Best EHR for New Therapists in 2026: SimplePractice, TherapyNotes & TheraNest Compared
Your EHR choice affects everything: how long documentation takes, whether billing is a nightmare, how clients experience intake, and whether you spend your administrative time actually working or fighting software. Getting it right early matters.
The good news: for new therapists in solo or small-group private practice, the field narrows pretty quickly. Three platforms handle the vast majority of the market, each with a genuinely different profile. This guide gives you an honest breakdown of all three — what each does well, where each falls short, and who each one is actually the right fit for.
We’ll compare on: pricing, scheduling, documentation, telehealth, billing, and customer support.
No vendor relationships were involved in this review. If you sign up through our links, we may earn a commission — and we’ve disclosed that clearly next to each link.
The Three Platforms: Quick Summary
| SimplePractice | TherapyNotes | TheraNest | |
| Best for | Solo therapists who want polish | Documentation-heavy practices | Budget-conscious new therapists |
| Starting price | ~$29/mo | ~$49/mo | ~$39/mo |
| Full-featured solo price | ~$69/mo | ~$59/mo | ~$39–49/mo |
| Free trial | 30 days | 30 days | 21 days |
| Telehealth built-in | ✅ Yes | ✅ Yes | ✅ Yes |
| Insurance billing | ✅ Plus plan | ✅ All plans | ✅ All plans |
| Client portal | ✅ Strong | ✅ Functional | ✅ Basic |
SimplePractice: Best All-Around for Solo Therapists
SimplePractice is the most popular EHR in private practice therapy, and it’s earned that position. The interface is cleaner and more intuitive than most competitors, the client portal is genuinely good, and the all-in-one model means you rarely need a third-party tool.
Pricing
For most new therapists, Essential is where you’ll land. It covers everything for a self-pay or limited-insurance practice at a reasonable price point.
What SimplePractice Does Well
Client intake experience. The client portal is among the best in the field. New clients receive an email invitation, complete intake paperwork online with e-signatures, and add their card on file — all before the first session. From the client’s perspective, it’s seamless. From yours, it eliminates the intake paperwork shuffle completely.
Scheduling. Clean, fast calendar. Recurring appointments, multiple appointment types, configurable reminders. Clients can self-schedule through the portal for appointment types you designate. Syncs with Google Calendar and Apple Calendar.
Telehealth. Built-in HIPAA-compliant video. No Zoom subscription needed. Clients join from a link in their reminder email — no app download required. Quality is solid; Chrome works best on both ends.
Interface. SimplePractice looks like it was designed in the last five years. Everything is where you’d expect it to be. For new clinicians who don’t want to learn a clunky system while simultaneously learning how to run a practice, this matters.
Where SimplePractice Falls Short
Documentation flexibility. The note template system is functional but limited. You can create custom templates, but the builder is basic. Clinicians who want highly structured documentation, complex treatment plans, or embedded outcome measures will hit a ceiling.
Group practice pricing. Solo therapists pay one flat rate. Group practices pay per clinician above the first, which scales poorly. If you’re building toward a group model, factor this in.
No phone support. Chat and email only. When something breaks during a session, there’s no one to call.
Best for
New to early-career solo therapists who prioritize a polished, easy-to-learn platform, primarily see self-pay or limited insurance clients, and want scheduling + documentation + telehealth + payments in one place.
👉 Try SimplePractice free for 30 days →
Affiliate disclosure: TherapistDesk earns a commission on referrals, at no cost to you.
TherapyNotes: Best for Documentation-Focused Practices
TherapyNotes has been around longer than SimplePractice and has a loyal following among clinicians who prioritize clinical documentation over interface elegance. It’s less polished visually, but the depth of its documentation tools is genuinely stronger.
Pricing
This is simpler than SimplePractice’s tier structure, and the all-in pricing is a genuine advantage. Insurance billing is included without paying for an upgraded plan.
What TherapyNotes Does Well
Documentation. This is where TherapyNotes earns its reputation. The note template system is more flexible and more configurable than SimplePractice’s. Treatment plans are better developed and easier to connect to progress notes session over session. For clinicians who care deeply about documentation quality and want a system that’s built around clinical thinking rather than administrative convenience, TherapyNotes is stronger.
Insurance billing. TherapyNotes includes full insurance billing on all plans. The clearinghouse integration is reliable and the ERA/EOB workflow is more intuitive than SimplePractice’s. If you’re billing insurance from day one, this is a meaningful advantage.
Scheduling. Solid calendar with recurring appointments, multiple locations, and waitlist management. Slightly less polished than SimplePractice but functionally complete.
Customer support. TherapyNotes offers phone support during business hours — something SimplePractice doesn’t. For a new therapist navigating billing or documentation questions, being able to call someone matters.
Where TherapyNotes Falls Short
Interface. It looks older. Not broken or unusable — just dated. The client portal is functional but not as smooth as SimplePractice’s. Some clients find the intake process less intuitive.
Telehealth. Built-in telehealth is available but has historically been behind SimplePractice’s in reliability. It works — it’s just not the platform’s strongest feature.
Learning curve. More features = more to learn. TherapyNotes is not difficult, but it rewards the time you invest in setting it up properly. New therapists who want something running fast may find it slightly slower to get comfortable with.
Best for
Therapists who prioritize clinical documentation depth, are billing insurance from the start, and want phone support available when things go wrong. Also a strong choice if you’re in a group or agency setting that uses TherapyNotes as the standard.
👉 Try TherapyNotes free for 30 days →
Affiliate disclosure: TherapistDesk earns a commission on referrals, at no cost to you.
TheraNest: Best for Budget-Conscious New Therapists
TheraNest is the least discussed of the three platforms, which undersells it somewhat. For new therapists who need a functional, HIPAA-compliant EHR at the lowest price point, TheraNest is a legitimate option.
Pricing
The client-count pricing model is different from SimplePractice and TherapyNotes. For a therapist just starting out with 5–10 clients, the entry price is lower than either competitor.
What TheraNest Does Well
Pricing accessibility. For therapists who are still in the early caseload-building phase and are watching every expense, the lower entry price is real. You get a functional EHR without paying $69/month for a full caseload you don’t have yet.
Core functionality. Scheduling, documentation, telehealth, billing, and a client portal are all included. It does what an EHR needs to do.
Insurance billing. Available on all plans, no upgrade required.
Group practice pricing. More affordable than SimplePractice for small groups.
Where TheraNest Falls Short
Interface. It’s the weakest of the three in terms of design and ease of use. Not unusable, but noticeably less polished. Client-facing experience is rougher than SimplePractice.
Documentation. Basic note templates with limited customization. If documentation quality is important to your workflow, TheraNest lags behind both competitors.
Client portal. Functional but minimal. Intake documents work; the overall experience for clients is less seamless.
Support. Chat and email primarily. Slower response times reported in user reviews.
Best for
New therapists on a tight budget building their first caseload, or small group practices looking to keep per-clinician costs low. If you outgrow the platform as your practice scales, plan to migrate — most established therapists in growing practices eventually move to SimplePractice or TherapyNotes.
How to Choose: Decision Framework
Choose SimplePractice if:
Choose TherapyNotes if:
Choose TheraNest if:
One More Thing: Don’t Switch Mid-Stream
Whatever you pick, the single most expensive EHR decision you can make is switching platforms after you’ve built a caseload. Migrating client records, rebuilding templates, re-learning a new system while seeing clients — it’s painful. The 30-day free trials exist for a reason. Use them seriously before you commit.
Set up your calendar. Try intake with a test client. Write a few notes. Run through a billing cycle. You’ll know within two weeks whether a platform fits how you work.
Prices referenced are approximate and subject to change. Verify current pricing at each platform’s website before signing up. TherapistDesk may earn affiliate commissions on referral sign-ups, disclosed at each link.