Guide to Choosing The Right Therapy Billing + Practice Management Platform for Your Needs

Want to go paperless in your therapy practice, but not sure where to start?

Ultimately, the system you choose will depend on your needs, practice size, and budget. We created this guide to help you better understand what therapy software is available, and which tool is right for you!

What features should I look for in billing and practice management tools?

The features of a practice management tool can include:

  1. Scheduling: Ideally with integration to other calendars you already use, such as Google Calendar or Outlook; this could also include attendance tracking for individual and group sessions
  2. Billing & invoicing: Include mental health CPT codes for billing; create invoices, superbills, receipts and CMS-1500 (HCFA) form
  3. Customizable note-taking platform: Individual notes, group notes that you can share internally.
  4. A client portal: Clients can schedule appointments; secure client-therapist messaging available
  5. Customizable intake forms: Secure form that you can send prior to first client appointment
  6. Integrated credit card processing for clients
  7. Claim management: Submitting, filing, tracking
  8. A tele-health component for remote sessions: Ideally integrated directly as a calendar feature
  9. Appointment reminders: Via text, email, or phone call
  10. A mobile app for 24/7, anywhere access: iOS, Android, and/or Apple Watch compatible
  11. HIPAA-compliant security

What billing and practice management brands are available?

Some tools are designed especially for billing and practice management in the mental health field. These include:

Other tools, like Office Ally, are designed for billing and software, but not necessarily equipped for total practice management.

Other options include:

billing-practice-management.jpg

How much does each billing and practice management tool cost?

The following platforms have a base fee of $38-100+ per month, depending on factors like practice size and additional features:

The cost of hiring a billing professional can range from 10% of all billed services, to a percentage of the amount collected from insurance.

The following platforms are free to use:

See a full breakdown and cheatsheet of costs and features at the end of this article!

Calculating the cost of each platform for your caseload

Let’s consider a few private practice scenarios to see how your costs might play out. These consider factors such as your caseload size, how many private pay vs. insurance clients you have, how many clients pay using a credit card, and whether you want text appointment reminders.

We’ve assumed a solo practice with a 25 client per week caseload, and that you opt into having text appointment reminders in all cases.

We reached out to all platforms to confirm features and costs where details weren’t publicly available. As of the writing of this article, we have not received confirmations from Office Ally and TheraNest,  so we’ve included placeholders as necessary.

Office Ally is by far the lowest cost option in all scenarios — it’s free other than a flat rate for appointment reminders! — so consider the cost differences between SimplePractice, Therapy Notes, and TheraNest.

Scenario One

In this scenario, you’re seeing 25 insurance clients per week, all of whom pay through a health insurance that you are in-network with.

Below is what your true monthly cost would be for each platform. Office Ally is the lowest cost option, and SimplePractice follows suit. Because TherapyNotes has a flat fee of $13.50/mo for its credit card processing feature, it’s more costly at low credit card transaction volumes.

Scenario one: 25 appointments/week, all insurance

Scenario one: 25 appointments/week, all insurance
SimplePractice (Essential) SimplePractice (Professional) Office Ally TherapyNotes (Solo) TheraNest
Monthly Fee $39 $49 $0 $49 $38
Appointment Reminders (text) $0 $0 $29.95 $14 $2
Credit card processing $62 $62 ? $66 $57
E-file Insurance Claims n/a $25 $0 $14 $23
ERA Payment Reports n/a $0 $0 $7 $0
True Monthly Cost $101 $136 $29.95 + CC fees $150 $120

Scenario Two

Let’s now say you’re seeing 25 clients per week, half of whom pay through their insurance, and half private pay at a rate of $150 per session.

In this scenario, we assume all clients pay their session fees with a credit card. Because of credit card processing fees at high volumes, SimplePractice’s monthly cost goes up, but approximately equals that of TherapyNotes.

Scenario two: 25 appointments/week, half insurance, half private pay $150/session

scenario two: 25 clients per week, half of whom pay through their insurance, and half private pay
SimplePractice (Essential) SimplePractice (Professional) Office Ally TherapyNotes (Solo) TheraNest
Monthly Fee $39 $49 $0 $49 $38
Appointment Reminders (text) $0 $0 $29.95 $14 $2
Credit card processing $254 $254 ? $235 $232
E-file Insurance Claims n/a $13 $0 $7 $12
ERA Payment Reports n/a $0 $0 $7 $0
True Monthly Cost $293 $315 $29.95 + CC fees $312 $272

Scenario Three

Now let’s take a full private pay caseload. You’re seeing 25 private pay clients per week, all of whom are paying $150 per session, and use a credit card to pay their fee.

At this high volume of credit card processing fees, SimplePractice’s costs are higher than that of TherapyNotes.

Scenario three: 25 appointments/week, $150/session

SimplePractice (Essential) SimplePractice (Professional) Office Ally TherapyNotes (Solo) TheraNest
Monthly Fee $39 $49 $0 $49 $38
Appointment Reminders (text) $0 $0 $29.95 $14 $2
Credit card processing $446 $446 n/a $404 $407
E-file Insurance Claims n/a n/a n/a n/a n/a
ERA Payment Reports n/a n/a n/a n/a n/a
True Monthly Cost $485 $495 $29.95 + CC fees $467 $447

Scenario Four

You’re seeing 25 private pay clients per week at $150 per session, and all of whom pay in cash.

With cash-only payments, SimplePractice (which only has transaction-based fees) comes out cheaper than TherapyNotes (which has both transaction-based fees and a flat fee). Here’s what your true monthly cost would be for each platform:

Scenario four: 25 appointments/week, mostly cash pay

Scenario four: 25 appointments/week, mostly cash pay
SimplePractice (Essential) SimplePractice (Professional) Office Ally TherapyNotes (Solo) TheraNest
Monthly Fee $39 $49 $0 $49 $38
Appointment Reminders (text) $0 $0 $29.95 $14 $2
Credit card processing $0 $0 $0 $13.50 $0
E-file Insurance Claims n/a n/a n/a n/a n/a
ERA Payment Reports n/a n/a n/a n/a n/a
True Monthly Cost $39 $49 $29.95 + CC fees $77 $40

Features & Cost Cheatsheet

Want to see a comparison of all features and costs across platforms? Use the table we compiled below!

You can download and print out this cheatsheet, too.

Therapist Billing & Practice Management Platforms: Featured Comparison

therapist billing practice management software comparison cheatsheet
SimplePractice (Essential) SimplePractice (Professional) Office Ally TherapyNotes (Solo) TheraNest
Flat rates
Monthly Fee $39 $49 $0 $49 $48
Claims filing and processing
E-file insurance claims
ERA payment reports
Credit card processing
Autopay (charges client credit cards automatically) ? ?
Coverage report ?
Scheduling & Reminders
Online appointment booking
Google Calendar or Apple iCal ?
Client self-scheduling
Online booking widget for your website
Secure client portal
Appointment reminders (SMS/voice)
Appointment reminders (email)
Practice management functions
Templated intake forms
Customizable intake forms ?
Customizable note templates ?
Patient communication
Video telehealth platform
Secure messaging
Device usability
Video telehealth platform

Still not sure which billing and practice management platform is right for your practice? Read the survey we conducted of 100 Zencare therapists, with honest, firsthand insight on cost, ease of use, and overall experiences with different platforms!

And if you’re starting or looking to grow your private practice, and want to join a supportive community of vetted providers, join the Zencare therapist network.

You can ask questions via our active email list-serv, build a professional online presence, and receive referrals for clients who are a great fit your practice!

Schedule a free call with our Therapist Success Team today to learn more.


This is part of our series on the best billing and practice management software. For further reading, visit our reviews of TherapyNotes, TheraNest, Office Ally, and SimplePractice, as well as an objective comparison of TherapyNotes vs. SimplePractice.