Best SimplePractice Alternatives (2026)

Best SimplePractice Alternatives for Billing Companies (2026)

Short answer

SimplePractice is a well-built EHR and practice management platform for behavioral health and therapy clinicians. If you are a solo therapist or a small group practice running your own scheduling, notes, telehealth, and insurance billing, it is a reasonable choice and no alternative roundup should talk you out of it.

The story is different for a third-party billing company. SimplePractice is priced per clinician per month and designed around a single practice tenant. There is no shared operator view that spans multiple client practices, no cross-practice denial queue, and no aggregate A/R aging for a full book of clients. The Vista Equity Partners acquisition in January 2024 has been accompanied by price increases that reviewers have noted, and allegations from class action attorneys that third-party tracking pixels from Meta, Google, and TikTok appeared in the authenticated client portal remain publicly unresolved as of March 2026. Those factors matter differently to a billing company advising clients than they do to a solo clinician who chose SimplePractice themselves.

The alternatives below are the tools a billing company would realistically evaluate after deciding SimplePractice is not the right operating layer for the billing side of the business. They cover different categories: purpose-built billing company platforms, behavioral-health practice management, general practice management, and clearinghouse-as-system approaches. No single platform wins every comparison honestly, and this list names where each one genuinely earns the look.

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

Why billing companies look for a SimplePractice alternative

SimplePractice is designed for the practice, not the company that bills on its behalf. That distinction shows up in concrete operational friction every day.

**Per-clinician pricing scales the wrong way.** Per SimplePractice's published pricing page, Essential is $79 per month and Plus is $99 per month for the base account. Additional clinician seats on Plus run $74 each for seats two through five, $72 for seats six through fifteen, and $69 for sixteen or more. For a solo clinician, that is transparent and reasonable. For a billing company managing ten client practices at varying headcounts, the billing company's software cost rises every time any client hires a new provider, whether or not that additional hire changes the billing company's workload meaningfully.

**No multi-practice operator view.** SimplePractice structures each practice as a separate account. A billing company that manages ten behavioral health practices operates in ten separate SimplePractice contexts. Denial work, ERA review, and claims follow-up require switching between accounts. There is no native shared queue where all client practices appear together, no aggregate denial trend, and no single-screen A/R aging for the full book.

**Vista Equity acquisition and pricing trajectory.** EngageSmart, SimplePractice's parent company, was acquired by Vista Equity Partners for $4 billion in a transaction that closed in January 2024. Vista Equity is a large private equity firm with a documented pattern of raising prices in acquired software businesses over a multi-year ownership period. Pricing changes since the acquisition have been noted by reviewers on G2 and Capterra. This is not a reason to panic, but it is a factor worth weighting when choosing a platform you expect to use for years.

**Client portal tracking pixel concern.** In 2023, class action attorneys alleged that SimplePractice embedded third-party tracking pixels from Meta, Google, and TikTok in its authenticated client portal. The allegation is that these pixels, combined with device login state, transmitted information that the HHS Office for Civil Rights has described as potentially constituting protected health information. As of March 2026, no public denial or resolution statement from SimplePractice has been located. Billing companies whose clients use SimplePractice's patient-facing portal should know this question is open.

**Wrong fit for multi-specialty books.** SimplePractice is tuned for behavioral health, counseling, and therapy: SOAP and DAP note templates, mental health intake forms, telehealth delivery, and a client portal built around the therapy relationship. A billing company managing practices in primary care, orthopedics, physical therapy, and mental health together needs something that does not assume a single specialty shape.

None of these are reasons to recommend a billing company move every client off SimplePractice. Practices doing their own billing through SimplePractice should keep doing so if it works for them. The decision for a billing company is whether to use SimplePractice as the billing company's own operating platform, and for that specific use case, the architecture is not the right fit.

The main options

SimplePractice

Before the alternatives: SimplePractice is genuinely the right tool for a solo therapist or a small behavioral health practice running its own billing. The Starter plan at $49 per month gives a solo clinician scheduling, clinical notes, a client portal, and telehealth. Essential at $79 per month adds insurance billing at $0.25 per claim. The product is well-designed for that job, and a billing company should not pressure a client to leave a system that works for their clinical operations just to make the billing company's workflow simpler.

Where SimplePractice becomes the wrong tool is when the buyer is a billing company rather than the practice. The per-clinician seat structure, the per-account isolation, and the absence of any cross-practice operator layer are not deficiencies in SimplePractice's design. They reflect what SimplePractice is: an EHR for practices, not an RCM platform for the companies that bill on their behalf.

For a billing company managing behavioral health clients, the realistic path is for each practice to keep SimplePractice for clinical operations (scheduling, charting, telehealth, client portal) while the billing company uses a separate platform for the billing layer. Medi has no EHR and does not try to replace SimplePractice's clinical tools. The two can coexist.

Compare Medi vs SimplePractice in detail

Medi

Medi is built for the billing company managing many client practices, not for a single practice. The billing company is the primary tenant, and each client practice is a scoped workspace inside a shared operator view. Denial queues, ERA review, follow-up tasks, and A/R aging all work across the full book by default, with practice-level filters to narrow when needed.

On the claims side, Medi routes through Stedi as its clearinghouse. EDI pricing is published line by line: $0.25 for the first claim line, $0.20 for each additional; $0.25 for the first paid ERA line, $0.20 for each additional paid line, and $0 for denied ERA lines after the first; $0.20 per eligibility or claim status inquiry; $1.00 each for COB, insurance discovery, and attachments. There is no per-clinician fee. A client practice that adds five providers does not change the billing company's Medi bill.

Pricing is $20 per client practice per month, with graduated volume discounts: 26 to 50 practices at $15 each, 51 and above at $10 each. Migration is free with a 12-month commitment, or $100 per practice one-time on a month-to-month basis, capped at $3,000. Data export from Medi is always free. There is no early-termination fee.

Where Medi is not the right answer: it has no EHR, no scheduling, no clinical notes, and no patient portal. It does not replace what SimplePractice does for the clinician. It handles revenue cycle for the billing company operating across client practices. For a solo therapist running their own billing, Medi is not designed for that use case and should not be positioned as a SimplePractice replacement for someone in that situation.

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

TherapyNotes

TherapyNotes is the alternative most billing companies encounter when a behavioral health practice asks "what else could we use besides SimplePractice?" It is a practice management and EHR platform built specifically for behavioral health, with SOAP and DAP note templates, treatment plan workflows, telehealth, scheduling, and a patient portal. The clinical feature set is comparable to SimplePractice with a few differences in design philosophy and note template flexibility.

Pricing is published on the TherapyNotes website. The solo plan is $69 per month. Group practices pay $79 per month for the first clinician and $50 per month for each additional clinician. Claim submission is $0.14 per claim, which is lower than SimplePractice's $0.25 per claim. For a small group practice, TherapyNotes often comes out less expensive than SimplePractice at the same clinician count, and reviewers on G2 and Capterra consistently note satisfaction with the behavioral-health-specific clinical workflows.

The caveat for billing companies is the same as with SimplePractice: TherapyNotes is built for practices doing their own billing, not for a third-party billing company operating across many clients. There is no multi-practice billing company workspace. A billing company that manages ten TherapyNotes practices operates in ten accounts with no shared denial queue or cross-practice ERA review. TherapyNotes is worth recommending to behavioral health client practices that want a SimplePractice alternative for their own operations. It is not the billing company's operating platform.

Tebra

Tebra, the company formed from the Kareo and PatientPop merger, is a practice management and EHR platform built primarily for independent medical practices outside behavioral health: primary care, urgent care, and specialty medical. For billing companies that manage a broad client mix including primary care and specialty alongside behavioral health practices, Tebra comes up more naturally than TherapyNotes.

Tebra does not publish its pricing. Third-party reviewers and reseller materials cite a range of roughly $99 to $399 per provider per month, though these figures are second-hand and should be verified directly. The per-provider pricing model creates the same scaling pressure as SimplePractice for a billing company: cost rises with each new provider hire at any client practice, regardless of the billing company's actual workload increase.

For the billing company specifically, Tebra has a "Central Billing Office" concept that is designed for multi-practice billing management, which is a genuine structural differentiator over SimplePractice and TherapyNotes. How well that feature set actually supports a billing company's operational workflow at scale is worth verifying in a Tebra demo. Billing companies that have worked with both Tebra and its predecessor Kareo report that the merger integration introduced some workflow disruptions, so current reviews are worth reading before committing.

Compare Medi vs Tebra

Office Ally

Office Ally occupies a different category from the other options on this list. It is primarily a clearinghouse, not a practice management or billing company platform, and it is worth naming because billing companies moving off SimplePractice often reach for it as a lower-cost submission path while they evaluate full PM replacements.

Claim submission through Office Ally is free for in-network (par) payers. Non-par payer enrollment is $44.95 per Tax-ID and NPI combination, which is the main cost to account for. Practice Mate, Office Ally's companion PM tool, is free and covers basic scheduling, patient demographics, and claim tracking for a single practice. It is functional for very small practices or billing companies with a minimal book, but it does not have the cross-practice operator view, denial management depth, or ERA review workflow that a growing billing company needs.

Where Office Ally genuinely wins is cost and accessibility. For a billing company that is early in building its book, that manages clients who submit claims infrequently, or that needs a stopgap submission path while transitioning to a full platform, Office Ally is a practical option with real longevity in the market. It is not trying to be an EHR or a full billing company platform, which means it will not disappoint on features it never claimed to have.

Compare Medi vs Office Ally

CollaborateMD

CollaborateMD is a practice management platform with an explicit billing company offering, which makes it one of the few alternatives on this list that is actually designed for the same buyer as Medi. It positions itself toward multi-practice billing operations, with client-level access controls, claim tracking, and ERA posting across a book of clients.

CollaborateMD does not publish its pricing on its website. Aggregators and reseller references cite approximately $225 per month plus per-claim fees for standard accounts, but these figures are third-hand and CollaborateMD's billing company pricing is quote-required. Contact them directly for current rates. For pricing transparency comparison purposes: Medi publishes its full rate schedule at /pricing and CollaborateMD does not, which means you are comparing a known number against an estimate before you talk to their sales team.

The areas to probe in a CollaborateMD demo: how granular are the cross-practice denial and ERA workflows, what does the billing company operator view actually look like at 20 or 30 client practices, and what does migration onto and off the platform cost? The product has been in the market for a long time, which gives it payer connection depth and a support team familiar with billing company operations. The question is whether the platform's architecture and pricing still make sense at the book size you expect to reach in two to three years.

How to choose your SimplePractice replacement

The practical questions for a billing company evaluating these options:

• **Who is actually replacing what?** If the practice wants to keep SimplePractice for clinical operations (scheduling, notes, telehealth), that is separate from the billing company choosing its operating layer. You may not need to replace SimplePractice at all; you may need to add a billing company platform alongside it.
• **Does pricing scale with providers or with client practices?** Per-provider pricing (SimplePractice, TherapyNotes, Tebra) grows every time any client hires a new clinician. Per-practice pricing (Medi) grows only when you add a new client practice. At higher provider counts, the difference is substantial.
• **Can you see all client practices in one view, or one at a time?** This is the daily workflow question. Cross-practice denial queues, shared ERA review, and aggregate A/R aging are features, not assumptions. Ask for a live demo of those surfaces specifically.
• **What happens to specialty fit?** If your book includes behavioral health, primary care, orthopedics, and physical therapy, a platform tuned for behavioral health (TherapyNotes) may create friction for the non-behavioral-health clients. Evaluate against your actual client mix.
• **What does leaving cost?** Data export fees, migration timelines, and early-termination clauses vary significantly. Confirm these before signing anything.
• **How does the vendor's pricing history look?** PE-owned platforms have a documented track record of post-acquisition price increases. That is not automatically disqualifying, but it is a variable worth modeling into a three-year cost projection.

Where Medi fits

Medi's honest niche is the third-party billing company that manages revenue cycle for a book of client practices it does not own, where the daily work is claims, ERA posting, denial follow-up, and A/R aging across those practices in a shared operator view. The pricing model is designed for that business: per client practice, not per provider, with volume discounts as the book grows.

What Medi is not: it is not an EHR, it does not do scheduling, clinical notes, telehealth, or patient portals. It does not replace what SimplePractice provides to a behavioral health clinician, and it should not be presented to a solo therapist as a SimplePractice alternative for their own practice operations. It is for the billing company, not the practice.

For a billing company that wants to evaluate whether Medi fits the book you have today and the book you expect in two years, the pricing calculator models per-practice costs across volume tiers. The demo shows the cross-practice denial, ERA, and A/R workflow directly. For the broader decision across more vendors, the best medical billing software for billing companies roundup covers the full platform landscape.

Frequently asked questions

Is SimplePractice ever the right choice for a billing company?

For the billing company's own operating platform, no. SimplePractice is designed for practices doing their own billing, not for third-party billing companies managing multiple client practices. That said, a billing company's clients may use SimplePractice for clinical operations, scheduling, and charting, and that is fine. Medi and SimplePractice can coexist: the practice keeps SimplePractice for clinical, and the billing company uses Medi for the billing layer. The decision is whether to force a clinical-tool migration, and often the answer is not to.

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

It depends on the book. If most clients are small behavioral health practices doing their own billing (and you are advising on what they should use), TherapyNotes is the most direct SimplePractice alternative on clinical and pricing grounds. If you are a third-party billing company that bills for behavioral health practices, Medi is built for that operator role and TherapyNotes is not. The distinction 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?

SimplePractice does not have a billing company tier. If you access each client's account individually, your cost is whatever each practice pays for its own SimplePractice plan, because you are not SimplePractice's customer in that arrangement. If you tried to use a single SimplePractice account to manage multiple clients, that is not a supported use case. Per SimplePractice's published pricing, Plus runs $99 per month for the base account with additional clinician seats from $74 each. At ten clinicians, the seat fees alone are over $700 per month before any claim charges, and that is for one practice, not a book of clients.

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

In 2023, class action attorneys alleged that SimplePractice embedded tracking pixels from Meta, Google, and TikTok in its authenticated client portal, and that the combination of those pixels with device login state could constitute a HIPAA violation under HHS guidance. As of March 2026, no public resolution or denial statement from SimplePractice has been located. The direct exposure for a billing company is reputational: if clients ask whether the billing company vetted the tools their patients are using, and the billing company recommended SimplePractice's portal, the question becomes relevant. Billing companies advising behavioral health clients on platform choice should be aware that this is open. See the compare page for a fuller treatment of the security comparison.

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

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

A note on the pricing figures here

The pricing shown for other vendors is gathered from their public pricing pages where they publish one, and from third-party aggregators, reseller materials, and customer reports where they do not. Many of these vendors do not publish their pricing, so these figures are approximate, may not reflect negotiated or current rates, and can change without notice. Treat them as a starting point and confirm current pricing with each vendor directly. Where a vendor does not publish its 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