SimplePractice vs Alternatives: When Does It Stop Making Sense in 2026?

SimplePractice is one of the most popular EHR systems for therapists, and for good reason—it's easy to use, designed specifically for mental health professionals, and gets you up and running quickly. But after working with hundreds of therapists who've used SimplePractice for 2-3 years, a pattern emerges: what works perfectly at the start becomes limiting as your practice grows.

This isn't a hit piece on SimplePractice. It's an honest look at when it makes sense, when it doesn't, and what alternatives offer better value for growing practices.

Quick Answer

SimplePractice costs $708-1,188/year by year 2-3, plus SMS fees ($76-154/year), totaling $784-1,342 annually. ClinikEHR offers the same features for $348-948/year with unlimited SMS included—saving $240-394 annually. SimplePractice works great for year 1 ($348/year), but as you grow, you'll pay more for features that are free elsewhere (SMS reminders, AI notes, customization). ClinikEHR starts free ($0/month for 20 clients), includes AI documentation on Professional plan ($79/month), and never charges per-message fees. Most therapists save $200-400/year switching to ClinikEHR while gaining AI features that save 2-3 hours/week.

Why SimplePractice Works Early On

Let's start with what SimplePractice does well, because there's a reason it's so popular:

The Good Stuff

1. Designed for Therapists SimplePractice was built specifically for mental health professionals. The note templates (SOAP, DAP, BIRP) are therapy-focused, the language is clinical, and the workflows make sense for therapy practices.

2. Easy to Learn You can set up SimplePractice and see your first client within an hour. The interface is intuitive, the setup wizard is helpful, and you don't need technical skills.

3. Integrated Telehealth SimplePractice includes video sessions in all plans. The telehealth feature works well, is HIPAA-compliant, and patients can join with one click.

4. Client Portal Clients can book appointments, complete intake forms, access documents, and pay invoices through a clean, easy-to-use portal.

5. Insurance Billing SimplePractice handles electronic claims submission, eligibility verification, and ERA processing. For therapists who bill insurance, this is valuable.

6. Large Community With thousands of users, there's a strong community, lots of tutorials, and plenty of support resources.

Why It's Perfect for Year 1

Starting Out:

• You have 5-15 clients
• You're learning the business side of private practice
• You need something simple that just works
• You can afford $29-59/month
• You don't have complex needs yet

SimplePractice shines here. It removes technical barriers and lets you focus on building your practice.

Common Complaints After Year 2-3

But here's what happens as your practice grows:

Complaint #1: The Cost Adds Up Fast

The Pricing Reality:

Solo Plan: $29/month

• Sounds affordable
• But SMS reminders cost extra ($0.04 per message)
• 20 clients × 4 appointments/month × $0.04 = $3.20/month extra
• Annual cost: $348 + $38 = $386

Plus Plan: $59/month

• Needed for insurance billing and custom branding
• Annual cost: $708

Professional Plan: $99/month

• Needed for multiple locations or advanced features
• Annual cost: $1,188

The Problem: By year 2-3, you're likely on the Plus or Professional plan, paying $708-1,188/year. Meanwhile, alternatives like ClinikEHR offer the same features for $348-948/year—a savings of $240-360 annually.

Complaint #2: Limited Customization

What You Can't Change:

• Note templates are pre-built (you can't create truly custom templates)
• Intake forms have limited customization
• You can't modify the client portal appearance much
• Reporting is basic and inflexible
• You can't add custom fields to client profiles

Why This Matters: As you develop your practice style, you want your EHR to match your workflow—not force you into SimplePractice's workflow.

Real Example: "I do EMDR therapy and need specific fields in my notes. SimplePractice's templates don't support this, so I end up writing everything in the 'notes' section, which defeats the purpose of structured documentation." - Sarah, LMFT

Complaint #3: No AI-Assisted Documentation

The Reality: SimplePractice doesn't offer AI-powered note generation, voice-to-text transcription, or smart templates. You're writing every note manually, which takes 10-15 minutes per session.

The Math:

• 20 clients/week × 15 minutes per note = 5 hours/week on documentation
• That's 260 hours per year spent writing notes
• At $100/hour (your therapy rate), that's $26,000 worth of your time

The Alternative: EHRs like ClinikEHR (Professional plan) include AI-assisted notes that reduce documentation time by 50-70%, saving you 2.5-3.5 hours per week.

Complaint #4: SMS Reminders Cost Extra

The Hidden Cost: SimplePractice charges $0.04 per SMS reminder. This seems small until you do the math:

Typical Practice:

• 20 clients
• 4 appointments per month each
• 2 reminders per appointment (48 hours and 24 hours)
• 20 × 4 × 2 × $0.04 = $6.40/month
• Annual cost: $76.80

Growing Practice:

• 40 clients
• Same calculation
• Annual cost: $153.60

The Alternative: ClinikEHR includes unlimited SMS and email reminders on all plans—even the free plan.

Complaint #5: Limited Reporting

What You Get:

• Basic financial reports
• Simple appointment reports
• Client demographics

What You Don't Get:

• Custom reports
• Outcome tracking
• Detailed analytics
• Practice growth metrics
• Retention analysis

Why This Matters: By year 2-3, you want to understand your practice metrics: Which services are most profitable? What's your client retention rate? Which referral sources work best? SimplePractice's reporting doesn't answer these questions.

Complaint #6: No Free Plan or Trial

The Reality: SimplePractice offers a 30-day free trial, but then you must pay. There's no free-forever option for small practices.

The Problem: If you're starting part-time or building slowly, paying $29-59/month from day one adds up. In your first year, that's $348-708 before you're even profitable.

The Alternative: ClinikEHR offers a truly free-forever plan (up to 20 clients) that includes all essential features. Most new therapists operate free for 6-12 months.

Lower-Cost and Better-Fit Alternatives

Let's compare SimplePractice to alternatives that offer better value:

Alternative #1: ClinikEHR (Best Overall Value)

Pricing:

• Free: $0/month (up to 20 clients)
• Starter: $29/month (up to 50 clients, insurance billing)
• Professional: $79/month (unlimited clients, AI notes, telehealth)

What You Get That SimplePractice Doesn't: ✅ Free-forever plan for small practices ✅ AI-assisted documentation (Professional plan) ✅ Unlimited SMS/email reminders included ✅ More customizable note templates ✅ Better reporting and analytics ✅ Lower cost at every tier ✅ No per-message SMS fees

What SimplePractice Has That ClinikEHR Doesn't:

• Larger user community (for now)
• More third-party integrations
• Longer track record (SimplePractice launched 2012, ClinikEHR is newer)

Cost Comparison (3 Years):

SimplePractice:

• Year 1: $348 (Solo plan)
• Year 2: $708 (Plus plan as you grow)
• Year 3: $708 (Plus plan)
• SMS fees: ~$230 over 3 years
• Total: $1,994

ClinikEHR:

• Year 1: $0 (Free plan)
• Year 2: $348 (Starter plan)
• Year 3: $948 (Professional plan with AI)
• SMS fees: $0 (included)
• Total: $1,296

Savings: $698 over 3 years

Best For:

• Therapists starting out or growing
• Practices wanting AI-assisted documentation
• Budget-conscious practitioners
• Anyone wanting to start free

Alternative #2: TherapyNotes (Best for Insurance Billing)

Pricing:

• Essential: $49/month
• Professional: $69/month

Pros: ✅ Excellent insurance billing features ✅ Strong reporting ✅ Good for group practices ✅ Robust clinical documentation

Cons: ❌ More expensive than SimplePractice ❌ No free plan or trial ❌ Steeper learning curve ❌ No AI features

Best For:

• Established practices billing insurance heavily
• Group practices
• Therapists who need advanced reporting

Alternative #3: TheraNest (Best Budget Option)

Pricing:

• Solo: $39/month
• Group: $59/month

Pros: ✅ Lower cost than SimplePractice ✅ Good basic features ✅ Includes telehealth ✅ Decent insurance billing

Cons: ❌ Less polished interface ❌ Smaller user community ❌ Limited customization ❌ No AI features

Best For:

• Budget-conscious therapists
• Simple practices without complex needs

Alternative #4: Headway/Alma (Best for Insurance-Only)

Pricing:

• Free (they take a percentage of insurance payments)

Pros: ✅ Completely free ✅ They handle all insurance billing ✅ Credentialing included ✅ Good for insurance-only practices

Cons: ❌ You don't own your client data ❌ Limited to their insurance panels ❌ No private pay option ❌ Less control over your practice

Best For:

• Therapists who only want to bill insurance
• Those who don't want to manage billing

Data Migration Considerations

If you decide to switch from SimplePractice, here's what you need to know:

What You Can Export from SimplePractice

Available Exports: ✅ Client demographics (CSV) ✅ Appointment history (CSV) ✅ Financial data (CSV) ✅ Clinical notes (PDF) ✅ Documents (PDF)

Export Limitations: ❌ Notes export as PDFs (not editable) ❌ No structured data export for notes ❌ Treatment plans export as PDFs ❌ Some custom fields may not export

How to Export Your Data

Step 1: Export Client List

1. Go to Clients → Export
2. Select all clients
3. Choose CSV format
4. Download file

Step 2: Export Notes

1. Go to each client profile
2. Click "Export Notes"
3. Download PDF
4. Repeat for all clients (time-consuming)

Step 3: Export Financial Data

1. Go to Reports → Financial
2. Export transactions
3. Download CSV

Step 4: Export Documents

1. Go to each client profile
2. Download documents individually
3. Save to organized folders

How to Import into ClinikEHR

ClinikEHR Import Process:

Step 1: Import Client Demographics

• Upload CSV file
• Map fields (name, email, phone, etc.)
• Review and confirm
• Import completes in minutes

Step 2: Upload Clinical Notes

• Upload PDF notes to each client profile
• Or manually re-enter recent notes (recommended for active clients)
• Historical notes remain accessible as PDFs

Step 3: Import Financial Data

• Upload transaction CSV
• Map fields
• Review and confirm

Step 4: Upload Documents

• Drag and drop documents to client profiles
• Organize by category

ClinikEHR Advantage: We offer free data migration assistance on all paid plans. Our team helps you export from SimplePractice and import into ClinikEHR.

Timeline for Migration

Realistic Timeline:

• Week 1: Export data from SimplePractice
• Week 2: Set up ClinikEHR, import demographics
• Week 3: Upload documents and notes
• Week 4: Run both systems in parallel
• Week 5: Fully transition to ClinikEHR

Total Time Investment: 10-15 hours spread over 4-5 weeks

Who Should Stay vs Switch

Stay with SimplePractice If:

✅ You're in your first year and still learning ✅ You have fewer than 15 clients ✅ Cost isn't a concern ($708/year is fine) ✅ You're happy with the features ✅ You don't need AI-assisted documentation ✅ You value the large user community ✅ You don't want to deal with switching

Bottom Line: If SimplePractice is working for you and you're not bothered by the cost or limitations, there's no urgent reason to switch.

Switch to ClinikEHR If:

✅ You're paying $59-99/month and want to save money ✅ You want AI-assisted documentation ✅ You need more customization ✅ You're frustrated by SMS fees ✅ You want better reporting ✅ You're starting out and want to begin free ✅ You're willing to invest 10-15 hours in migration

Bottom Line: If you're looking to save $200-400/year, get AI features, and have more flexibility, switching to ClinikEHR makes financial sense.

Switch to TherapyNotes If:

✅ You bill insurance heavily ✅ You need advanced reporting ✅ You're running a group practice ✅ Cost isn't your primary concern

Bottom Line: If insurance billing is your top priority and you need enterprise features, TherapyNotes is worth the higher cost.

Real Therapist Experiences

Case Study 1: Sarah, LMFT (Switched to ClinikEHR)

Background:

• 3 years with SimplePractice
• 35 clients
• Paying $59/month (Plus plan)
• Frustrated by SMS fees and lack of AI

Why She Switched: "I was paying $708/year plus SMS fees. ClinikEHR's Professional plan ($79/month) costs about the same but includes AI notes, unlimited SMS, and better customization. The AI alone saves me 3 hours per week."

Migration Experience: "The migration took about 2 weeks. ClinikEHR's team helped me import my client list. I uploaded recent notes as PDFs and started fresh with new notes in ClinikEHR. It was easier than I expected."

Result:

• Saves $240/year
• Saves 3 hours/week on documentation
• Happier with customization options

Case Study 2: Michael, PsyD (Stayed with SimplePractice)

Background:

• 2 years with SimplePractice
• 20 clients
• Paying $29/month (Solo plan)
• Happy with features

Why He Stayed: "SimplePractice works for me. I'm not seeing enough clients to justify the time investment of switching. The $29/month is affordable, and I like the community and resources."

Bottom Line: "If I grow to 40+ clients or start wanting AI features, I'll reconsider. But for now, SimplePractice meets my needs."

Case Study 3: Jennifer, LCSW (Switched to TherapyNotes)

Background:

• 4 years with SimplePractice
• 50 clients
• Billing insurance heavily
• Needed better reporting

Why She Switched: "I needed more robust insurance billing and reporting. TherapyNotes costs more ($69/month) but the insurance features are worth it for my practice."

Migration Experience: "Migration was more complex than I expected. TherapyNotes has a steeper learning curve, but the insurance billing features are significantly better."

Frequently Asked Questions

Is SimplePractice worth the cost for a new therapist? For your first year, yes—if you can afford $29/month. SimplePractice is easy to learn and gets you started quickly. However, ClinikEHR's free plan offers similar features at $0/month, making it a better choice if budget is tight.

Can I export all my notes from SimplePractice? Yes, but notes export as PDFs (not editable text). You can upload these PDFs to your new EHR or manually re-enter recent notes. Most therapists re-enter notes for active clients and keep historical notes as PDFs.

How long does it take to switch from SimplePractice to another EHR? Plan for 4-5 weeks running both systems in parallel. The actual work is 10-15 hours spread over that time. ClinikEHR offers free migration assistance to make this easier.

Will I lose my client data if I switch? No. You can export all client data from SimplePractice. The challenge is that notes export as PDFs rather than structured data, but you won't lose anything.

Does ClinikEHR have all the features SimplePractice has? ClinikEHR has all essential features (scheduling, notes, client portal, billing, telehealth, insurance billing) plus some SimplePractice doesn't (AI notes, unlimited SMS, better customization). SimplePractice has more third-party integrations and a larger user community.

What's the biggest advantage of switching to ClinikEHR? Cost savings ($200-400/year) and AI-assisted documentation (saves 2-3 hours/week). For most therapists, these benefits justify the 10-15 hour migration investment.

Should I switch if I'm happy with SimplePractice? Not necessarily. If SimplePractice meets your needs and cost isn't a concern, there's no urgent reason to switch. But if you're frustrated by limitations or cost, alternatives like ClinikEHR offer better value.

Can I try ClinikEHR before fully switching from SimplePractice? Yes. ClinikEHR's free plan lets you test the system with up to 20 clients. You can run both systems in parallel for a month to compare before fully committing.

Related Reading on ClinikEHR

• EHR comparison: Best EHR for Solo Private Practice | Best EHR for Mental Health 2026
• Free options: Top 5 Free EHR for Private Practice
• Specialty guides: EHR for Therapists | EHR for Mental Health | EHR for Psychiatrists
• AI documentation: AI Revolution in Clinical Notes | Best AI Note-Taking for Psychiatry | Reduce Documentation Time
• Practice setup: How to Start a PMHNP Private Practice | Private Practice Software Guide
• Switching guides: How to Switch EHR Without Losing Data | EHR Pricing Explained

Conclusion: Make the Switch That Makes Sense for You

SimplePractice is a solid EHR that works well for many therapists, especially in the first 1-2 years. But as your practice grows, the limitations become more apparent: higher costs, SMS fees, lack of AI features, and limited customization.

The Bottom Line:

• Stay with SimplePractice if you're happy, it's working, and cost isn't a concern
• Switch to ClinikEHR if you want to save $200-400/year, get AI features, and have more flexibility
• Switch to TherapyNotes if insurance billing is your top priority and you need enterprise features

Ready to Explore a Better Alternative?

Try ClinikEHR Free — Start with our free-forever plan (up to 20 clients). No credit card required, no time limit. See if ClinikEHR is the right fit before committing.

Need help migrating from SimplePractice? Contact our team — We offer free migration assistance on all paid plans.

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External Resources:

• SimplePractice Official Site
• HIPAA Journal: EHR Data Migration
• APA: Choosing Practice Management Software