An honest comparison from Cima EHR
TherapyNotes alternative: what the December 2026 price change costs you
From billing cycles starting December 1, 2026, TherapyNotes' Group and Enterprise plans go to $89 a month for the first clinician plus $60 for each additional one (from $79 and $50), electronic claims to 25¢ and ERAs to 9¢. Solo stays $69. For a four-clinician group that's $269 a month before claims and add-ons, against $176.00 on Cima EHR. TherapyNotes includes basic video and a client portal and has live e-prescribing; Cima doesn't have the first or the last yet. The cost table by practice size, who each fits, and how to move are below.
Updated October 24, 2026. TherapyNotes facts come from its own blog, help center and pricing pages, read on that date. Written by the team that built Cima EHR and runs a licensed Texas outpatient program.
What changes on December 1, 2026
TherapyNotes announced the change on October 20, 2026 in its post December 2026 Pricing Updates. It takes effect with each practice's next billing cycle starting on or after December 1, 2026. TherapyNotes published the new rates five weeks ahead, which is more notice than many vendors give. Here's what it says:
| Item | Before | From December 1, 2026 |
|---|---|---|
| Solo (one user) | $69 a month | $69 a month (unchanged) |
| Group and Enterprise, first clinician | $79 a month | $89 a month |
| Each additional clinician | $50 a month | $60 a month |
| Electronic claim | Lower (TherapyNotes says claims go up) | 25¢ per claim |
| ERA (electronic remittance) | Higher (TherapyNotes says ERAs go down) | 9¢ per claim |
| Add-ons | TherapyFuel $40 per clinician; Premium Telehealth $15 per clinician who uses it; ePrescribe $65 per prescriber | Unchanged |
The "before" Group rates are from TherapyNotes' December 2025 pricing update and its current pricing and subscription options article. We left exact pre-December claim and ERA rates out because TherapyNotes' current pages don't all agree; your own invoice is the best record.
What it costs by practice size
Subscription only, per month, before claims and add-ons. TherapyNotes figures are its published Group rates; a one-clinician practice can use its $69 Solo plan. Cima figures use the Solo plan (the right Cima plan for a therapy practice of any size) plus $39 per added clinician.
| Clinicians | TherapyNotes now | TherapyNotes from Dec 1 | Cima EHR |
|---|---|---|---|
| 1 | $69 (Solo) | $69 (Solo) | $59.00 |
| 2 | $129 | $149 | $98.00 |
| 4 | $229 | $269 | $176.00 |
| 6 | $329 | $389 | $254.00 |
| 10 | $529 | $629 | $410.00 |
The math: TherapyNotes Group is $89 + $60 × (clinicians − 1) from December 1; Cima is $59 + $39 × (clinicians − 1). Billing and front-desk logins are free on Cima. Ask TherapyNotes how it counts non-clinical users on your plan.
Claims, add-ons and the real total
Here the comparison gets closer, and in one line TherapyNotes is cheaper. From December 1, a TherapyNotes claim plus its ERA costs 34¢ (25¢ + 9¢). On Cima, the clearinghouse's standard rate is 30¢ per claim plus 20¢ per ERA, 50¢ together. The more claims you send per clinician, the more that matters.
Worked example: a group of four clinicians sending 320 insured claims a month.
| Line | TherapyNotes from Dec 1 | Cima EHR |
|---|---|---|
| Subscription | $269.00 | $176.00 |
| 320 claims with ERAs | 320 × 34¢ = $108.80 | 320 × 50¢ = $160.00 |
| Subtotal | $377.80 | $336.00 |
| AI notes for all four | TherapyFuel 4 × $40 = $160.00, total $537.80 | Included, total $336.00 |
| Group video (more than 2 people) | Premium Telehealth $15 per clinician who uses it | Not built in; your own video service's price |
Without AI notes, Cima still comes out lower for this group, by about $42 a month. A solo therapist on TherapyNotes' unchanged $69 plan with no add-ons pays $96.20 at 80 claims a month, a few dollars less than on Cima ($99.00), so the December change alone isn't a reason for a solo clinician to move. Redo it with your own numbers on Cima's pricing estimator, or with the worksheet in how EHR pricing works.
Features side by side
| Feature | TherapyNotes | Cima EHR |
|---|---|---|
| Video sessions | Basic Telehealth included (up to 2 participants); Premium up to 16, $15 per clinician, per its telehealth update | Not built in; add a link from any HIPAA-ready video service |
| Client portal and paperwork | TherapyPortal included, per its portal article; telehealth runs through it | No client account: a secure link by text or email; consents signed with a finger; PHQ-9 and GAD-7 on the phone |
| AI note help | TherapyFuel, $40 per clinician a month | Included in every plan |
| E-prescribing | ePrescribe, $65 per prescriber a month | On Solo Prescriber and Program, not live yet |
| Group therapy | Each participant gets their own progress note and needs their own treatment plan, per its group session article | Program plan: shared topic and summary, each client's own entry tied to a plan goal, one PIN signs all, near-copies stopped |
| IOP / PHP | Levels of care and per diem billing not found on its public pages | Program plan: levels, attendance hours from signed notes, per diem 837P or 837I, authorizations and continued-stay reviews |
| Supervision | Check with TherapyNotes for your license types | Notes by an LPC-A, LMFT-A, LCDC-I or intern wait for the supervisor's co-sign |
| Leaving | Its account termination FAQ recommends exporting before you leave; its terms make the export your responsibility | Whole practice in one file or any chart as a PDF, any time, and at least 90 days after you cancel |
Who TherapyNotes fits better
- Solo clinicians happy on the $69 plan. Its price doesn't change on December 1. Moving costs a few hours of setup and a new paperwork round for clients; on cost alone, it may not pay back.
- Practices that want video and a client portal in the same system. Both are included at TherapyNotes; Cima has no built-in video.
- Prescribers who need e-prescribing now. TherapyNotes offers ePrescribe today; Cima's isn't live.
- Very high claim volume per clinician without AI notes. Its 34¢ claim-plus-ERA beats Cima's 50¢.
Who Cima fits better
- Group practices of two or more. The gap widens with every clinician: $39 per added clinician against $60. See Cima for group practices for roles and co-signing.
- Practices that want AI note help for everyone. It's included, so it doesn't scale with headcount.
- Practices adding an IOP or PHP. The Program plan runs groups, attendance, per diem billing and UR on the same charts as your outpatient sessions.
- Practices that want guardrails: a missing-items list before signing, late-entry marking after 72 hours, a red safety card when a PHQ-9 self-harm answer comes in, and claims checked for NPIs, taxonomy, member ID and filing limit before they go.
Other directions are worth a look too: our SimplePractice comparison, free EHRs and what they leave out, and, for programs, the IOP EHR comparison.
Decide before your December bill
- Pull your last three invoices. Count clinicians, claims, ERAs and add-ons. Multiply by the new rates.
- Price the same month on Cima with the estimator. Add whatever you'd pay elsewhere for video or card processing.
- If you'll move, export first. TherapyNotes documents a per-client download (the patient's Documents tab, Download Multiple). Ask its support whether a full-account export is available for your plan and how long data stays readable after you cancel.
- Start a trial and import your client list from a CSV. Cima shows a preview and saves nothing until you press Import; past notes stay in your export.
- Enroll for ERAs with each payer (1 to 3 weeks each), then cut over on a Monday. The full plan is in switching EHRs.
Run your group's December numbers on Cima
30 days free with no card. Invite your clinicians, import your clients and see the bill before you pay.
Questions
How much is TherapyNotes going up?
From billing cycles starting December 1, 2026, TherapyNotes says Group and Enterprise practices pay $89 a month for the first clinician (from $79) and $60 for each additional clinician (from $50). Electronic claims become 25¢ and ERAs 9¢. The Solo plan stays at $69 a month, and add-on prices are unchanged.
Is TherapyNotes' Solo plan changing?
No. TherapyNotes' October 20, 2026 announcement says the Solo rate stays at $69 a month for one user.
What's a cheaper alternative to TherapyNotes for a group practice?
On published prices, Cima EHR is $59 for the first clinician and $39 for each added one, with AI notes included; a four-clinician group pays $176.00 a month before claims, against $269 on TherapyNotes from December 1. Per claim, TherapyNotes is cheaper (34¢ with the ERA against Cima's 50¢), and Cima has no built-in video, so price the whole month.
Can I move my TherapyNotes notes to another EHR?
Notes don't usually move between EHRs as editable notes. Download them (TherapyNotes documents a per-client download from the Documents tab) and keep them as your record. Cima imports your client list and you add current clients' key documents to their chart.
Does Cima have a client portal like TherapyPortal?
Not as an account clients sign into. Cima sends a secure link by text or email; the client confirms their date of birth, updates details and insurance, signs consents and fills in screenings on their phone, and books through your booking page.
Sources
- TherapyNotes blog: December 2026 Pricing Updates (October 20, 2026); December 2025 Pricing Update; Portal File Uploads and Flexible Telehealth Subscriptions. Read October 24, 2026.
- TherapyNotes Help Center: Pricing and Subscription Options; TherapyPortal; Group Therapy Session; Account Termination & Account Abandonment; TherapyNotes Terms of Service. Read October 24, 2026.
- Cima EHR: the app's plan and clearinghouse price lists and its import, group and export features (alturaops
server/solo), the same numbers as cimaehr.com/pricing.
TherapyNotes is a trademark of its owner, named here only to compare published facts. If something here is out of date, tell us and we'll fix it.
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