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SimplePractice Hidden Fees in 2026: The Full List of Extra Costs

SimplePractice's plan prices are just the start. Depending on how you use the platform, additional fees can add $30-150+/month to your true cost. Here is every fee, who pays it, and how to minimize it.

FeeAmountWho pays itTypical monthly costCan you avoid it?
Clearinghouse fee$0.25 per claimInsurance billers on Essential or Plus$7.50-50/mo depending on volumeUse Office Ally (free external clearinghouse)
Credit card processing2.95% + $0.30/transactionAnyone accepting card payments$15-60/mo on typical practice revenueEncourage ACH transfers (1%, $1 min)
ACH bank transfer1% (minimum $1)Anyone using bank transfer payments~$5-20/moCannot avoid if accepting online payments
AI Note Taker add-on$35/monthOptional for any plan$35/moUse Mentalyc or other AI note tools
ePrescribe add-on$49/monthPrescribers (psychiatrists, NPs) only$49/moNot applicable for non-prescribers
CPT licensing fee$20/year per clinicianAnyone submitting insurance claims~$1.67/mo per clinicianCannot avoid if billing insurance

True Monthly Cost: Real Practice Scenarios

Cash-pay solo therapist, telehealth

Essential plan$79.00
Card processing (20 sessions x $150, 80% card)$70.80 of revenue at 2.95% + $0.30 = ~$25.00
CPT licensing (if no insurance)N/A
ClearinghouseN/A
Total~$104/mo

Card processing varies by revenue volume. Use ACH to reduce this.

Insurance-heavy solo therapist

Essential plan$79.00
Clearinghouse (40 claims/mo)$10.00
CPT licensing ($20/year)$1.67
Card processing (some clients)~$10-20
Total~$102-112/mo

Insurance copays via card add more. ACH encouraged.

The CPT Licensing Fee: The Most-Missed Hidden Cost

SimplePractice charges $20/year per clinician for access to AMA CPT codes used in insurance billing. This is a real cost most therapists discover only when they see their first annual charge.

For a solo therapist: $20/year ($1.67/month). For a 10-clinician group: $200/year ($16.67/month). It does not break the budget but it is a genuine hidden cost that no competitor prominently discloses either.

How to Minimize SimplePractice Hidden Fees

Use Office Ally instead of built-in clearinghouse

Saves: Up to $25/mo for high-volume insurance billers

Encourage clients to pay by ACH bank transfer instead of card

Saves: $3-4 per session (2.95% vs 1% rate)

Skip the AI Note Taker if you have another solution

Saves: $35/mo

ePrescribe only needed for prescribers (psychiatrists, NPs)

Saves: $49/mo if not applicable to you

Honest Verdict: Are Hidden Fees a Dealbreaker?

For most therapists, no. A solo therapist on Essential with moderate insurance volume pays $100-120/month all-in, which is reasonable for a full EHR. Knowing about the fees lets you budget properly and compare fairly with competitors who bundle costs differently.

TherapyNotes at $49/month also has per-claim fees. Jane App bundles some costs differently. The honest comparison requires calculating total cost for your specific practice, which is what the cost calculator does.

Frequently Asked Questions

Does SimplePractice have hidden fees?

Yes. Beyond the monthly plan fee: $0.25/claim clearinghouse fee, 2.95% + $0.30 credit card processing, 1% ACH, $35/mo AI Note Taker (optional), $49/mo ePrescribe (prescribers only), $20/year CPT licensing (insurance billers). A typical insurance-billing solo therapist pays $100-115/month total.

What is the CPT licensing fee?

$20/year per clinician for access to AMA Current Procedural Terminology codes used in insurance billing. Often missed when calculating SimplePractice costs. Adds about $1.67/month per clinician.

How much does the AI Note Taker add-on cost?

$35/month. It transcribes sessions and drafts notes automatically. Mentalyc is an alternative AI note tool that integrates with SimplePractice at potentially lower cost depending on your volume.

What is the ePrescribe cost?

$49/month. Only relevant for prescribers (psychiatrists, psychiatric nurse practitioners). Therapists who do not prescribe medications do not need this add-on.