5 best TheraNest alternatives in 2026: Telehealth and pricing compared

The best TheraNest alternatives in 2026 are Pabau (the practice management platform we build), SimplePractice, TherapyNotes, Carepatron and Counsol. The right one depends on your practice size and how you bill.

Pabau is our top pick for growing and multi-specialty practices. SimplePractice is the easiest switch for solo therapists, and TherapyNotes leads on insurance billing. Carepatron is the cheapest way in, while Counsol suits solo counselors who choose their tier carefully.

Choosing well matters, because a switch moves every patient record, note and open claim. Nobody wants to do that twice. Below, we compare features, first-party pricing and which plans include telehealth, then share a checklist for the move.

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Key takeaways

1. Pabau — best for growing and multi-specialty practices that want records, scheduling and billing in one system.

2. SimplePractice — the easiest switch for solo therapists, with telehealth on every plan.

3. TherapyNotes — the strongest insurance billing for behavioral health group practices.

4. Carepatron — the lowest cost of entry, with a free plan that includes basic telehealth.

5. Counsol — a simple counseling platform, with telehealth from its Premium tier.

Why therapists start looking for TheraNest alternatives

Therapists who leave TheraNest usually name one of three triggers. Prices have gone up, newer platforms have added features faster, or the practice has grown past what the setup handles well.

In practitioner forums, the same complaints come up again and again. Multi-clinician scheduling feels rigid, telehealth needs workarounds, and billing trails tools built for insurance-heavy practices. Solo therapists also watch per-clinician costs closely, so every price rise stings.

Knowing your own trigger shortens the shortlist fast. If billing is the pain point, TherapyNotes is the most-cited fix. If you want simplicity and telehealth, SimplePractice dominates that conversation. If you offer services beyond therapy, Pabau gives you a broader clinical and operational toolkit.

How we judged each platform

We scored each platform on six criteria that therapists name most often when they switch from TheraNest.

• HIPAA compliance: Does the vendor sign a Business Associate Agreement (BAA)? Per HHS HIPAA guidance, software handling protected health information needs a BAA with the covered entity. Every platform here offers one.
• Telehealth: Is video built into the platform, and which plan includes it? We flag tier-gated telehealth wherever the vendor’s pricing page shows it.
• Billing: Does it handle insurance claims, ERA/EOB processing and clearinghouse submission? We note where a tool suits private-pay work best.
• Clinical documentation: How good and how flexible are the note templates, SOAP notes, treatment plans and intake forms?
• Pricing model: Is it priced per clinician, per tier or per location? We flag free plans and what they leave out.
• Practice-type fit: Is the platform optimized for solo, small group or multi-specialty practices?

TheraNest alternatives side by side

The table gives you the quick version. Starting prices come from each vendor’s own website, and ratings come from Capterra.

Starting price only tells half the story, because telehealth is not on every entry plan. Here is what the cheapest plan with video costs on each platform.

1. Pabau suits growing and multi-specialty practices

Pabau is a unified practice management and EHR platform for practices that need more than a single-specialty tool. It covers therapy practice management, mental health documentation, scheduling and invoicing in one system. That makes it a good fit if you offer therapy alongside other clinical services.

For therapists, Pabau provides customizable clinical notes, including SOAP format, plus digital intake forms and treatment plans. Patients use the Client Portal for secure messages and documents, and integrated video consultations cover remote sessions. Every subscription includes every feature, so no core clinical tool sits behind a higher plan.

Key features

• Clinical documentation: Customizable note templates, SOAP notes and structured treatment plans that work across specialties
• Digital forms: Paperless intake forms and consent documents that patients complete before their appointment
• Scheduling: Multi-clinician calendar, online booking, automated reminders and waitlist management
• Telehealth: Video consultations inside the platform, billed through usage credits
• Billing and payments: Invoicing, online payments and billing linked to the clinical record
• Client Portal: Secure messaging, document access and appointment management for patients
• Multi-location support: Scheduling, records and reporting across several sites from one account
• Automation: Recall workflows, follow-up sequences and reminders that cut no-shows and manual admin

Where Pabau shines

• Multi-specialty practices: Therapy runs alongside wellness, dermatology or functional medicine in one system, so you don’t add a second platform as you diversify
• Scaling from solo to team: Adding clinicians, locations or services doesn’t mean migrating to a different product
• Automation depth: Recalls, follow-ups and reminder sequences take admin off small teams with busy calendars
• No feature gating: Pricing scales with users and locations, not with which tools you can access

Where Pabau falls short

• US insurance billing depth: TherapyNotes has more mature ERA/EOB processing for insurance-heavy US practices
• Therapy-only templates: Therapy-only platforms ship with more therapy note templates out of the box. Pabau needs more setup for a therapy-only workflow
• Solo entry price: Solo therapists can start for less on SimplePractice or Carepatron

Customer reviews

According to Capterra reviewers, Pabau earns 4.7 out of 5 from over 600 verified reviews. Reviewers highlight easy scheduling, the depth of features for multi-clinician practices, and the Client Portal. The most common critique is a learning curve when configuring it for one specialty.

Who Pabau is best for

• Multi-specialty practices that offer therapy alongside wellness, aesthetics or other clinical services
• Group practices that want scheduling, clinical records and billing in one place
• Practices that have outgrown a single-specialty EHR
• Therapy practices that want to cut manual admin with automation and online booking

Pricing

Every Pabau plan includes the full platform, and annual billing saves up to 20%. You can see the breakdown on Pabau’s pricing page.

2. SimplePractice is the easiest switch for solo therapists

SimplePractice is the most widely cited TheraNest alternative in practitioner communities. It’s built for private practice therapists, counselors and psychologists, and reviewers praise its clean design and quick setup.

Native HIPAA-compliant telehealth and a polished client portal make it the default comparison point for solo therapists. If you’re weighing it against Pabau, our side-by-side SimplePractice comparison covers the differences.

Key features

• Built-in telehealth: HIPAA-compliant video sessions inside the platform, with no Zoom link required
• Client portal: Self-scheduling, secure messaging, document signing and payments in one patient-facing interface
• Insurance billing: ERA/EOB processing, clearinghouse submission and claim tracking on higher plans
• Note templates: Pre-built therapy templates, including SOAP, DAP and treatment plan formats
• Scheduling: Online booking with automated reminders and a calendar optimized for solo practice
• Measurement tools: Outcome measures and progress tracking inside the clinical record

Where SimplePractice shines

• Solo practice UX: Reviewers consistently rate it the easiest EHR to set up for a one-therapist practice
• Telehealth quality: Native video is reliable and HIPAA-compliant, with no third-party link to manage
• Patient experience: Reviewers say the client portal cuts phone calls and speeds up document collection

Where SimplePractice falls short

• Price trajectory: Reviewers note that costs rise noticeably as you upgrade plans or add clinicians
• Limited customization: Complex documentation or multi-specialty workflows are hard to configure beyond its therapy defaults
• Group practice scaling: Group features exist, but the platform is clearly optimized for solo therapists

Customer reviews

According to Capterra reviewers, SimplePractice earns 4.6 out of 5 from over 2,700 verified reviews. That makes it one of the most-reviewed therapy EHRs on the site. Praise centers on ease of use, the client portal and telehealth reliability, while complaints focus on price and rigid workflows.

Who SimplePractice is best for

• Solo therapists, counselors and psychologists in private practice
• Practitioners who put a polished patient experience ahead of operational depth

Pricing

Solo plans run from $49 to $99 a month, and new accounts get 50% off for three months. Our SimplePractice pricing breakdown covers add-ons and group rates.

3. TherapyNotes handles insurance billing best

TherapyNotes built its reputation on clinical documentation and insurance billing. For group practices running high volumes of insurance-covered sessions, it’s often called the strongest pure-EHR option in mental health.

Its note templates are purpose-built for behavioral health. Its billing workflows, including ERA/EOB processing and clearinghouse integration, are mature and well regarded by billing staff.

Key features

• Insurance billing: Integrated clearinghouse submission, ERA/EOB processing, claim tracking and patient statements
• Clinical notes: Pre-built DSM-aligned templates designed for behavioral and mental health documentation
• Scheduling: Calendar management with appointment reminders, functional but more basic than rivals
• Telehealth: Built-in HIPAA-compliant video sessions, included on its plans
• Patient portal: Self-scheduling, document sharing and payments for patients

Where TherapyNotes shines

• Insurance billing workflows: Widely regarded as the strongest in the segment for practices that bill insurance regularly
• Mental health note templates: DSM-aligned templates cut documentation setup time for behavioral health providers
• Support quality: Reviewers consistently describe support as responsive and knowledgeable

Where TherapyNotes falls short

• Interface design: Reviewers describe the interface as functional but dated next to newer platforms
• Scheduling limitations: Practices with complex scheduling needs may find it limiting
• Multi-specialty use: It’s built for behavioral health, so other service lines need a separate system

Customer reviews

According to Capterra reviewers, TherapyNotes earns 4.7 out of 5. Reviewers highlight billing workflows, clinical note templates and support. Interface design and scheduling are where they most want improvement.

Who TherapyNotes is best for

• Group practices with high insurance billing volume
• Behavioral health practices that need DSM-aligned documentation out of the box

Pricing

TherapyNotes charges more for each clinician you add, so check the current group rate on the TherapyNotes site before you budget.

4. Carepatron gets you started for free

Carepatron targets practitioners who need a working EHR at the lowest cost. Its free plan lets a solo therapist run a full practice system before paying for anything.

The platform covers scheduling, clinical notes, a client portal and telehealth. That makes it a practical starting point for newly independent practitioners and very lean practices.

Key features

• Free plan: Core scheduling, notes and patient management for solo practitioners at no cost
• Scheduling: Online booking and calendar management with appointment reminders
• Client portal: Secure messaging, document sharing and self-booking for patients
• Telehealth: Basic telehealth on the free plan, with group telehealth on paid plans
• Clinical notes: Standard note templates with basic customization

Where Carepatron shines

• Affordability: The free plan and low paid pricing suit practitioners not ready for a bigger monthly bill
• Onboarding simplicity: Reviewers consistently mention fast setup and a short learning curve

Where Carepatron falls short

• Billing depth: Insurance billing is limited compared to TherapyNotes or SimplePractice
• Integrations: A smaller integration ecosystem means less flexibility if you rely on other tools
• Reporting: Reporting and analytics are lighter than on mid-tier and premium platforms

Customer reviews

According to Capterra reviewers, Carepatron earns 4.5 out of 5. Reviewers like its price, ease of use and the free plan for new practitioners. Those who need deeper billing or integrations tend to move to bigger platforms as they grow.

Who Carepatron is best for

• New solo practitioners looking for a zero-cost starting point
• Private-pay therapists who don’t need complex insurance billing

Pricing

The 50% promo runs for six months, so budget for the regular price after that. Our Carepatron pricing guide walks through what each plan leaves out.

5. Counsol keeps counseling simple, if you pick the right tier

Counsol is a counseling-focused platform with four plans. Standard covers scheduling, a patient site, notes and invoicing, but it leaves out telehealth and insurance claims.

Premium adds secure video and live chat, and Standard Plus adds insurance claims instead. Premium Plus includes both. Counsol has a smaller user base than SimplePractice or TherapyNotes, yet its counseling-first design keeps daily work simple.

Key features

• Telehealth: Secure video sessions and live chat on the Premium and Premium Plus plans
• Client site: Scheduling, form completion, secure messaging and payments for patients
• Scheduling: Online booking and calendar management with automated reminders
• Intake forms: Customizable online intake forms and consent documents
• Billing: Invoicing on every plan, with electronic claims and ERA on Standard Plus and Premium Plus

Where Counsol shines

• Clear tiers: Each plan lists exactly what it includes, with no setup fees or long-term contract
• Counseling focus: Defaults and templates are tuned to how counselors work

Where Counsol falls short

• Telehealth costs extra: The Standard plan has no video, so telehealth means paying for Premium
• Smaller community: Fewer peer reviews and community resources than SimplePractice or TherapyNotes
• Reporting: Analytics and reporting are lighter than on larger platforms

Customer reviews

According to Capterra reviewers, Counsol earns 4.7 out of 5. Reviewers praise the built-in telehealth, the straightforward pricing and the client site. Most critiques mention the limited reporting and the small peer community.

Who Counsol is best for

• Solo counselors who want a simple platform and know which tier they need
• Private-pay counselors who want telehealth without insurance billing

Pricing

Each extra counselor adds $35 to $45 a month, depending on the plan. Those are Counsol’s current sale prices, so confirm them when you sign up.

Five features decide whether a switch works

Every platform on this list covers the basics. The differences show up in five areas, which are also where most therapists report their frustration with TheraNest.

Solo therapists should start with the billing question

Solo practitioners weigh things differently from groups. Price matters more, there’s no admin team, and the platform has to do the front desk’s job.

• SimplePractice is the most established choice for solo practitioners. Its client portal, native telehealth and clean interface keep admin time low. Choose it if reliability matters more to you than price.
• Carepatron is the right choice when cost comes first. The free plan can run a solo private-pay practice. Its billing is limited, though, so it suits therapists who invoice patients directly.
• Counsol suits solo counselors who want a simple, counseling-first tool. Telehealth starts on its Premium plan at $64.95 a month, so pick the tier before you sign.

So, do you bill insurance? If yes, SimplePractice’s higher tiers or Counsol’s Standard Plus will handle it. If not, Carepatron or Counsol keep monthly costs lower.

Group practices need scheduling and billing that scale

Groups need multi-clinician billing, per-provider scheduling and shared records with access controls. Solo-focused platforms often struggle with all three, so the shortlist changes.

• TherapyNotes is the most reliable choice for insurance-heavy groups. Its billing workflows are built for high ERA/EOB volume, where claim accuracy is critical.
• Pabau suits groups that need more than a therapy EHR. Multi-clinician scheduling, multi-location support and automation suit busy calendars. Pricing is based on locations and users, with every feature included.
• SimplePractice supports groups, but it’s optimized for solo work. It works for small groups of two to five clinicians, though per-clinician costs add up at scale.

Torn between the two insurance-ready options? Our SimplePractice vs TherapyNotes breakdown compares their billing and pricing in detail.

How to choose the right TheraNest alternative in five steps

These five platforms cover most therapy practice setups. Here’s how to narrow five down to one.

1. Define your non-negotiables first. A signed BAA and telehealth on your plan are near-universal requirements. The American Psychological Association’s telepsychology guidelines expect your platform to support secure remote care.
2. Identify your billing model. Heavy insurance billing points to TherapyNotes. Private-pay work suits Carepatron, Counsol or SimplePractice. Billing across several clinical disciplines points to Pabau.
3. Match on practice type. Solo therapists should look at SimplePractice or Carepatron. Small groups suit SimplePractice or TherapyNotes, and multi-specialty practices suit Pabau or TherapyNotes.
4. Test the documentation workflow. Request a demo or a structured walkthrough, and write one session note end to end. Count the clicks, because daily friction is what derails adoption.
5. Calculate the five-year cost. Per-clinician pricing compounds as you hire. SimplePractice’s group Plus plan lists $99 for the first clinician and $74 for each one after. At five clinicians, that’s $395 a month before add-ons.

Plan the move before you cancel TheraNest

Switching pain usually comes from doing the steps in the wrong order. Work through this checklist before your TheraNest renewal date.

• Sign the BAA first. Don’t upload a single patient record until the new vendor’s BAA is signed.
• Export a full copy of your data. Ask for demographics, notes, treatment plans, documents and the billing ledger, then check the file opens.
• Close out open claims. Let in-flight claims settle in TheraNest, and start new claims in the new system.
• Run both systems for two to four weeks. Book new appointments in the new platform while old ones finish in TheraNest.
• Rebuild your note templates. Recreate your most-used templates and test them on a mock session.
• Tell patients what changes. Send new portal and booking links before their next appointment.

The most common mistake is cancelling TheraNest before the export is confirmed. Another is forgetting saved payment cards, which often can’t move between payment processors. Plan to collect them again at the first visit.

How Pabau supports a therapy practice that’s outgrown TheraNest

A practice that has outgrown TheraNest usually runs on a patchwork by now. Notes live in one tool, intake forms in another, and someone confirms appointments by phone.

Pabau brings scheduling, online booking, digital intake forms, Client records and invoicing into one system. Patients complete intake before their first session, and automated reminders confirm the slot. Your team stops chasing paperwork.

Pricing scales with locations and users, and every plan includes every feature. Adding a clinician or a new service means adding a user, not a new product. Structured onboarding, with a dedicated coordinator, moves your records across.

See Pabau run your therapy practice

Watch scheduling, intake, notes and billing work together in one system. Book a demo to walk through your own workflow with our team.

Book a demo

Conclusion

Start with the bill you send most often. If insurance claims drive your revenue, TherapyNotes is worth its dated interface. If you’re solo and private-pay, SimplePractice or Carepatron gets you live fastest.

Counsol works well too, once you pick a tier that includes telehealth. And if you’re adding clinicians or services beyond therapy, the cheapest switch today can turn into a second migration in two years.

Whichever you choose, check that the vendor signs a BAA and that telehealth is on your plan before you buy. Book a demo to see how Pabau handles intake, notes and billing for a growing therapy practice.

Continue your research

Comparing therapy EHRs more broadly? Carepatron alternatives covers the wider mental health EHR field with feature and pricing data.

Leaning toward SimplePractice? Our SimplePractice review breaks down its features, pricing, pros and cons.

Want more options beyond SimplePractice? SimplePractice competitors compared ranks seven rivals for 2026.

Deciding between the two budget picks? Carepatron vs SimplePractice shows which EHR fits which practice.

Running an allied health or mixed practice? Jane App alternatives compares features, pricing and reviews for 2026.

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