Vista Equity Partners in January 2024 for $4 billion. Medi is a billing-company-first revenue cycle platform priced per client practice, with no EHR, no scheduling, and no per-clinician or per-provider fee. Both companies publish their pricing. These two products are not direct competitors. SimplePractice is for the therapy practice doing its own billing. Medi is for the billing company that bills on behalf of practices it does not own. At ten clinicians across two client practices, SimplePractice's Essential tier is $790 per month in seat fees before any per-claim charges. Medi's same two-practice book is $40 per month in practice fees ($20 each) plus EDI usage, typically $400 to $600 per month at that volume. The real question is not which costs less. It is who the buyer is.

Choose Medi if billing is your business

• You are a third-party billing company that manages revenue cycle for practices you do not own or operate.
• Your clients are responsible for their own EHR, scheduling, and charting, and they do not expect you to provide those.
• You need cross-practice denial queues, all-practices A/R views, and ERA review across your full book of clients on one screen.
• You want a fee structure where adding providers or clinicians inside an existing client practice never changes the bill, and where the per-practice rate falls as your book grows past 25 and 50 practices.
• You need practice-scoped and role-scoped permissions so an offshore posting team can reach the right clients and no others.
• Your clients span multiple specialties - primary care, orthopedics, mental health, physical therapy - and you need one system that covers all of them rather than a platform tuned for behavioral health.
• You want EDI pricing you can audit line by line: $0.25 first claim line, $0.20 each additional; $0.25 first paid ERA line, $0.20 each additional, $0 for denied ERA lines after the first.

Choose SimplePractice if the practice does its own billing

SimplePractice is a well-built product for what it is designed to do. It is the right choice in several real situations.

• The buyer is a therapy or behavioral health practice that runs its own front desk, does its own insurance billing, and wants scheduling, clinical notes, telehealth, client portal, and claims in one system.
• The practice is solo or small group - one to fifteen clinicians - and the per-clinician fee is manageable and transparent.
• The practice specializes in behavioral health, counseling, or therapy and values a platform built specifically for that clinical context: specialized intake forms, SOAP and DAP note templates, treatment plan workflows.
• Telehealth is a core delivery channel and the practice wants it native, not added through a third-party integration.
• The practice wants a client portal where clients can schedule, complete intake paperwork, and pay balances without calling the front desk.
• Clients want a recognized, certified platform: SimplePractice holds HITRUST CSF certification and markets HIPAA-compliant infrastructure to both practices and clients.

Pricing model

The arithmetic at a ten-clinician behavioral health group using SimplePractice Plus: $99 base plus nine additional seats at $74 each is $765 per month in plan fees, before any claim fees, before credit card processing, before the annual AMA CPT fee. Medi at those same ten providers across five client practices (a common billing-company structure) is $100 per month in practice fees ($20 per practice) plus EDI usage, typically $400 to $600 for a book that size at standard claim volumes. At 25 practices across a full book, Medi is $500 per month in practice fees plus EDI usage. Hiring more clinicians inside any of those practices does not add to the Medi bill. The comparison shifts materially at higher clinician counts, because SimplePractice's fee scales with every seat while Medi's does not.

That is not SimplePractice doing something wrong. It is a product that prices like a practice EHR, because that is what it is.

Billing-company architecture vs. practice-first design

SimplePractice is built around the individual practice as the tenant. Each practice account has its own calendar, client list, notes, portal, and billing configuration. If a billing company manages ten client practices, it operates ten separate SimplePractice accounts - or asks each practice to grant external-user access to theirs. There is no native cross-client work queue, no shared denial routing, and no aggregate A/R view across unrelated practices. A biller working denials for five clients cycles between five contexts, five client lists, five claim histories.

Medi is built the other way: 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 surfaces work across the full book by default, with practice-level filters to narrow when needed. The billing company sees all client practices in one place, and access controls limit what each team member or subcontractor can see by practice and by role.

This architectural difference has direct daily consequences:

• Where does a denial specialist work all fifteen clients' outstanding denials in the same sitting, without switching accounts?
• How does the owner see aggregate A/R aging for the whole book, not fifteen separate practice dashboards?
• What happens to cross-client posting continuity when a new client practice is onboarded - does it create a new isolated silo, or does it join the shared operator view?
• How are permission groups managed when one offshore posting contractor should see four practices but not the other eleven?

SimplePractice has no answer to these questions because they are not its design problem. Its design problem is how a therapy practice runs its clinical and administrative operations cleanly from one login. For that job, it works 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. Practices on Essential and Plus can submit electronic claims at $0.25 per claim. The platform tracks claim statuses, supports secondary claims, and handles ERA / remittance posting. For a solo therapist or a small group practice billing twenty to fifty claims per month, this is more than sufficient.

The gaps that show up at billing company scale are different:

SimplePractice does not publish ERA line-item pricing, PLB segment handling, or held-line exception policies. There is no described workflow for routing a contested ERA line to a denial specialist separate from the original poster. Payment posting controls visible in review-site screenshots reflect a practice-billing workflow - per-session payment entry, insurance payment allocation - rather than a bulk ERA review workflow.

Medi's ERA review surface is built for billing company volume: 835 remittances come in, the BPR footer shows the check total, each service line is held or auto-accepted based on configurable policy, CARC and RARC codes are translated to plain English, and PLB and recoupment segments appear as discrete entries rather than absorbed into the payment total. A biller reviews exceptions across all client practices in one pass, not one ERA at a time per practice.

For a single practice doing self-billing, SimplePractice's claims and ERA workflow is adequate. For a billing company whose posting team works 40 to 400 ERAs a month across diverse payers and clients, the depth of exception management and audit trail matters in ways a per-practice EHR is not designed to provide.

Questions to probe in any system demo, for either platform:

• Where does a held ERA line go, and who decides the resolution?
• How is a write-off tolerance configured 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 distinguish a denial from an underpayment from a payer adjustment at the service-line level?

Data portability and migration

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

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

Medi publishes its migration pricing. Migration is free with a 12-month commitment. On a month-to-month contract, migration is $100 per practice as a one-time fee, capped at $3,000. Data export from Medi is always free. There is no early-termination fee. The standard migration pattern is a legacy A/R closeout approach: 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. Those records preserve historical balance context without entering active work queues unless a specific action promotes them. The operational continuity challenge (open denial investigations, in-flight appeals, unposted ERAs) applies to any migration, not just moves to Medi, and no export format resolves it cleanly.

If your billing company manages practices that each have their own SimplePractice account, the migration question is whether each practice's clinical data stays in SimplePractice (which is fine - Medi has no EHR and does not need it) while billing operations move to Medi. That is the common shape: practices keep their EHR, billing company changes its operating layer. The clinical and billing data do not have to move together.

Security and audit posture

The tracking pixel allegation is worth noting for billing companies whose clients ask about patient privacy practices. The claim - that Meta, Google, and TikTok pixels on the authenticated client portal transmitted identifiers that, combined with device login state, constitute protected health information - was raised by class action attorneys at ClassAction.org. The HHS Office for Civil Rights has issued guidance that this combination can constitute PHI. As of March 2026, no public statement addressing the allegations has been found from SimplePractice. Billing companies advising clients who use SimplePractice for their patient portal should be aware this question is open.

Medi's security posture is the inverse on certifications: HITRUST and SOC 2 Type II are not claimed, while SimplePractice holds HITRUST. For a billing company that must respond to client security questionnaires that require HITRUST, this matters. Neither platform is a clear winner on the full security picture - they have different profiles.

Is Medi always a better fit than SimplePractice?

No. The honest answer here is that these products do not compete for the same buyer in most situations.

SimplePractice is a strong choice for a therapy or behavioral health practice that does its own billing and wants everything - scheduling, charting, telehealth, client portal, and insurance billing - from one system. Its HITRUST CSF certification is real. Its specialty-specific clinical workflows (SOAP notes, treatment plans, intake forms tuned for mental health) are features Medi does not have and does not try to have. For a solo therapist or a five-clinician counseling group, SimplePractice is well-designed for the job.

The comparison becomes genuinely relevant when a billing company is asked by a behavioral health client practice whether the billing company can "just use SimplePractice for the billing part." The answer is that SimplePractice's billing features work, but they are embedded in a per-practice, per-clinician-seat product that does not support the billing company operating across multiple client practices from a shared workspace. A billing company can access a client's SimplePractice account, but that does not give the billing company a cross-client view, shared denial routing, or practice-scoped permissions for its own team structure.

Medi loses the comparison when the client practice wants a single system that handles both clinical and billing operations, when HITRUST certification is a procurement requirement, or when the practice manages telehealth and client-portal workflows that need to stay tightly integrated with 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 similar in structure to SimplePractice.
• Medi vs athenahealth - cloud-based EHR and RCM for larger practice groups; higher cost, deeper payer network.
• Medi vs AdvancedMD - per-provider PM platform with a Central Billing Office offering for multi-client billing companies.
• Billing company software evaluation guide - the criteria that matter most when a billing company is choosing operating software, independent of any specific shortlist.

Frequently asked questions

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

Technically yes, but with meaningful operational friction. SimplePractice is structured around individual practice accounts. A billing company can receive access credentials from each client practice and log in to manage that practice's billing, but there is no native workspace where all client practices appear in a shared view. Denial routing, ERA review, and claim follow-up tasks are siloed per account. If you manage ten behavioral health practices, you work ten separate contexts. For a billing company that bills for more than two or three practices, the lack of a shared operator layer creates daily overhead that compounds as the book grows.

Does SimplePractice support billing companies as a customer type?

SimplePractice's product is designed for practices, not for the billing companies that service them. There is no published "billing company" tier, partner program, or multi-client workspace feature. Some billing companies do use SimplePractice on behalf of clients that require it, typically by accessing the client's own account. That is a client-driven requirement, not a SimplePractice product 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) plans only. Claims submit at $0.25 each, with volume tiers that reduce the rate above 250 claims per month. SimplePractice uses a built-in clearinghouse; you cannot substitute a different clearinghouse. ERA / 835 remittance posting works within the practice account, with payment allocation per session. Separate ERA line-item pricing, PLB segment handling, and held-line exception workflows are not described in SimplePractice's public support documentation. For the claim volume and posting complexity a billing company typically manages, verify these details directly before assuming the workflow matches your team's process.

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

SimplePractice's support documentation specifies a retention period of no more than 64 days after account cancellation, after which data is no longer accessible through the platform. The guidance is to complete a full data export before canceling. The export outputs client demographics as CSV and clinical records as per-client PDFs, but custom note templates, future scheduled appointments, and some billing record details require separate handling. See the SimplePractice data export article and cancellation article for current policy. For billing companies advising a client practice that is migrating off SimplePractice, plan the export and clinical records 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 that the HHS Office for Civil Rights has described as potentially constituting protected health information. The parent company EngageSmart was acquired by Vista Equity Partners in a transaction that closed in January 2024. As of March 2026, no public denial or resolution statement from SimplePractice has been located. See the published therapist-facing analysis for a detailed timeline. Billing companies advising behavioral health clients who use SimplePractice's client portal should be aware 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 compliance on its public pricing materials. HITRUST CSF incorporates requirements from HIPAA, ISO 27001, PCI, and NIST CSF. Medi does not claim HITRUST or SOC 2 Type II certification. For billing companies whose client contracts or procurement processes require HITRUST certification from software vendors in the workflow, this is a real difference to account for.

How current is this comparison?

Last reviewed 2026-06-03. 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/. Per-claim fee structure was cross-referenced with third-party pricing analysis. Ownership and acquisition context sourced from public reporting. Get current rates and contract terms directly from SimplePractice before any purchasing decision.

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For more on how Medi structures multi-practice operations, see billing company operations and the software evaluation guide. For a comparison against another per-provider practice-management platform with a more explicit billing-company offering, see Medi vs AdvancedMD.