You opened a therapy practice because you wanted to help people — not because you wanted to evaluate software platforms. But here you are, comparing pricing pages on SimplePractice, TherapyNotes, Jane, and IntakeQ, trying to figure out which one will cost the least while still letting you run your practice.
The pricing models across these platforms share a common trait that should bother you: they charge per provider.
SimplePractice starts at $49 a month for a solo clinician; group practices are on its Plus plan, at $99 for the first clinician and $74 for each additional one, with custom pricing from 6 clinicians up (SimplePractice pricing, checked October 2026). TherapyNotes charges group practices $79 for the first clinician plus $50 for each additional one (TherapyNotes pricing update, checked October 2026). Jane charges per practitioner who books appointments (Jane pricing, checked October 2026). For a group with five therapists, that's $395 a month on SimplePractice's group plan or $279 on TherapyNotes at list price, before add-ons.
This is the per-seat tax. It's the same model that made DocuSign expensive for businesses with large teams, and it's the same model that's silently inflating your operational costs.
What You Actually Use vs. What You Pay For
Talk to any practice owner running one of the major platforms, and you'll hear some version of the same story:
"We use it for scheduling, intake forms, and collecting signatures on consent documents. The billing module is there but we do billing through our clearinghouse. The telehealth is there but we use Zoom. The clinical notes are there but half my team uses their own templates."
Practice management software bundles everything — scheduling, billing, clinical documentation, telehealth, client portal, intake forms, e-prescribing, outcome tracking — into one platform. You pay for the whole bundle even when you only need parts of it.
For a solo practitioner just starting out, that bundle makes sense. One tool for everything.
For a growing practice with 5 to 20 providers, the math breaks down. You're paying per-provider prices for features that most of your team doesn't touch.
Which Costs Scale With Headcount and Which Don't
Split the bill by the kind of work each part of it pays for.
Work that really is per clinician: clinical notes, treatment plans, and insurance billing. Each clinician produces their own documentation, so a per-clinician price tracks real use.
Work that's practice-wide: intake forms and consent documents, records organization, physician orders and authorizations, payment collection, and staff paperwork. Most of it is done by the front desk and the office manager, and it doesn't grow in step with the number of clinicians.
When the practice-wide work is billed per clinician, every new hire raises the price of work that didn't change.
The Per-Seat Problem in Healthcare Software
Non-clinical staff are not always the expensive part. Jane, for example, doesn't charge for admin or support staff who don't have appointments booked under their profile. The cost bites on clinicians. Every associate, part-time clinician, or supervisor who needs to document adds a seat — $74 a month on SimplePractice's group plan, $50 on TherapyNotes — at the same published rate whatever their caseload. (Jane is an exception, with a separate part-time rate.)
That creates a specific dysfunction in group practices: it incentivizes limiting access. Practices think twice before giving a part-time clinician their own login, and people work around the system instead of through it. The worst outcome is a practice that's paying for software but still running on paper and email workarounds because not everyone has a login.
Businesses run into the same thing with e-signature. A 50-person company on DocuSign Standard pays $1,500 a month — 50 seats at $30 each, billed annually (DocuSign pricing, checked October 2026). A flat-rate e-signature plan, such as GetDocsSigned's Business plan at $99.99 a month for up to 100 envelopes, covers the same 50 people for 93% less. That's for regular business documents with no patient information; GetDocsSigned's e-signature is outside its HIPAA environment.
Real Numbers: A 10-Clinician Practice
Per-clinician pricing, at published group rates:
- SimplePractice Plus: $99 + 9 × $74 = $765/month (groups of 6 or more are quoted, so yours may differ)
- TherapyNotes: $79 + 9 × $50 = $529/month
- Annual cost: $6,348 to $9,180, before add-ons such as premium telehealth or AI note tools
Moving intake and patient records to a flat-rate healthcare account:
- Patient paperwork needs a BAA. On GetDocsSigned that means a healthcare account, set up by hand with a signed BAA: healthcare forms, patient records, order tracking and fax run in a separate HIPAA environment. Healthcare accounts start at $199 a month per practice, with unlimited staff users. That includes the BAA and setting up your forms from your blank PDFs. Practices with several locations get a quote.
- Annual cost: from $2,388
- The EHR stays, for notes and billing
That second line is an added cost unless it lets you cut the first. For 10 clinicians, the EHR bill has to fall by more than $199 a month — about $20 per clinician — to break even. Whether it can depends on your EHR. On SimplePractice, group practices are on the Plus plan, so taking intake out doesn't move you to a cheaper tier.
What the flat fee does do is stay flat. At 15 clinicians, SimplePractice's published group rates come to $1,135 a month and TherapyNotes' to $779. The healthcare account still starts at $199 a month per practice, with unlimited staff users.
Staff and vendor paperwork, which never contains patient information, is a separate line: regular plans start at $9.99 a month, with unlimited users. Payment links cost card processing plus a small per-payment platform fee, deducted from each payout. Payments are an add-on we turn on by request, including for healthcare accounts. They run outside the HIPAA environment, so payment descriptions stay neutral, such as an invoice number, and never name a diagnosis or service.
For which tools fit which job, and when to stay on SimplePractice, see SimplePractice alternatives for group practices.
Where the Per-Clinician Model Hurts Most
Practices with many part-time clinicians. On SimplePractice's and TherapyNotes' published group pricing, a clinician who sees five clients a week costs the same seat as one who sees thirty.
Group practices growing from 5 to 20 clinicians. Each hire adds a seat, and add-ons priced per clinician multiply with it.
Outpatient therapy clinics (PT, OT, speech) where much of the paperwork — intake, physician orders, authorizations — is handled by front desk staff rather than by clinicians.
The Question to Ask Yourself
Look at your current software bill. Add up every per-provider fee across every platform your practice uses. Then ask: how much of that total is paying for features your team actually uses daily?
If the answer is "less than half," you're not getting a practice management solution. You're getting a tax on growth.
The practices that thrive aren't the ones with the most expensive tools. They're the ones that matched the right tool to the right job — and didn't let per-seat pricing turn every new hire into a software cost.
GetDocsSigned sets up healthcare accounts by hand with a signed BAA: healthcare forms, patient records, order tracking and fax. E-signature, payments and the AI form builder are outside that environment. Unlimited users. See how it works