SimplePractice Alternatives for Private-Pay Therapists Who Only Need AI Notes

About one-third of US psychologists now run private-pay or cash-only practices, according to APA 2024 survey data. No insurance panels. No credentialing. No claims submission. Just client appointments, session work, and progress notes.

Then SimplePractice restructured its pricing in March 2025. Starter plan went up. The features bundled into higher tiers pulled along tools that many therapists were quietly not using anyway: insurance billing, electronic remittance advice (ERA) processing, a full claims dashboard. For a private-pay therapist, that is a lot of overhead in both cost and interface complexity.

The question that followed was reasonable: do I actually need an EHR, or do I just need AI notes?

This guide is for therapists who have already answered that question. If you are private-pay, have your scheduling covered, and just want a tool that helps you write SOAP notes, DAP notes, or another session documentation format faster, here is what you need to know.

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What Private-Pay Therapists Actually Need from a Documentation Tool

Insurance billing requirements drive much of what makes a clinical EHR complex. When you remove insurance from the equation, the documentation problem becomes simpler in structure, though no less important clinically.

Here is what a private-pay practice actually requires from a documentation tool:

Accurate session notes. You still need to document what happened in session, the client's presentation, interventions used, the clinical assessment, and the plan. Licensing boards expect this. Continuity of care depends on it. If a client comes back six months after a break, you need a legible record of where you left off.

A consistent format. Whether you use DAP (Data, Assessment, Plan), SOAP (Subjective, Objective, Assessment, Plan), or BIRP (Behavior, Intervention, Response, Plan), consistency matters. Supervisors, consulting colleagues, and your own future self benefit from notes that follow a predictable structure.

Secure storage with reasonable access controls. You need to be able to retrieve notes, and you need a reasonable level of security around client records. This does not require a full EHR portal.

Speed. The documentation burden is real regardless of your payer mix. Writing a 45-minute session note after a full caseload day is exhausting. An AI tool that cuts that time meaningfully is worth paying for.

Here is what private-pay practices generally do NOT need from a documentation tool:

• Insurance claim generation or submission
• ERA processing or payer enrollment
• Credentialing workflows
• Superbill auto-generation linked to clearinghouses
• CPT code libraries built for billing
• Wiley treatment planner integrations

Many full EHR platforms bundle all of these together because their primary customer is an insurance-billing practice. If that is not your customer profile, you are paying for infrastructure you will never use.

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The SimplePractice Pricing Shift and Why It Matters for Private-Pay Practices

Before the March 2025 restructure, SimplePractice offered a Starter plan at a price point that many private-pay therapists found tolerable, even if they were using only a fraction of the features. The restructure moved scheduling, client portal, and telehealth into tiers that no longer made the math work for a solo private-pay practice that just wanted note-writing assistance.

The problem is not that SimplePractice is a bad product. For insurance-billing practices, it does a lot, and the full feature set earns its price. The problem is that the pricing structure assumes a practice that uses those features. If you are private-pay and your scheduling is handled through a separate tool like Calendly, Acuity, or Jane, you are now paying a premium for EHR features you route around daily.

This is the trigger behind the "SimplePractice alternative" searches that have been rising steadily since mid-2025. Therapists are not looking for a cheaper EHR. They are asking whether they need an EHR at all.

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When a Full EHR Is Overkill

A full EHR makes sense when you need at least some of the following:

• Insurance billing and claims submission
• An integrated client portal for intake forms and secure messaging
• Telehealth built directly into the platform
• Treatment planning tied to billing codes
• Wiley-style planner modules

If your private-pay practice runs on separate tools for each of these, or skips some entirely, a standalone AI note tool handles the remaining piece without the overhead.

Consider a therapist like Dr. Priya, a licensed psychologist running a private-pay trauma practice in a mid-size city. She schedules through Acuity, does telehealth through a dedicated HIPAA-covered platform, and sends invoices manually. The only thing she ever opened SimplePractice for was to write session notes. After the March 2025 pricing change, she realized she was paying $79/month for a note-writing workflow. Moving to a standalone AI note tool cut that to $25/month with no feature loss for her actual workflow.

This is not an unusual situation.

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The Standalone AI Note Tool Landscape

Several tools focus specifically on AI-assisted session documentation without the EHR overhead. Here is a current read on the main options.

Quill (Quill Therapy Notes)

Price: $20/month

Quill is a generation-based tool that produces notes from your session information. It is priced below most competitors and has a clean interface. The note output is AI-generated from what you provide, which means quality depends on how much structured input you give it.

Quill does offer a BAA, which matters for therapists who want that layer of contractual protection. The note format is mostly provider-configurable. It does not tie into billing or scheduling, which is exactly the profile private-pay therapists are looking for.

Worth knowing: at $20/month, it is the lowest-priced paid option among the dedicated tools, which makes it a common starting point for therapists who are testing the waters.

Twofold

Price: $49/month

Twofold positions itself as a therapy-specific AI documentation tool with a focus on format control and clinical specificity. It is priced toward the mid-tier of the standalone market.

The interface is more polished than some alternatives, and the output tends to be clinically grounded. For therapists who want something that feels built for the mental health context specifically (not a general medical scribe), Twofold is a solid candidate.

The $49/month price point is a consideration if your primary need is documentation and nothing else. It is more than double Quill and about double NotuDocs, so you want to make sure the output quality justifies the premium for your workflow.

Berries

Price: $99/month

Berries targets clinicians who want a high level of automation and are willing to pay for it. At $99/month, it is at the top end of the standalone documentation tool market.

If you are running a full caseload and documentation is your primary operational pain point, the monthly cost may make sense. But for a private-pay solo therapist who just left SimplePractice to reduce overhead, $99/month is likely higher than the previous pain.

Berries does have a richer feature set and more customization options. If documentation volume is high enough, the per-note economics may be favorable. For most solo private-pay practices, though, the price alone will filter it out early.

Heidi Health

Price: $99/month (professional tier)

Heidi Health comes from the medical documentation space and has expanded to mental health. It uses ambient recording during sessions to capture content, which is worth noting for therapists who have strong preferences about session recording.

The ambient approach means you do not need to write notes after the session in the traditional sense. Heidi listens during the appointment and generates a draft. For some therapists this is an advantage. For others, especially those working with trauma or in contexts where the recording dynamic feels clinically significant, it is a concern.

At $99/month, the price matches Berries. The use case is somewhat different: Heidi is optimized for in-session capture, while most other tools work from post-session notes or a brief after-session summary.

If your clinical work involves sensitive disclosures where client awareness of any recording device, even for note-taking purposes, would affect the therapeutic relationship, the ambient model warrants careful thought.

NotuDocs

Price: $25/month

NotuDocs uses a template-first model: you define your note structure, and AI fills the template from what you provide after the session. There is no in-session recording. Templates are customizable to your preferred format (SOAP, DAP, BIRP, or your own variation). For private-pay therapists who want clean, predictable notes without EHR overhead, it covers the documentation piece at a price point close to Quill.

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A Practical Comparison

One note on BAAs: A Business Associate Agreement (BAA) is a HIPAA-required contract between a covered entity (your practice) and a vendor who handles protected health information (PHI) on your behalf. If HIPAA compliance is a firm requirement for your practice setup, verify BAA availability before committing to any tool. NotuDocs does not currently offer a BAA. For therapists whose compliance framework requires one, Quill is the most transparent option in the lower price tier.

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What to Look for Beyond Price

Price is an easy filter, but it should not be the only one. Here is what actually differentiates these tools in daily use.

Note Consistency

Does the tool produce notes that sound like your clinical voice, or does it produce something generic that you spend 10 minutes editing back into recognizable language? A template-based approach gives you structural control up front. A fully AI-generated approach produces more varied output. Neither is wrong, but your preference for consistency vs. flexibility matters.

Format Control

Can you specify DAP, SOAP, or your own variation? Can you require or exclude specific sections? If you work with a supervisor or consulting psychiatrist who expects a particular note structure, that is a practical constraint.

Friction After Sessions

How much do you need to input to get a usable note out? Some tools require detailed prompts. Others work from minimal input. The right amount of friction depends on your workflow: more input usually means more clinically accurate output, less input means faster turnaround but with more generic output.

What Happens to Your Data

This matters more in a private-pay context where you are the sole data controller. Read the privacy policy. Understand whether session content is used to train models. Understand where data is stored and for how long.

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The "Keep Your Scheduling, Add Notes Separately" Stack

Many private-pay therapists are already running a hybrid stack. They schedule through Acuity, Calendly, or Jane. They do video through a dedicated platform. They handle invoicing separately. The only missing piece is session documentation.

This approach makes practical sense for private-pay practices that built their tech stack before AI documentation tools existed. You do not need to consolidate everything into a single EHR to get AI-assisted notes. A standalone note tool slots in alongside your existing tools without disrupting them.

The math is also straightforward. If you were paying $79-99/month for a full EHR and using it primarily for notes, switching to a $20-25/month dedicated tool and keeping your existing scheduling tool produces the same workflow at roughly a third of the cost.

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Common Mistakes When Switching Tools

Assuming you need to migrate everything. If you move to a standalone note tool, your historical records stay where they are. You do not need to export five years of session notes from SimplePractice. Keep your old records in read-only mode or export as PDFs. Start fresh with the new tool.

Choosing based on demo impressions rather than daily workflow. Every tool looks good in a demo. The real test is: what does it feel like to write your fourth note of the day when you are running behind? Take the free trial seriously and use it on real sessions, not toy inputs.

Ignoring the BAA question before signing up. If you share session content with any AI tool, you are making a data handling decision. Know your compliance requirements before you sign up. If your practice situation requires a BAA, filter your options accordingly.

Conflating "no insurance billing" with "no documentation standards." Private-pay does not mean unregulated. Licensing board requirements, duty-to-warn obligations, continuity of care, and clinical risk management all still require solid progress note documentation. The tool changes; the standard does not.

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Decision Checklist: Do You Need an EHR or Just AI Notes?

You probably need an EHR if:

• You bill any insurance, even occasionally
• You need integrated telehealth with a waiting room portal
• You rely on Wiley treatment planners linked to billing codes
• Your intake forms, scheduling, and notes all need to live in one system
• You have employees or subcontractors who need role-based access to the full clinical record

A standalone AI note tool is likely sufficient if:

• You are 100% private-pay with no insurance billing
• You have separate tools for scheduling and telehealth that you are happy with
• You primarily need help writing progress notes faster
• You are the only clinician in your practice
• You want to reduce software costs after the SimplePractice pricing change

Before committing to any tool, verify:

• Does the tool offer a BAA, and do you need one?
• Can you use your preferred note format (DAP, SOAP, BIRP)?
• Is there in-session recording, and are you comfortable with that?
• How is session data handled, stored, and retained?
• Is there a meaningful free trial you can test on real sessions?

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Related Reading

• How to Document Private-Pay Therapy Sessions Without a Full EHR
• How Therapist Documentation Burnout Affects Practice
• Concurrent Documentation in Therapy