Sessions Health vs SimplePractice 2026 — Free EHR vs Paid: Which Is Right for You?
Sessions Health is the only fully free HIPAA-compliant EHR for therapists. SimplePractice starts at $29/month and is the most widely used therapy EHR in the US. Both sign a BAA, both offer telehealth — but the differences in insurance billing, reminders, and support are significant. Here is an honest, detailed comparison.
Updated June 21, 2026 · Both platforms verified HIPAA-compliant
Quick Answer
Sessions Health is the right choice if you are a cash-pay solo therapist who wants a permanently free, HIPAA-compliant EHR. SimplePractice is the right choice if you bill insurance, need SMS appointment reminders, or plan to grow beyond one clinician — the Essential plan at $69/month pays for itself in billing time saved.
WHAT IS SIMPLEPRACTICE?
SimplePractice is the most widely used EHR for therapists in private practice, trusted by over 185,000 mental health clinicians. It offers integrated scheduling, notes, billing, telehealth, and insurance claim submission in one platform — starting at $29/month.
WHAT IS SESSIONS HEALTH?
Sessions Health is a free, HIPAA-compliant EHR built specifically for therapists. It covers documentation, telehealth, scheduling, and a client portal at no cost — with a signed BAA even on the free plan. Ideal for solo cash-pay practices.
CHOOSE SIMPLEPRACTICE IF
- →You bill insurance
- →You want SMS reminders
- →You need group practice features
- →You want the most polished experience
- →You see 10+ clients per week
SESSIONS HEALTH IS FINE IF
- ✓You are cash-pay only
- ✓You are just starting out
- ✓You see a small caseload
- ✓Budget is your top priority
- ✓You do not need insurance billing
| FEATURE | SimplePractice | Sessions Health |
|---|---|---|
| Starting price | $29/month | Free forever |
| HIPAA BAA | ✓ Included | ✓ Included |
| Progress notes | ✓ Full templates | ✓ Basic templates |
| Telehealth | ✓ Built-in (all plans) | ✓ Built-in |
| Client portal | ✓ Full portal | ✓ Basic portal |
| Online scheduling | ✓ Client self-booking | ✓ Client self-booking |
| Insurance billing | ✓ Full clearinghouse | ⚠️ Limited (no ERA) |
| Credit card processing | ✓ Stripe integration | ✓ Included |
| Wiley Treatment Planners | ✗ Not included | ✗ Not included |
| Mobile app | ✓ iOS + Android | ✓ iOS + Android |
| Automated reminders | ✓ Email + SMS | ✓ Email only (free) |
| Customer support | Chat + email | Email only |
| Group practice support | ✓ Full multi-clinician | ⚠️ Limited |
| Customizable intake forms | ✓ Fully customizable | ✓ Basic customization |
What Therapists Say
SIMPLEPRACTICE — FROM VERIFIED USERS
“SimplePractice is super easy to learn and use. I love the integration with treatment planners to make diagnosis and treatment planning easier than ever.”
“I have really enjoyed the simplicity and effectiveness of the SimplePractice platform. It’s my favorite EHR because it’s so easy to navigate.”
SESSIONS HEALTH — FROM VERIFIED USERS
“I think Sessions Health is the best value, as it includes most, if not all, of the features of the high end systems, but at a much lower cost.”
“Its easy interface, reliability, and support are 10/10. Sessions Health is user friendly and allows my clients to have a seamless experience.”
Where Sessions Health Falls Short
Sessions Health is genuinely impressive for a free product — HIPAA-compliant, solid notes, telehealth, scheduling. But there are real limitations that matter depending on your practice:
No ERA/EOB processing
Sessions Health does not have a full insurance billing clearinghouse. You cannot submit claims directly or receive Electronic Remittance Advices. If you take insurance, you need a separate billing solution or a different EHR.
Email-only reminders on free plan
SimplePractice sends both email and SMS reminders automatically. Sessions Health's free plan only sends email reminders. SMS can reduce no-shows significantly — for a busy practice, this alone may justify the SimplePractice cost.
Limited group practice functionality
Sessions Health is designed for solo therapists. If you plan to add clinicians, SimplePractice has much better multi-provider support with proper access controls for HIPAA compliance.
When Free Is the Right Choice
If you are a new therapist building a cash-pay practice with a small caseload, Sessions Health is a legitimate option. It is HIPAA-compliant, has a signed BAA, and covers the basics. Starting free and switching to SimplePractice as your practice grows is a reasonable strategy — the main cost of switching is re-entering client data, which is manageable for a small caseload.
Sessions Health vs SimplePractice — Pricing Breakdown
Sessions Health offers a permanently free plan with no credit card required. Their paid plans (starting around $29/month) add SMS reminders, additional storage, and priority support — but the free plan covers clinical documentation, telehealth, scheduling, and a HIPAA BAA.
SimplePractice has three tiers: Starter ($29/month), Essential ($69/month), and Plus ($99/month). The Starter plan lacks billing and automated reminders. Most solo therapists use the Essential plan. SimplePractice also charges transaction fees: 2.95% + $0.30 per credit card payment processed through the platform.
Real cost at $5,000/month billing volume:
- → Sessions Health free plan: $0/month (no insurance billing)
- → SimplePractice Essential: $69 + ~$148 in transaction fees = ~$217/month
- → SimplePractice Essential with external payment processor: $69/month
Sessions Health vs SimplePractice — Insurance Billing
This is the biggest functional gap between the two platforms. SimplePractice has a full integrated insurance billing clearinghouse: you can submit claims directly to payers, receive ERA/EOB responses, and track claim status inside the platform. This saves significant administrative time for therapists who take insurance.
Sessions Health does not have a full clearinghouse integration on its free plan. If you take insurance, you would need to use a separate billing service or clearinghouse. This is a significant limitation — if insurance billing is part of your practice, SimplePractice or TherapyNotes is a better fit.
Sessions Health vs SimplePractice — HIPAA Compliance
Both platforms are HIPAA-compliant and sign a Business Associate Agreement with every user — including free Sessions Health accounts. Both encrypt data at rest and in transit. Both maintain audit logs. From a HIPAA compliance standpoint, you are covered with either platform.
The HIPAA difference is in the details: SimplePractice's Plus plan adds advanced audit logging and role-based access controls relevant for group practices. For solo therapists, both platforms meet the same HIPAA threshold.
Sessions Health vs SimplePractice — Telehealth Compared
Both platforms include built-in HIPAA-compliant video sessions at no extra charge. Both sign a BAA that covers telehealth. The practical differences are in the experience:
SimplePractice
Dedicated telehealth room with a waiting room, customizable link per clinician, session countdown, and the ability to collect co-pays before the session begins. Polished experience that clients recognize and trust.
Sessions Health
HIPAA-compliant video that works reliably — no separate app needed. Fewer bells and whistles than SimplePractice, but fully functional for solo cash-pay practices.
If telehealth is your primary service modality and client experience matters, SimplePractice has the more polished product. If you just need reliable HIPAA video that works, Sessions Health is sufficient.
Sessions Health vs SimplePractice — Customer Support
Support is a meaningful practical difference between the two platforms — especially when something goes wrong 20 minutes before a session.
SimplePractice Support
- ✓ Live chat (Essential + Plus plans)
- ✓ Email support all plans
- ✓ Extensive help center + video library
- ✓ Community forum with 185,000+ users
Sessions Health Support
- → Email only (free plan)
- → Priority support on paid plans
- → Help center available
- → Smaller community (newer platform)
For a solo therapist, the lack of live chat on Sessions Health's free plan is a real limitation. SimplePractice's live chat resolves most billing and technical issues within minutes. Sessions Health's email-only support means waiting hours or until the next business day.
Sessions Health Pricing 2026 — What the Free Plan Actually Covers
Sessions Health's free plan is genuinely useful — not a stripped-down teaser. Here is exactly what you get at $0/month:
- ✓Unlimited client records and progress notes
- ✓HIPAA-compliant telehealth (built-in video)
- ✓Client scheduling and self-booking portal
- ✓Signed Business Associate Agreement (BAA)
- ✓Customizable intake forms
- ✓Basic insurance tracking (not full clearinghouse)
- ✓Credit card collection via Stripe
- ✓Email appointment reminders
Paid Sessions Health plans add SMS reminders, additional document storage, and priority support. For the vast majority of what a solo cash-pay therapist needs day-to-day, the free plan is complete.
What is NOT included on the free plan:
- ✗ Full insurance billing clearinghouse (no ERA/EOB processing)
- ✗ SMS appointment reminders
- ✗ Group practice / multi-clinician support
Bottom Line: Sessions Health vs SimplePractice
Choose Sessions Health if:
- ✓ You are cash-pay only and starting out
- ✓ Budget is your #1 priority
- ✓ You have a small caseload (under 15 clients)
- ✓ You want to test an EHR before committing
Choose SimplePractice if:
- → You bill insurance (no contest)
- → You need SMS appointment reminders
- → You see 15+ clients per week
- → You want live chat support
Our pick for most therapists: SimplePractice Essential ($69/mo) — the billing and reminder features pay for themselves within the first month for any practice seeing 10+ clients weekly.
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FAQ — Sessions Health vs SimplePractice
Is Sessions Health really free?
Yes — Sessions Health has a genuinely free plan with no time limit and no credit card required. The free plan includes notes, telehealth, scheduling, client portal, and a HIPAA BAA. Paid plans add features like SMS reminders and additional storage, starting around $29/month.
Is Sessions Health HIPAA-compliant?
Yes. Sessions Health signs a Business Associate Agreement with all users, including free accounts. Data is encrypted in transit and at rest. The platform meets core HIPAA Security Rule requirements. There is no HIPAA compliance difference between Sessions Health and SimplePractice for solo therapists.
Can I switch from Sessions Health to SimplePractice later?
Yes, but the migration requires manual work. Sessions Health allows you to export client data as a CSV. Clinical notes can be exported as PDFs. SimplePractice does not have an automated import from Sessions Health — you would re-enter client records manually, which is manageable for a small caseload of under 20 active clients.
Which is better for a new therapist starting out?
If you are cash-pay only and just starting: Sessions Health free plan is a reasonable choice while you build your caseload. If you plan to take insurance, or want the most professional client experience from day one, start with SimplePractice — the $29/month Starter plan covers most solo therapist needs.
Does Sessions Health have insurance billing?
Sessions Health's free plan does not include a full insurance billing clearinghouse. You cannot submit claims directly to payers or receive ERA/EOB responses through the platform. If you take insurance, SimplePractice or TherapyNotes is a significantly better fit — both include integrated insurance billing clearinghouses.
What does SimplePractice have that Sessions Health does not?
The main advantages SimplePractice has over Sessions Health: full insurance billing clearinghouse (claim submission, ERA/EOB), SMS appointment reminders on all paid plans, more robust group practice support with role-based access controls, a larger template library, and dedicated customer support with live chat. For cash-pay solo therapists with simple needs, these differences may not matter.
Is SimplePractice worth the cost compared to Sessions Health?
It depends on your practice. For insurance-based therapists: yes, SimplePractice's integrated billing alone saves hours per week. For cash-pay therapists seeing 15+ clients weekly: yes, SMS reminders and polished client experience justify the cost. For new cash-pay therapists with under 10 clients: Sessions Health free plan is a reasonable starting point.
Is Sessions Health owned by SimplePractice?
No. Sessions Health and SimplePractice are completely separate, independent companies. SimplePractice is owned by WebPT. Sessions Health is a standalone platform. They are direct competitors in the therapist EHR market.
Does Sessions Health have a free trial?
Sessions Health does not need a free trial because the core plan is free forever — no credit card, no time limit. SimplePractice offers a 30-day free trial of its paid plans. If you are comparing both, you can use Sessions Health permanently for free while trialing SimplePractice's insurance billing features.
Can Sessions Health work for a group practice?
Sessions Health is designed primarily for solo therapists. It has limited multi-clinician features and does not support the kind of role-based access controls that HIPAA requires for group practices with multiple staff members accessing PHI. For group practices, SimplePractice, TherapyNotes, or TheraNest are significantly better choices.
How does Sessions Health make money if it is free?
Sessions Health generates revenue through its paid tier (which adds SMS reminders and additional features) and through payment processing fees when credit cards are collected through the platform. The free plan is a freemium model designed to build a user base — a common SaaS strategy. The platform is HIPAA-compliant and legitimate, not a privacy risk.