If you’re comparing SimplePractice vs TheraNest for your mental health practice, you’re probably wrestling with a decision that feels bigger than just software. You’re choosing the foundation that will shape how you document sessions, manage billing, engage clients, and ultimately, how much time you spend on administrative work versus patient care.
Here’s what makes this comparison particularly challenging: both platforms are comprehensive, mature solutions with thousands of users. Both promise to streamline your practice. And both come with monthly fees that add up to thousands of dollars annually.
The real questions you should be asking are:
In short, here’s what we recommend:
👉 SimplePractice is the polished, user-friendly choice that gets you up and running quickly. With over 225,000 practitioners using the platform, it offers an intuitive interface, seamless telehealth integration, and a robust client portal that clients actually enjoy using. The platform excels at automating administrative tasks like appointment reminders and insurance claims, and now includes measurement-based care features. However, following its acquisition by Vista Equity Partners, users have expressed concerns about potential price increases and support quality. For growing practices, costs escalate as you add clinicians.
👉 TheraNest provides maximum flexibility through its unique pricing model and extensive customization options. You can choose between paying per active client (starting at $42/month for 30 clients) or per therapist (starting at $29/month on their new pricing model). The Dynamic Form Builder allows you to create completely custom documentation, and you can add unlimited staff members at no extra cost. The trade-off is a steeper learning curve and an interface that some users find less polished than SimplePractice.
Both platforms are solid choices that have served thousands of practices well. But what if there’s a third option that addresses the shortcomings of both while adding something neither provides to the same degree: built-in tools for actually improving therapy outcomes and growing your practice sustainably?
👉 CarePaths brings something different to the table: it’s a platform built by clinical psychologists with Measurement-Based Care (MBC) deeply integrated into its design. While SimplePractice recently added MBC features and TheraNest focuses on practice management, CarePaths has been refining its automated outcome tracking for over two decades, developed with Bruce Wampold, PhD.
Insurers are increasingly reimbursing for MBC, potentially turning it into a revenue generator. At $49/month for the full EHR with transparent pricing (core features included, no hidden costs), it’s particularly attractive for group practices that can save $430/month compared to SimplePractice Plus for a 20-clinician practice.
It includes unlimited admin users, special rates for students and supervised clinicians, and features others charge extra for, like AI-assisted session summaries, free electronic claims, and integrated telehealth. CarePaths’ 24-year history means proven reliability, though some users note the interface could use modernization.
If you’re interested in a platform that not only manages your practice but actively helps improve client outcomes while supporting sustainable growth, see how CarePaths works with a 30-day free trial.
Table of contents:
Here’s the fundamental difference: while all three platforms offer comprehensive practice management, they approach the challenge from distinctly different philosophies.
| SimplePractice | TheraNest | CarePaths | |
|---|---|---|---|
| Founded | 2012 | 2013 | 2000 |
| Ownership | Vista Equity Partners | Ensora Health | Private (founders) |
| Starting Price | $49/month | $42/month (30 clients) or $29/month per therapist | $49/month (or $10 for low volume) |
| User Base | 225,000+ practitioners | Thousands of practices | 6,000+ users |
| Core Philosophy | User-friendly, all-in-one | Flexible and customizable | Clinician-built, simple pricing with MBC focus |
| Ease of Use | Very intuitive | Steeper learning curve | Mixed reviews |
| Customization | Good with Template Builder | Extensive | Good |
| Customer Support | Email-based | Mixed reviews | Phone and ticket support |
| Telehealth | Included, excellent | Add-on ($12-25/month) | Included |
| Group Practice Support | Gets expensive at scale | Good flexibility | Cost-effective for 20+ clinicians |
| Best For | Solo practices wanting simplicity | Customization-focused practices | Growing group practices & training clinics |
The way these platforms charge tells you everything about who they’re designed for, and how much they’ll actually cost as your practice grows.
SimplePractice uses a straightforward tiered model: Starter at $49/month, Essential at $79/month, and Plus at $99/month.
Each tier unlocks more features, with group practice features only available at the Plus level. This traditional SaaS pricing is predictable but can feel restrictive. You might need just one feature from the Plus plan but have to pay for the entire upgrade.
Following the Vista Equity Partners acquisition, users have expressed concerns about future price increases. For group practices, costs multiply quickly: a 20-clinician practice at the Plus level would pay about $1,400/month.
TheraNest offers two completely different pricing approaches.
Their legacy per-client model starts at $42/month for up to 30 active clients, scaling to $98/month for 80 clients. This can be incredibly cost-effective for practices with stable, smaller caseloads. Alternatively, their newer per-therapist model ranges from $29 to $89 per month per clinician. The flexibility to choose your pricing model is unique in this market, though add-ons like telehealth can increase costs significantly.
Source: Capterra
CarePaths keeps it simple with transparent pricing where core features are included, no hidden costs or excessive add-ons.
The full EHR costs $49/month per clinician, but here’s where it gets interesting for growing practices: unlimited admin users are included at no extra cost, and they offer special rates for students and supervised clinicians.
A 20-clinician group practice would pay just $980/month, saving $430/month compared to SimplePractice Plus. They also offer a $10/month plan for practitioners with fewer than 15 sessions monthly, and their free Measurement-Based Care tier for up to 30 clients lets you try their clinical outcome tools without commitment. Unlike competitors, CarePaths includes features like electronic claims, telehealth, and AI-assisted notes in the base price.
SimplePractice is the leading product of practice management software.
The interface is clean, modern, and intuitive. New users can typically start seeing clients within hours of signing up. The platform guides you through setup with helpful prompts and suggestions. Even the mobile apps for both clinicians and clients are polished and fully featured. This ease of use is why it’s attracted over 225,000 practitioners.
While SimplePractice is opinionated about how things should work, they do offer customization through their Template Builder (available on Essential and Plus plans), allowing you to create custom progress note templates and forms.
The platform works best when you adapt to their workflows rather than trying to force it to match yours exactly. And as your practice grows, the per-clinician pricing model means costs escalate predictably.
TheraNest takes the opposite approach.
With its Dynamic Form Builder, you can create virtually any document or workflow your practice needs. Custom intake forms, unique progress note templates, specialized assessment tools: if you can imagine it, you can probably build it in TheraNest. The platform also allows unlimited staff members at no extra cost, making it extremely scalable for growing group practices.
The price of this flexibility is complexity.
Users report spending considerable time learning the system and setting up their customizations. The interface, while functional, lacks the modern polish of SimplePractice. Some workflows require more clicks than necessary, and the mobile app doesn’t include all desktop features.
This is where CarePaths differentiates itself. While SimplePractice and TheraNest focus primarily on managing the business of therapy, CarePaths has integrated tools to improve the therapy itself for over two decades, making it particularly valuable for group practices and university training clinics that prioritize clinical excellence.
The platform’s Measurement-Based Care system, developed with psychotherapy researcher Bruce Wampold, PhD, automatically sends assessments to clients weekly. These brief questionnaires track symptoms, well-being, and the therapeutic relationship with zero administrative burden on therapists. Results appear as visual graphs at the top of each client’s chart, giving you immediate insight into their progress.
This isn’t just data collection for compliance.
Research shows that tracking outcomes and adjusting treatment accordingly can significantly improve the effectiveness of therapy. Even better, insurers are increasingly reimbursing for measurement-based care, potentially turning this feature into a revenue generator for your practice.
For university training clinics, this provides invaluable educational benefits: students can track their outcomes as developing therapists, using real data to improve their skills through the crucial feedback loop that research shows is necessary for therapist improvement.
The platform also includes AI-assisted session summaries for teletherapy sessions. With client consent, the system can generate accurate summaries that you can import directly into your progress notes. Unlike SimplePractice’s Note Taker (an additional $35/month), CarePaths includes this feature for free in their standard pricing.
Source: CarePaths
For growing practices, CarePaths offers unique advantages through its supervision features. Recent graduates who are still unlicensed can practice therapy under licensed therapists at special rates, helping established therapists grow their practices while keeping costs predictable, unlike other systems where costs increase dramatically with practice growth.
How each platform handles clinical documentation reveals their core philosophy.
SimplePractice provides an extensive library of pre-built templates for various note types and treatment approaches.
Their Wiley Treatment Planners integration (available on Essential and Plus plans) offers evidence-based treatment plans you can customize. The workflow is streamlined: schedule appointment, conduct session, write note, and billing can be generated automatically if you enable that setting. It’s efficient and works well for most practices.
Source: SimplePractice
TheraNest shines in documentation flexibility.
Beyond standard templates, their Dynamic Form Builder lets you create any document type from scratch. You can design intake paperwork, assessment tools, and progress notes that match your exact needs. For practices with specific documentation requirements or unique treatment approaches, this flexibility is invaluable.
Source: TheraNest
CarePaths takes a different approach by integrating outcome data directly into the clinical workflow.
The client’s latest assessment scores and progress graphs appear at the top of their chart, providing immediate context when documenting sessions. The AI-assisted summaries can populate your notes with session content, while the outcome data provides objective evidence of progress. This creates richer, more clinically meaningful documentation that’s particularly valuable for training purposes in university clinics and for demonstrating treatment effectiveness to insurers.
All three platforms handle billing, but their approaches, and hidden costs, differ considerably.
SimplePractice offers robust billing features, but they’re scattered across pricing tiers.
The Starter plan includes basic billing with per-claim fees. You need Essential for 10 free insurance claims monthly and Plus for 35 free claims plus automatic insurance verification. Their Managed Billing service handles the entire insurance process but comes with additional fees. Credit card processing runs 3.15% plus $0.30 per transaction. For a busy group practice, these limitations and fees add up quickly.
Source: SimplePractice
TheraNest includes core billing features in all plans, but electronic claims are charged per submission ($0.17 to $0.23 each).
They also offer a comprehensive Managed Billing service for practices that want to outsource insurance billing entirely. Credit card processing fees vary by processor. Their batch invoicing feature is particularly useful for practices that bill monthly.
CarePaths includes unlimited free electronic claims in their base price, including Medicare and Medicaid, with no per-claim fees or monthly limits.
Insurance eligibility verification is also free. Their simplified billing workflow automatically generates charges from completed notes, reducing manual data entry. They can help set up merchant accounts with competitive credit card processing rates. For group practices processing hundreds of claims monthly, this represents significant savings compared to competitors.
How each platform engages clients reveals their priorities.
SimplePractice’s Client Portal and mobile app are standout features.
Clients can request appointments, complete paperwork, message securely, and join telehealth sessions with remarkable ease. The Monarch directory integration helps new clients find you. Their automated reminders via text, email, and voice are unlimited and included on Essential and Plus plans (Starter includes reminders only for telehealth appointments). The experience is smooth enough that clients often appreciate the modern approach.
Source: SimplePractice
TheraNest’s client portal requires an add-on subscription (first license free, then $6/month per therapist).
However, it offers unique features like the Client Contact Network, allowing family members to manage portal access for minors or dependents. Automated reminders cost extra ($0.10 per text or call), but email reminders are free. The portal is functional though less polished than SimplePractice.
CarePaths integrates client engagement with clinical outcomes.
Through the CarePaths Connect app, clients not only manage appointments and payments but also complete weekly assessments that feed directly into their treatment.
The “Digital Front Door” feature lets new clients find therapists, verify insurance, and book appointments directly. All reminders are included free, and the platform emphasizes keeping clients engaged in their treatment progress. For university training clinics, this engagement helps students learn the importance of tracking outcomes from the start of their careers.
Beyond monthly fees, consider these often-overlooked factors that particularly impact growing practices:
SimplePractice integrates you into their ecosystem with costs that rise as you grow.
While they do offer data export capabilities, migrating to another system requires significant effort. A practice growing from 5 to 20 clinicians would see their monthly costs jump from $395 to $1,410 on the Plus plan, a 257% increase. The recent acquisition by Vista Equity Partners has users concerned about future price increases and feature restrictions. Some former Luminello users who were forced to migrate report missing critical features they relied on.
Source: SimplePractice
TheraNest requires significant time investment to set up and customize.
While powerful, the learning curve means you might spend weeks getting everything configured correctly. The modular pricing for add-ons like telehealth ($12-25/month) and e-prescribing ($65/month) can quickly increase your total cost. However, their flexibility with unlimited staff can help offset costs for larger practices.
CarePaths, despite being the oldest platform (founded in 2000), has some users reporting occasional glitches and a less polished interface.
However, they do offer phone support at 1-800-357-1200 in addition to their ticket system. Their long history suggests stability, and being privately held means they’re not subject to investor demands for aggressive monetization. Their pricing structure is specifically designed to support practice growth. The ability to add unlimited admin users and special rates for supervised clinicians means your costs grow predictably as you expand.
The best platform depends on your practice’s specific needs, growth plans, and priorities.
Choose SimplePractice if:
Start with SimplePractice’s free 30-day trial to experience the platform yourself
Choose TheraNest if:
Explore TheraNest with their 21-day free trial
Choose CarePaths if:
Try CarePaths free for 30 days and see how MBC transforms your practice
The reality is that all three platforms can effectively manage a mental health practice. SimplePractice offers the smoothest experience for solo practitioners, TheraNest provides the most flexibility for unique workflows, and CarePaths delivers the best value for growing group practices while adding clinical intelligence through its long-established MBC system.
But, since therapy effectiveness is increasingly scrutinized by insurance companies and clients alike, and practice growth often determines financial viability, CarePaths’ combination of outcome tracking, sustainable pricing for growth, and support for supervision models might be more than nice features. They could be the keys to building a thriving, evidence-based practice that delivers measurably better results for your clients while maintaining healthy margins as you scale.
