TherapyNotes Alternatives for Group Practices 2027: 5 Picks

Start with per-clinician math, not feature counts

A TherapyNotes alternative for a group practice is a practice-management EHR that keeps scheduling, notes and claims in one system and charges for each clinician, not only for the owner's account. The cost question sits mostly in the second through fifth clinician, because several vendors advertise a low entry price for a solo account and a higher one once a team is added.

TL;DR: Among the vendors whose pricing pages we could read, CarePaths' group rate and TheraNest's Advanced tier are the lowest-cost group options, SimplePractice's Plus plan costs more per added clinician, and Jane's additional licenses are quote-based. Choose on claims depth and group features only after the per-clinician math fits your budget.

Key Takeaways

• At five clinicians on list prices, CarePaths is the lowest of the three vendors with full published group pricing, and SimplePractice's Plus plan is the highest; the math is in the pricing section below.

• TherapyNotes and Owl Practice did not load plan prices in this research, so this guide prints no figure for either one.

• Claims depth varies: a ChoosingTherapy review calls SimplePractice's billing a strength, describes Owl's billing as simpler than deep, and calls TherapyNotes' billing reliable but less flexible at scale.

• Group telehealth is included in TheraNest's Advanced tier and in SimplePractice's Plus plan, while Jane sells it as a paid add-on.

• Get written answers on data export and API access before you sign, because the SimplePractice and Jane reviews both flag the lack of an open API.

How we evaluated these tools

This guide weights seven criteria, and the weights sum to 100 percent. Cost and group features carry 45 percent of the weight together, claims depth carries 20 percent, and the remaining 35 percent covers transparency, staff access, integrations and onboarding.

Prices come only from vendor pricing pages opened for this guide, and the review evidence comes mainly from ChoosingTherapy, a review site that says it may earn commissions from the products it covers. Several other review sites blocked our research tool, so independent coverage is thinner than we would like. Treat the review scores below as one reviewer's view. No product was trialed for this guide.

Side-by-side feature matrix

Yes means a vendor page or a cited review says so. "Not verified" means no source we could open answered that cell.

The matrix is a normalized view, not a ranking. Two questions are worth putting to every vendor in writing: its API status, and how its role controls work for billers and schedulers, since we could not verify role controls for CarePaths.

What each option costs for five clinicians

SimplePractice's Starter, Essential and Plus plans list at $49, $79 and $99 a month, and its Insurance Navigator add-on is $1.79 per claim after 30 free days and is marked coming soon, according to SimplePractice.

Plus group plan: $74 per added practitioner (SimplePractice, 2026). The Plus group card shows $99 for the first practitioner, and a $37 figure appears beside the $74 rate that we read as a promotional price, so confirm the current rate with SimplePractice. Groups of six or more practitioners are routed to a sales consultant. At list prices, five practitioners on Plus come to $395 a month ($99 plus four at $74).

Advanced tier: $59 per therapist per month according to Ensora Health (2026). TheraNest's Essentials and Premier tiers list at $29 and $89 per therapist, and annual billing lowers the monthly rates to $27, $54 and $82. Only Advanced adds group practice reports, online booking and unlimited group telehealth, so it is the group tier, and five therapists at list come to $295 a month.

The same page lists Ensai Session Assistant at $35 per provider per month and an annual CPT license fee of $19.50 per therapist, and it allows 50 free claims, eligibility checks and reminders per practice each month, after which claims cost $0.23 each, according to Ensora Health.

Group pricing: $49 per licensed therapist according to CarePaths (2026), with part-time therapists at $34 and unlimited administrative staff included. The EHR and measurement-based care plan is listed at $49 a month, with a free 30-day trial that needs no card, according to CarePaths. The same page's comparison table says it was last updated May 2025, so confirm current figures before relying on them. Five full-time licensed therapists come to $245 a month at list.

Jane's Balance, Practice and Thrive plans list at $59, $79 and $99 a month for one practitioner, group telehealth is $15 per opted-in practitioner, and insurance billing is $20 a month plus $5 per additional full-time license, according to Jane (2026). Practice and Thrive charge per additional license, but the page shows no dollar amount for those seats, so a five-clinician Jane price is quote-based.

Owl Practice's pricing page did not load in this research; its owlpracticesuite.com pricing URL returned a 404, so this guide prints no Owl figure. TherapyNotes' pricing page is titled Pricing Plans, according to TherapyNotes (2026), but it returned no plan figures in our research, so this guide prints none for TherapyNotes either.

SimplePractice group pricing checked October 25, 2026. Every figure above comes from a vendor page opened for this guide, and third-party price listings were excluded.

Owl Practice and TherapyNotes are left out of this table because neither pricing page loaded plan figures; the matrix shows both as not verified.

Claims are where group practices feel the gap

Insurance-heavy groups usually notice billing differences before they notice feature gaps. ChoosingTherapy's SimplePractice review calls its insurance billing "one of its biggest strengths for practices that want to submit claims, track status," and says the Plus plan adds automatic status checks. The same site's TherapyNotes review calls the billing "a well-structured, reliable billing system" but says larger groups "may find it limiting as they scale." Its Owl review says Owl's billing tools "prioritize ease of use over depth."

A proposed claims-exceptions workflow, which a practice could configure on US Tech Automations or build itself, would start with a trigger: a claim status export or API record marked denied or rejected. The configured action copies the claim ID, payer and denial code into a review queue and opens a task for the billing lead, and the output is one daily exceptions list. Prerequisites are a scheduled export or API access from the chosen system. Because the SimplePractice review says the product has no public API, that design would begin with an export file. In this design, a human stays in the loop: the billing lead decides every resubmission, and the workflow never resubmits a claim on its own.

A second proposed workflow covers reminder failures for practices that send SMS through their own Twilio account. The trigger is a message status update that shows a failed or undelivered send. The configured action routes that client's appointment to the front desk with the appointment time, and the output is a same-day call list. Prerequisites are Twilio API access and a mapping from appointment records to phone numbers. A front-desk staff member confirms the number before any call, and nothing is resent automatically.

A five-clinician month, worked through

Take a five-clinician group on TheraNest's Advanced tier, billed monthly, that files 230 claims in one month. The tier's list price is $295 (five times the $59 rate above). The 50-item monthly allowance covers claims, eligibility checks and reminders, so if claims use all 50, the other 180 claims cost $0.23 each, or $41.40 (180 times $0.23), for a total of $336.40 before add-ons such as Ensai or the annual CPT fee. If reminders also go out through a Twilio account, a failed send appears in the Message resource's error_code field, which a proposed workflow could read and route to a person instead of resending.

Build it yourself, or buy it?

Many groups first try to stitch this together in Zapier, Make or n8n. Those tools can keep run histories, retries, error branches and audit evidence when they are configured that way. The buyer still owns observability, idempotency so a retried run does not create a duplicate task, escalation paths, access controls for client records, and ongoing maintenance when a vendor changes an export format. A US Tech Automations design could set run-history, retry and escalation rules in the workflow specification before go-live, but it would still need the same API or export access and named human reviewers.

Who should choose which option

Who this is for

This guide is for an owner or operations lead at a small therapy group who is close to choosing a TherapyNotes replacement and needs per-clinician costs, group features and claims depth in one view.

Red flags: no written answer on data export, a need for a public API the vendor does not publish, or a decision that depends on a quote you have not received.

Before you shortlist, work through these checks:

1. Count licensed and part-time clinicians separately, because CarePaths and Jane price them differently.

2. Confirm the group tier you need, such as Advanced on TheraNest or Plus on SimplePractice.

3. Ask each vendor for its export format and API status in writing.

4. Price your claims volume against each vendor's allowance or per-claim rate.

5. Check whether non-clinical staff accounts are free on the tier you plan to buy.

Vendor profiles: five alternatives and the TherapyNotes baseline

SimplePractice

Best fit: groups that need a team tier, insurance workflows and a client portal. ChoosingTherapy says Starter and Essential are built for solo practices and that Plus is "the only plan that supports groups of providers." Plus adds group appointments, group telehealth and team features, and reviewers say staff roles let clinicians, administrators and billers see only what they need.

Integrations score: 3 out of 5 according to ChoosingTherapy (2025). The review calls the product's integrations a short list with no public API, and says expanded reporting, internal staff messaging and advanced access controls require Plus. Implementation means getting the Plus quote and export terms in writing before you migrate records.

TheraNest (sold by Ensora Health)

Best fit: practices that want per-therapist pricing, unlimited non-clinical staff accounts and a customizable forms builder. ChoosingTherapy calls TheraNest "a flexible option for solo and small group practices." The same review says "Per-therapist pricing adds up for group practices with many clinicians," so the cost of a larger group rises in a straight line.

Limitations: the review says "Limited forms and templates library is missing many essential document types," that the product ships with only two pre-made note templates, and that "occasional software instability" appears in user feedback. Implementation: the reviewer warns that "Extensive customization may take a lot of time and training," so budget setup time before go-live. The page offers a 21-day trial of Premier that needs no credit card.

CarePaths

Best fit: groups that want the lowest published group rate, free claims and reminders, and unlimited admin staff on one plan. The EHR listing says it includes group-capable telehealth, electronic billing and an ONC-certified EHR. Limitations: the page's comparison table is dated May 2025, the Enterprise tier has no published price, and we could not open an independent review for CarePaths, so its support and reliability record is unverified. Implementation: confirm role controls and the group telehealth setup directly with the vendor before you buy.

Jane

Best fit: mixed teams of solo and group practitioners who want calendar-heavy scheduling. ChoosingTherapy says Jane is "flexible enough for large group practices" and scores it well on calendar and support.

Reviewer score: 4.5 out of 5 according to ChoosingTherapy (2025). The same review says "No open API or Zapier integration," calls treatment planning "functional but minimal," and says the reporting tools "won't satisfy large practices looking for advanced analytics." Insurance billing runs through a Claim.MD partnership that needs its own subscription, and the review notes that Jane "does not currently support other payment processors." For a Jane-focused comparison, see Jane alternatives for therapy practices.

Owl Practice

Best fit: groups that want role permissions, supervision and co-signing in a simpler setup. A ChoosingTherapy review describes the product as "Group-practice ready with roles, permissions, supervision, and multi-location scheduling." Limitations: the review says "reporting depth is where Owl Practice shows its limits," that insurance workflows "lack some of the deeper automation and oversight features," and that some reviewers report "frustrations with insurance workflow reliability." Implementation: Owl's pricing page did not load and no Owl primary page loaded in this research, so the Pro plan's exact inclusions and prices need direct confirmation.

TherapyNotes (baseline)

TherapyNotes is the incumbent this guide is measured against, not one of the five alternatives. ChoosingTherapy says it is "especially well suited to solo clinicians and small therapy practices," with role-based permissions for clinicians, billers, schedulers and supervisors, and calls its supervision tools "particularly strong." Its limits for larger groups are scheduling and reporting: the review says multi-location or high-volume scheduling "can feel more manual than in newer EHRs," and that "There's no built-in way to easily track clinician utilization."

Common questions

Which option has the lowest published group price for five clinicians?

Among the vendors whose pricing pages loaded, CarePaths has the lowest published group rate, which is per licensed therapist. Its rate is for licensed therapists, and part-time therapists are priced separately.

Does the base group plan include group telehealth?

TheraNest's Advanced tier includes unlimited group telehealth on its pricing page, and ChoosingTherapy says SimplePractice's Plus plan adds group telehealth. Jane sells group telehealth as a paid add-on per practitioner.

Can I move records off TherapyNotes without losing data?

We found no migration guide for any option in this research, so ask each vendor for its import format and a written export of your records before you sign.

Is a free trial enough to test a group setup?

Both TheraNest and CarePaths list free trials, but confirm the trial includes the group tier you plan to buy and test staff roles and a group telehealth call during it.

Is SimplePractice's Starter plan enough for a group?

No; ChoosingTherapy says Starter and Essential are solo-only, so a group needs the Plus plan.

Why does this guide print no price for TherapyNotes or Owl Practice?

Because neither vendor's pricing page loaded plan figures during this research, and this guide prints only prices read on vendor pages during this research.

When not to use US Tech Automations: a solo clinician who needs only notes and scheduling is better served by the entry tier of the EHR itself, with no workflow layer to maintain. A group whose claims and reporting sit fully inside its EHR's built-in tools gains little from a second system. A practice with no export or API access would end up copying data by hand, which is a weaker setup than the EHR's own features.

The short version for a group practice

For five clinicians, the lowest list-price path among the vendors we could read is CarePaths, followed by TheraNest's Advanced tier and then SimplePractice's Plus plan, but cost is only the first filter. Claims depth, group telehealth and written export terms should decide the final shortlist, and the TherapyNotes and Owl Practice prices still need a direct quote. If your group wants a proposed claims or reminder workflow on top of the system you choose, see how US Tech Automations configures this and check its prerequisites against your EHR's export options.