Best TherapyNotes alternatives for therapy practices in 2026

The best TherapyNotes alternatives for therapy practices in 2026 are SimplePractice, TheraNest, Pabau, and Upheal.

SimplePractice is the strongest all-round pick for solo therapists and small groups, especially where telehealth carries much of the caseload. TheraNest has the lowest published price per therapist, and Upheal suits therapists who want AI-drafted session notes.

Pabau, the all-in-one practice management system we build, is the pick for practices adding services or locations beyond behavioral health. We compared all four on pricing, billing, documentation, telehealth, and how well each scales past a handful of clinicians.

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Key takeaways

1. SimplePractice — best overall pick for solo therapists and small groups that run much of their caseload over telehealth.

2. TheraNest — lowest published price per therapist, with unlimited patients on every plan.

3. Pabau — best fit for practices adding clinicians, services, or locations beyond behavioral health.

4. Upheal — AI-first option for solo therapists who want session notes drafted automatically.

TherapyNotes alternatives at a glance

Here is how the four alternatives compare on the criteria practices check first.

Ratings come from Capterra. Prices are list prices from each vendor’s own website in October 2026, before any promotions.

Why practices switch from TherapyNotes

TherapyNotes is a behavioral health EHR built mainly for solo practitioners and small therapy practices. It offers therapy-specific note structures, US insurance billing, and scheduling. That focus is both its strength and its limit, and practices that leave it tend to cite the same friction points.

• Per-clinician pricing adds up: TherapyNotes bills per clinician, so the monthly cost climbs with every therapist you add. Check current figures on therapynotes.com before you compare, because they change.
• Limited multi-location tools: TherapyNotes supports group practices with several clinicians. Its tools for running more than one site, such as cross-site reporting and room booking, are more limited. Groups opening a second location often cite this as their main reason to switch.
• Narrow specialty focus: TherapyNotes is optimized for psychotherapy workflows. Practices adding physical therapy, occupational therapy, or aesthetics need a platform that documents each discipline on its own terms.
• Restricted customization: Note templates, intake forms, and documentation structures are relatively fixed. Reviewers on Capterra note that customizing workflows beyond the defaults requires workarounds.
• Telehealth as a secondary feature: TherapyNotes includes video sessions, but reviewers describe them as an addition to the core workflow. That matters for practices where most sessions happen on video.

1. SimplePractice: Best overall pick for solo and small group practices

SimplePractice is the most direct competitor to TherapyNotes in the solo and small group therapy market. It covers scheduling, clinical documentation, insurance billing, telehealth, and a client portal in one package. Reviewers consistently describe its interface as more polished than TherapyNotes’.

For therapists who want an upgrade without moving to a more complex platform, SimplePractice is the most common landing spot. Our SimplePractice vs TherapyNotes breakdown covers the head-to-head in more depth.

Key features

• Integrated telehealth: Video sessions built into the platform, with no third-party tool to manage
• Insurance billing: Claim submission, ERA processing, and superbill generation for US insurance
• Client portal: Self-scheduling, secure messaging, and intake form completion for patients
• Documentation: Progress notes, treatment plans, and discharge summaries with therapy-specific templates
• Online booking: Patients self-book from a practitioner’s public profile or widget
• ePrescribe add-on: Optional prescribing for practices with prescribing clinicians

Where SimplePractice shines

• Telehealth experience: Video sessions sit inside the workflow, which matters for practices where telehealth is the majority of sessions
• Interface quality: Reviewers on Capterra frequently cite ease of use as the main reason for choosing SimplePractice over TherapyNotes
• Patient-facing experience: The client portal handles booking, intake, and secure messaging, which cuts back-and-forth admin

Where SimplePractice falls short

• Price increases: SimplePractice has raised its prices over time. Reviewers who joined at lower rates report frustration with the increases.
• Group practice limitations: Group features exist, but the platform is optimized for solo practitioners. Practices with 10 or more clinicians often need stronger operational tools.
• Limited customization: Documentation templates are relatively fixed. Practices needing bespoke forms or cross-specialty workflows find it as constraining as TherapyNotes.

Customer reviews

SimplePractice earns 4.6 out of 5 stars on Capterra. Reviewers praise the intuitive interface and strong telehealth integration. The most common complaints concern billing complexity for insurance-heavy practices and rising subscription prices.

Who SimplePractice is best for

• Solo therapists looking for a more polished alternative to TherapyNotes
• Small group practices of two to five clinicians where telehealth is a primary delivery channel
• Practices that prioritize a clean patient-facing experience over deep operational customization

Pricing

These are SimplePractice’s standard monthly rates, and new accounts currently get 50% off for the first three months. Add-ons such as ePrescribe ($49/month plus an $89 setup fee) cost extra, as our SimplePractice pricing breakdown explains.

2. TheraNest: Lowest per-therapist price for growing group practices

TheraNest, now part of Ensora Health, targets the same small-to-mid-size group therapy segment that TherapyNotes serves. Its plans are priced per therapist, start at $29 a month, and include unlimited patients. It covers progress notes, treatment plans, scheduling, insurance billing, and a client portal.

For practices that find TherapyNotes expensive at scale but don’t need a broader platform like Pabau, TheraNest is a credible option.

Key features

• Billing and insurance: Claim submission, ERA, and clearinghouse integration for US insurance billing
• Scheduling: Appointment scheduling with patient self-booking and reminders
• Clinical documentation: Progress notes, treatment plans, and group therapy notes
• Client portal: Intake forms, secure messaging, and payment collection
• Telehealth: Video sessions included in the platform

Where TheraNest shines

• Low per-therapist pricing: Each added therapist costs $29 a month on Essentials, against $74 on SimplePractice’s group plan
• Group therapy support: Group session notes and group billing are better developed than in TherapyNotes
• Billing depth: US insurance claim submission with ERA is a core workflow, with no workaround needed

Where TheraNest falls short

• Dated interface: Reviewers consistently describe the interface as older than SimplePractice or newer entrants. It works, but it isn’t polished.
• Customer support: Review themes on Capterra flag slower support response times than competitors
• Performance issues: Reviews note occasional platform slowness, particularly during peak hours

Customer reviews

TheraNest holds a 4.4 out of 5 rating on Capterra. Reviewers appreciate the affordable pricing for group practices and the depth of its billing features. Common criticisms center on the dated interface and inconsistent support response times.

Who TheraNest is best for

• Small to mid-size group practices where per-clinician pricing in TherapyNotes is becoming expensive
• Growing groups that want unlimited patients on every plan
• US-based practices that need solid insurance billing without paying for features outside behavioral health

Pricing

TheraNest publishes these prices on the Ensora Health website, and every plan includes unlimited patients. Annual billing lowers each tier slightly and includes one month free.

3. Pabau: Best for multi-specialty and multi-location growth

Pabau is an all-in-one practice management system for aesthetic, wellness, mental health, and multi-specialty practices. It brings patient records, clinical documentation, scheduling, and workflow automation into one platform. It is built for practices that have outgrown single-specialty, single-location tools.

For behavioral health practices adding allied health services or practitioners, Pabau handles operational complexity that a single-specialty tool like TherapyNotes isn’t built for. If you’re weighing it against our top pick, the Pabau and SimplePractice comparison sets the two side by side.

Pabau’s mental health EMR includes customizable note templates, treatment plans, and documentation that adapts across therapy disciplines. TherapyNotes ships DAP, SOAP, and BIRP templates designed for behavioral health. Pabau lets practices build their own template sets, which matters when mental health sessions run alongside physical therapy, occupational therapy, or wellness services.

Key features

• Customizable clinical documentation: Build note templates, treatment plans, and intake forms specific to each service type
• Multi-location, multi-practitioner scheduling: Room booking, staff calendars, and online booking across sites
• Automated appointment reminders: SMS and email reminders with configurable timing
• Digital intake forms: Paperless digital forms sent to patients before their first session
• Client Portal: A self-service Client Portal where patients book, complete forms, and message the practice
• Integrated billing and payments: Invoicing, online payments, and financial reporting
• Telehealth: Video consultations through Pabau’s telehealth software, which runs on top-up credits
• Reporting and analytics: Practice-wide dashboards across practitioners, locations, and services

Where Pabau shines

• Multi-specialty flexibility: Practices running mental health alongside aesthetics, physical therapy, or wellness can document every service type on one platform instead of two
• Scalable scheduling: Multi-room, multi-practitioner calendars with role-based access suit group practices with five, 10, or 20 clinicians
• Workflow automation: Automated recall sequences, pre-care and aftercare messages, and paperless onboarding reduce admin time per appointment
• No feature gating: Every plan includes the full feature set. Pricing scales with the number of users and locations, with no capabilities locked behind higher plans.

Where Pabau falls short

• US insurance billing: TherapyNotes ships clearinghouse integration and ERA processing built around behavioral health claims. In Pabau, US insurance billing needs configuring for your payer mix.
• Setup time: The breadth of features means initial setup takes longer than with a single-specialty tool. Pabau runs structured onboarding for this, and reviewers note it takes some investment.
• Therapy-specific note structures: DAP, BIRP, and other psychotherapy templates need configuring. They aren’t pre-built the way TherapyNotes ships them.

Customer reviews

According to Capterra reviewers, Pabau earns 4.7 out of 5 stars from 650+ verified reviews. Positive themes center on its feature set for multi-specialty practices and its scheduling tools. Reviewers who flag concerns most often cite onboarding time and the quote-based pricing process for larger teams.

Who Pabau is best for

• Mental health practices adding allied health or wellness services alongside therapy
• Group practices with five or more clinicians needing scalable multi-practitioner scheduling
• Multi-location practices that need cross-site reporting and centralized management
• Practices outside the US, or US practices less reliant on direct insurance billing

Pricing

Pabau doesn’t publish prices because they depend on your location and number of users. Plans differ only by user count, so a quote through a demo is the quickest way to see your figure.

4. Upheal: AI-first option for documentation-heavy practices

Upheal centers its platform on AI-generated session notes. It records and transcribes sessions, then drafts progress notes for the clinician to review and approve. The aim is to cut the documentation burden that many therapists cite as their main source of burnout.

Upheal is a newer entrant with a smaller user base than the other platforms reviewed here. Its billing tools are less proven than those of TherapyNotes, SimplePractice, or TheraNest, so insurance-heavy practices should test them carefully. For solo therapists in private pay or hybrid models, Upheal’s AI notes address a problem that most established alternatives solve less directly.

Who Upheal is best for

• Solo therapists on private pay or hybrid models who spend significant time on post-session documentation
• Tech-forward practitioners who want AI-assisted workflows and are comfortable with a newer platform
• Practices where reducing documentation time matters more than billing depth

Pricing

Upheal lists these prices on its own website. Insurance claims cost $0.30 each and card payments carry a 2.9% + $0.30 fee on top.

Feature comparison: TherapyNotes vs the main alternatives

The table below compares TherapyNotes with the three full practice platforms on eight criteria practices weigh when switching. Upheal is covered in its own section, since AI documentation is its main selling point.

How to choose the right alternative for your practice

The right choice depends on which TherapyNotes limitation matters most to you. Here is a decision framework for the four most common scenarios.

For group practices, the key question is whether growth means more of the same or something new. If you’re adding more therapists and more behavioral health patients, TheraNest’s per-therapist pricing keeps costs predictable. If you’re adding service types or locations, Pabau covers services that neither TherapyNotes nor TheraNest is built for.

Pabau’s therapy practice management tools handle behavioral health and allied health under one system. On cost, list prices show how quickly per-clinician pricing diverges as you hire. At three clinicians, SimplePractice’s group plan costs $247 a month and TheraNest Essentials costs $87. At five, those figures reach $395 and $145.

On HIPAA compliance, all four platforms meet the requirements, so the question is implementation depth and documentation. The US Department of Health and Human Services’ HIPAA Security Rule guidance outlines the technical safeguards any EHR vendor serving US providers must address. Ask each vendor for its Business Associate Agreement (BAA) and its documentation of administrative, physical, and technical safeguards.

On billing, US insurance claims through a clearinghouse are standard among TherapyNotes competitors. What varies is how deep that integration goes. Practices with complex payer mixes or high denial rates should test how each platform ties clinical notes to claims. Incomplete documentation is a common denial trigger.

How Pabau supports therapy practices that are outgrowing TherapyNotes

Practices leaving TherapyNotes are usually managing more than therapy notes. A second location brings separate calendars, and a new service line needs templates the EHR wasn’t built for. Reporting across sites often ends up in a spreadsheet.

Pabau puts scheduling, clinical notes, intake forms, billing, and reporting for every site and service in one system. Your team builds its own templates for each discipline. Patients book and complete their forms through the Client Portal before their first session, so your front desk spends less time chasing paperwork.

Switching starts with structured onboarding. A dedicated Client Coordinator guides your data migration, so patient records and appointment history move across before you go live. Every plan includes the full feature set, so adding a clinician or a site never means upgrading to unlock tools.

Running a growing therapy or wellness practice?

Pabau handles multi-practitioner scheduling, clinical documentation, billing, and automated workflows across every service type your practice offers, without stitching together separate tools.

Book a demo

Conclusion

Start with the limit TherapyNotes puts on your practice today, because each alternative here fixes a different one. If cost is the problem and your team is staying behavioral health only, TheraNest is the cheapest move. If you want a smoother telehealth and patient experience for a solo or small caseload, SimplePractice is the safest switch.

If notes are eating your evenings, test Upheal’s free plan before you commit. The trade-off to remember is that a behavioral-health-only system will hit the same wall if you add services or sites.

If that’s where your practice is heading, choose for the practice you’ll run in two years. Book a demo to see how Pabau runs scheduling, notes, and billing across every service and location in one system.

Continue your research

Want a deeper look at the top pick? SimplePractice review covers its features, pricing, and pros and cons in detail.

Comparing more options before you switch? SimplePractice competitors compared reviews seven platforms against the market leader.

Running a multidisciplinary practice? Jane App vs SimplePractice shows which EHR fits allied health teams better.

Mixing therapy with wellness or nutrition services? Practice Better vs SimplePractice compares the two for practices offering programs alongside sessions.

Frequently asked questions