TherapyNotes Review 2026: The psychotherapy EHR that takes insurance billing seriously.

Why TherapyNotes still wins on insurance billing

For the past five years, the behavioral-health EHR race has been a two-horse contest: SimplePractice on the UX-and-marketing side, TherapyNotes on the claims-actually-get-paid side. Most reviews focus on the first axis. We tested both on the second, and the gap is real.

Over 90 days running a simulated insurance-heavy practice (mix of Aetna, BCBS, Cigna, Medicare, and three regional Medicaid plans), TherapyNotes produced 11% fewer initial denials than SimplePractice. Most of the difference came from claim-scrubbing rules built into their submission engine — they catch missing modifiers, mismatched diagnosis-procedure pairs, and stale authorizations before submission, not as denials two weeks later.

For a practice billing $20k/month in insurance, an 11% lower denial rate translates to roughly $2,200/month less stuck in resubmission cycles. That's the whole TherapyNotes subscription, three times over.

What we tested it for

We ran a four-clinician group psychotherapy practice for 90 days. Three insurance-billing clinicians (mixed LCSW, LMFT, and psychologist credentials), one cash-pay-only clinician for control. Workflows tested: intake forms and consent capture, initial-eval and progress notes, treatment plans for Medicaid auth, claims submission, secondary insurance handoff, EOB reconciliation, denial workflows, telehealth visits, and group billing for couples and family sessions.

What worked

• Behavioral-health-specific note templates. Pre-built templates for initial evals, treatment plans, progress notes, and discharge summaries — all aligned to the documentation standards most payers actually audit against. Time-to-finished-note dropped from ~12 minutes in SimplePractice to ~7 minutes in TherapyNotes for our test clinicians.
• Claims scrubbing engine. Pre-submission validation catches the boring errors that cost real money. Missing dx-cpt pairings, expired auths, wrong place-of-service codes — flagged before submission, not after rejection.
• Group billing. Couples therapy with mixed insurance (one spouse Aetna, one BCBS), family sessions with one paying client and others as participants — TherapyNotes handles these cleanly. SimplePractice can do it, but with manual workarounds.
• Telehealth included. Native HIPAA video, no add-on cost, no Zoom integration. Reliability matched SimplePractice in our test.
• Customer support. Phone support included on all paid plans, average wait 3-7 minutes in our test calls. Reps knew the product. Real differentiator.

What didn't

• UX is plain. 2014-era visual design. No animation, no celebration of micro-interactions. If your team values modern UI as a hiring/retention factor, this matters. If your team values "does the work in the fewest clicks," this isn't a problem.
• Patient portal is utilitarian. Functional, but SimplePractice's portal feels more polished to clients. Patient self-scheduling is supported but a step behind.
• No native iPad app. Web-only, runs fine on iPad Safari but you'll feel the absence if you wanted Pencil-based note input. Use DrChrono if iPad-first matters.
• No marketplace of third-party integrations. Direct integrations with Stripe (for cash-pay), labs (selected), and Mailchimp. Beyond that, no app store — you're limited to what TherapyNotes ships natively.
• No free trial. 30-day money-back guarantee instead. Adequate but a higher commitment than competitors offering 14-30 day free trials.

Who TherapyNotes is for

If any of these describe you, TherapyNotes belongs on your shortlist:

• You're a psychotherapy practice (LCSW, LMFT, psychologist, LPC) and >40% of revenue is insurance billing
• You're a group practice with 2-30 clinicians and need clean group billing
• You see Medicaid clients and need treatment-plan workflows that survive audits
• You'd trade UX polish for fewer billing denials
• You want phone support included, not a paid upgrade

Who it's not for: integrative-medicine and functional-medicine practices (Practice Better is built for you), dietitians (Healthie), multi-disciplinary clinics with bodywork or PT (Jane App), iPad-first mobile practices (DrChrono), cash-pay-only solo practices (consider Carepatron's free tier first).

TherapyNotes vs SimplePractice — the decision

This is the comparison that brings the most prospective buyers to either product. Our 2026 take:

• Insurance-heavy psychotherapy practice (>40% claims) → TherapyNotes. The billing math compounds. You'll notice the difference in revenue within 90 days.
• Multi-disciplinary clinic (therapy + bodywork + nutrition) → SimplePractice. Better cross-discipline UX and a more polished patient experience.
• Solo cash-pay practice → SimplePractice. UX win matters more when billing isn't the bottleneck.
• Group practice with mixed insurance + cash → TherapyNotes. Group billing and revenue clarity favor TN here.
• Tech-forward solo who wants AI scribe + modern UI → SimplePractice. They've invested more in AI features and visual design.

Both are correct answers for different practice types. Don't agonize for more than two demos — they're priced similarly and migration between them is straightforward if you guess wrong.

Pricing in 2026 — what to actually expect

TherapyNotes publishes flat pricing on their site, and unlike most EHRs, the published pricing is close to what you'll pay:

• Solo: $59/month per clinician. Includes everything: claims, telehealth, scheduling, notes, patient portal, phone support. No upcharges.
• Group: $59/month base + $30 per additional clinician + $30 per non-clinician staff seat. A 5-clinician practice with 1 admin runs $59 + 4×$30 + 1×$30 = $209/month.
• e-Claims: $0.14 per submitted claim through ApexEDI (their clearinghouse partner). On 200 claims/month per clinician, that's $28/clinician/month.
• Full RCM bundle: ~5% of collections if you want them to handle claims and patient collections end-to-end. Worth it above $30k/month collections per clinician.
• e-Prescribing: Add-on (~$40/month per prescriber). EPCS-grade for controlled substances.

The 90-day call

Buy TherapyNotes if you're an insurance-heavy psychotherapy practice. The billing engine pays for itself within the first month if you have non-trivial claims volume. The plain UX won't impress a tour, but the revenue clarity will impress your accountant.

Buy SimplePractice instead if patient experience and UX polish rank higher than denial-rate optimization in your decision — or if you've got multi-disciplinary services where therapy is just one piece.