Key Takeaways
- SimplePractice is built for insurance-billing therapists who need clinical documentation. If that's you, it's the right tool.
- Private-pay therapists commonly overpay for SimplePractice — billing, superbills, and clinical notes they never use because they don't accept insurance.
- The private-pay therapist stack is much simpler: booking + payment + cancellation enforcement + an optional practice page.
- Merkora covers the private-pay therapist's real needs without the clinical overhead cost of $29–$99/month.
- The question that determines your platform: 'Do I bill insurance or process insurance claims?' Yes → SimplePractice. No → you probably need something lighter.
In this article
SimplePractice is the dominant practice management platform for licensed therapists and counselors in the US. If you bill insurance, need clinical documentation, or require HIPAA compliance across your entire workflow, it's probably the right tool.
But a significant number of therapists — particularly those in private practice who don't bill insurance, or coaches who get lumped into the same software searches — are paying $29–$99/month for features they never use. Insurance billing, progress notes in clinical format, HIPAA-compliant telehealth — these are essential for some practitioners and completely irrelevant for others. Here's what the alternatives look like if you're in the second group.
What SimplePractice does well
- HIPAA-compliant client portal and telehealth
- Insurance billing and superbills
- Clinical documentation and progress notes
- Appointment scheduling with automated reminders
- Online intake forms and e-signatures
- Basic website for your practice
When it's more than you need
SimplePractice starts at $29/month (Starter, one clinician) and goes to $99+/month for the Essential plan with full features. If you:
- Don't bill insurance or submit claims
- Don't need clinical progress notes in a specific format
- Are a life coach or wellness practitioner (not a licensed clinician)
- Want to sell courses or digital products alongside sessions
- Need automatic cancellation fee enforcement
— then you're paying for a clinical system when you need a practice management platform. Those are different products.
Acuity Scheduling
Acuity is a much simpler booking tool — no clinical features, just scheduling, intake forms, and payment collection.
Better than SimplePractice for: Simpler and cheaper ($20/month) if you only need booking and intake forms. No clinical overhead.
Still missing: Automatic cancellation enforcement, session credit system, course hosting.
Practice Better
Practice Better sits between Acuity and SimplePractice — more practitioner-focused than Acuity, less clinical than SimplePractice. Popular with nutritionists, health coaches, and wellness therapists.
Better than SimplePractice for: Less expensive, less clinical overhead, good for non-licensed practitioners, client portal without EHR complexity.
Still missing: Automatic cancellation enforcement, session credit system, course hosting. $25–$60/month.
TherapyNotes
TherapyNotes is another EHR specifically for therapists — similar to SimplePractice but often preferred for its note-writing interface and billing features.
Better than SimplePractice for: Some therapists find the note templates and billing workflow more intuitive. Worth comparing if you're choosing between EHRs.
Same gap: Still a clinical system — not the right fit if you don't need insurance billing or clinical documentation.
Merkora
Merkora is not a clinical system and doesn't try to be. It's an online practice platform for therapists and coaches who manage sessions, packages, and courses — without the clinical layer.
Better than SimplePractice for: Practitioners who don't bill insurance. Automatic cancellation fee enforcement (no manual action), session credit packages with automatic tracking, course hosting alongside sessions, public practice page clients can find and book from. Free to start.
Where SimplePractice still wins: HIPAA-compliant telehealth, insurance billing, clinical progress notes, e-prescribing. If any of those are requirements, SimplePractice is the right choice and Merkora is not.
If you're a therapist in private practice who doesn't bill insurance and wants booking, cancellation enforcement, and an online presence without paying for clinical software, Merkora is free to start. For more on therapist software broadly, see Best Therapist Software for Private Practice.
Frequently asked questions
What is the best SimplePractice alternative for therapists?
For private-pay therapists who don't need clinical billing: Merkora or Acuity Scheduling. For therapists who do need clinical features but find SimplePractice too expensive: TherapyNotes or TheraNest. For health coaches and wellness practitioners: Practice Better.
Why do therapists leave SimplePractice?
The most common reasons: price ($29–$99/month feels high for solo practices), and paying for insurance billing features they don't use (private-pay therapists). Some also find the interface heavier than they need for their workflow.
Does a private-pay therapist need SimplePractice?
No — SimplePractice is built around insurance billing and clinical documentation. Private-pay therapists who don't process insurance claims and don't need clinical notes in a specific format are paying for infrastructure they don't use.
What is the cheapest SimplePractice alternative?
Merkora is free to start. Acuity Scheduling starts at ~$20/month. Practice Better starts at ~$25/month. All three handle booking and payment, which are the core needs of a private-pay practice.
