SimplePractice Problems in 2026: Pricing, Outages, and Feature Gaps That Drive Practices to Switch
SimplePractice serves 200,000+ practitioners and remains one of the most popular practice management platforms in behavioral health. But a pattern of user-reported issues — aggressive pricing changes, telehealth disruptions, and architectural limitations for growing practices — is driving an increasing number of practices to evaluate alternatives.
Key Issues at a Glance
- 163% price increase in early 2025 — plans jumped from $29 to $49+ with minimal notice
- 2Telehealth drops reported 4-6 times per week by some users, disrupting active client sessions
- 3No group notes: 10-person group = 10 separate individual notes, manually cross-referenced
- 4No UB-04 billing: Cannot bill facility claims for IOP, PHP, or residential programs
- 5Vista Equity Partners acquired SimplePractice in 2024 — users report post-acquisition support and pricing changes
Overview of reported issues
This analysis is based on verified user reviews from Capterra, Trustpilot, G2, and Software Advice, along with published analyses from independent EHR review sites. We've organized the most frequently reported issues into six categories.
Important context: SimplePractice still has a strong overall satisfaction rating and serves solo practitioners well. The issues documented here primarily affect growing group practices, multi-discipline organizations, and practices expanding into structured programming (IOP/PHP/residential).
Issue Severity Assessment
Is SimplePractice Worth It in 2025?
Pricing increases and hidden costs
The most frequently cited issue in 2025-2026 reviews is pricing. In early 2025, SimplePractice restructured its pricing tiers with minimal advance notice:
SimplePractice Price Changes (2024-2025)
$29
Starter (2024)
$49+
Starter (2025)
$49
Essential (2024)
$99
Essential (2025)
Source: User-reported pricing from Capterra and Trustpilot reviews, early 2025
Key pricing concerns from verified user reviews:
- 63% base price increase on the Starter plan with minimal notice to existing customers
- E-prescribing add-on: $49/month per prescriber plus $89 one-time setup fee — for a practice with 3 prescribers, that's $147/month ($1,764/year) on top of the base subscription
- Telehealth add-on: Charged separately on lower tiers, despite being table stakes for post-pandemic behavioral health
- Multiple users report experiencing rate increases within months of joining, not just at annual renewal
For a 10-clinician behavioral health practice with 3 prescribers, the total SimplePractice cost can exceed $15,000/year — approaching the range of purpose-built behavioral health EHRs that include e-prescribing, telehealth, billing, CRM, and AI documentation in a single subscription.
Telehealth reliability problems
Multiple users report experiencing connection issues 4 to 6 times per week, including:
- Clients being kicked from active sessions mid-conversation
- Grinding background noise that disrupts therapeutic rapport
- Complete connection failures requiring restart or switch to phone
- Video quality degradation during sessions
For behavioral health specifically, telehealth reliability is not a convenience issue — it's a clinical one. A session drop during trauma processing, medication review, or crisis intervention can damage therapeutic rapport and compromise patient safety. Practices report that clients lose confidence in the platform after repeated disruptions.
Missing group therapy features
SimplePractice has no native group note functionality. This is a critical architectural gap for behavioral health practices that run group therapy — which is the foundation of most IOP, PHP, and intensive outpatient programming.
The current workaround requires:
- Creating individual notes for every member in the group
- Manually cross-referencing each note to the group session
- Duplicating shared group content (topic, interventions, observations) across every individual note
For a 10-person DBT group, this means 10 separate notes instead of one consolidated group session record. Users describe this workflow as "jerry-rigged" — it burns clinical hours on data entry rather than documentation of treatment effectiveness.
SimplePractice (No Group Notes)
~45 min documentation time
EHR with Native Group Notes
Group Session Note
10 clients, shared + individual sections
Auto-generated individual summaries
~10 min documentation time
UB-04 and billing limitations
SimplePractice only supports CMS-1500 professional claims. It cannot generate UB-04 (institutional/facility) claims, which are required for:
- Intensive Outpatient Programs (IOP)
- Partial Hospitalization Programs (PHP)
- Residential treatment services
- Any facility-level billing
Practices expanding into structured programming must either bolt on a separate billing platform (creating double reconciliation) or forgo facility-level revenue entirely. This is not a minor gap — it's a fundamental architectural limitation that makes SimplePractice unsuitable for behavioral health organizations operating at the facility level.
Additional billing limitations reported by users include challenges with setting up payment processing, insurance claim rejections, and difficulty managing high claim volumes efficiently.
Private equity ownership concerns
In 2024, Vista Equity Partners acquired EngageSmart (SimplePractice's parent company) for approximately $4 billion. This matters for SimplePractice users for several documented reasons:
- Price increases followed the acquisition: The 63% price hike in early 2025 aligns with the typical PE playbook of margin expansion post-acquisition
- Support quality decline: Multiple users report reduced responsiveness and quality of customer support since the ownership change
- Privacy policy changes: Users have flagged concerns about updated privacy policies and data handling practices post-acquisition
- Product development velocity: Some users report that feature development has slowed, with resources redirecting toward revenue optimization
For more context on PE ownership risks in behavioral health EHR, see our analysis of private equity's impact on behavioral health EHR vendors.
Customer support decline
Post-acquisition reviews consistently cite customer support as a deteriorating area:
- Difficulty reaching live support representatives
- Slow response times on billing and account management issues
- Difficulty cancelling subscriptions
- General unresponsiveness to pricing-related complaints
What to look for in an alternative
If the limitations documented here are affecting your practice, these are the capabilities that matter most when evaluating alternatives:
- Native group therapy notes: A single group session record with shared interventions and individual client observations — not 10 copy-paste workarounds
- UB-04 facility billing: Non-negotiable if you operate or plan to operate IOP, PHP, or residential programs
- Integrated e-prescribing (EPCS): Included in the base subscription, not a $49/prescriber/month add-on
- Stable pricing: Transparent pricing without a history of post-acquisition increases
- Census and bed management: For practices managing residential or inpatient beds
- Ownership independence: Founder-led or independent ownership reduces the risk of PE-driven pricing changes
For a structured evaluation of platforms that address these gaps, see our SimplePractice alternatives guide or browse our behavioral health EHR comparison.
Who should stay with SimplePractice
SimplePractice remains a strong choice for:
- Solo practitioners who value polished client-facing UX (booking, portal, intake forms)
- Small outpatient-only practices (1-5 clinicians) without group therapy or facility billing needs
- Practices where client acquisition UX (online booking, digital intake) is the primary growth driver
If your practice is not running group therapy, does not need UB-04 billing, and can absorb the pricing changes, SimplePractice's client experience remains best-in-class for its market segment.
However, if you're a behavioral health organization running IOP/PHP programs, managing census, prescribing controlled substances at scale, or growing beyond 10 clinicians, the architectural limitations documented here become real operational constraints. Start with our alternatives guide to evaluate platforms purpose-built for behavioral health at scale.
Frequently asked questions
What are the most common SimplePractice complaints in 2026?
The most frequently reported issues are aggressive price increases (63% jump in early 2025), unreliable telehealth with dropped sessions, no native group therapy notes, no UB-04 institutional billing, and declining customer support quality following the Vista Equity Partners acquisition.
Does SimplePractice support group therapy documentation?
No. SimplePractice has no native group note functionality. Practices must create individual notes for each group member and manually cross-reference them. For a 10-person DBT group, this means 10 separate notes instead of one consolidated group session record.
Can SimplePractice bill UB-04 facility claims?
No. SimplePractice only supports CMS-1500 professional claims. It cannot generate UB-04 institutional claims required for IOP, PHP, or residential services.
Why did SimplePractice raise prices in 2025?
SimplePractice restructured pricing in early 2025 with minimal notice following the 2024 Vista Equity Partners acquisition of EngageSmart for approximately $4 billion. Plans jumped from $29 to $49+ — a 63% increase.
Editorial Standards
Last reviewed:
Methodology
- Analyzed verified user reviews from Capterra, G2, Trustpilot, and Software Advice (2024-2026).
- Cross-referenced pricing data with multiple independent user reports.
- Verified feature limitations against SimplePractice official documentation.
- Acknowledged SimplePractice strengths for solo/small practice use cases.