SimplePractice vs Practice Pillar for a therapy group practice, and when to choose Pillar

Practice Pillar fits a therapy group practice that wants its software to enforce the practice's rules. SimplePractice fits a practice that needs insurance claims, card payments or prescribing working this month, because Practice Pillar has no clearinghouse, card processor or prescribing partner connected yet.

The difference matters most once a practice outgrows one clinician. A biller, a scheduler, a supervisor and an owner each need different reach, a deleted record becomes everyone's problem, and the owner answers for every associate's supervision. This guide takes those questions one at a time.

Practice Pillar publishes this guide, so treat its side as a vendor's statement and check it in a demo. Every SimplePractice line below is quoted from SimplePractice's own pages, read on October 22, 2026 and linked. When the guide says SimplePractice's pages do not mention something, it means the pages under Sources did not mention it that day, not that SimplePractice lacks it.

How do SimplePractice and Practice Pillar compare at a glance?

What does each one charge a group practice?

SimplePractice prices each practitioner and quotes larger groups. Its pricing page shows the Plus plan "Starting at $74/practitioner". It also says "Groups with 6+ practitioners are eligible to speak with a sales consultant to discuss your workflow needs and challenges."

Two fees sit beside the plan, and both grow with the practice.

Aside from optional add-ons, fees for processing insurance are $0.39 per claim, and online payment processing fees are 3.15% + $0.30 per successful transaction.

Add-ons include ePrescribe at $49 a month plus a one-time $89 setup fee, and the AI Note Taker at $35 a month. During the current promotion the page shows each price beside a figure half its size.

Practice Pillar's pricing page publishes every price for practices of up to 50 clinicians and runs an estimate for your clinician count. Which bill is lower depends on your size, your claim volume and the add-ons you would buy. Price both for your own practice. This guide does not total them line by line, because promotional prices change faster than a guide is checked.

What happens when someone deletes or merges a client record?

In SimplePractice a deletion is permanent, and its help center says so three times.

• "Deleting a client permanently removes their profile and all associated records from your account." (Deactivating and deleting a client profile, updated August 26, 2026)
• "Merging profiles is a permanent action and can't be undone." (Managing client contacts, updated August 26, 2026)
• "Deleted invoices and other deleted documents can't be retrieved." (Creating invoices, updated June 10, 2026)

A permanent delete suits one clinician who knows their own records. A group has more hands on each one, and a Texas practice must keep a client's record for years after the last session (the records retention guide gives the periods).

Practice Pillar's product pages state the opposite rules.

• "A signed note never changes. A correction goes in a dated addendum beside it."
• "Your staff sees a likely duplicate the moment an inquiry arrives, and two records are never merged into one."
• "A balance is always the sum of the client's charges and payments, so it cannot drift from them."

Who in the practice can reach a client?

SimplePractice fixes some reach that the practice cannot narrow. Its article on granting and revoking access (updated August 27, 2026) says "Clinical and administrative access can never be revoked for the Account Owner and the team member assigned as the primary clinician." Its team messaging article (updated October 12, 2026) says "any team member with the practice biller or practice scheduler role will have the ability to message any client."

Does that matter? For many practices it does not. An owner who wants a scheduler limited to one office's clients should read both articles before signing.

Practice Pillar's access page says each person reaches only what their access allows, checked on every page and every action. Access can be scoped to a person's own clients, their team or the whole practice, and limited by location.

How does each one protect a staff sign-in?

SimplePractice offers more ways in, including fallbacks. Its two-factor article, updated October 22, 2026, covers a text message, an authenticator app and a passkey. A passkey is a strong option that Practice Pillar's security page does not offer. The same article lets someone without either option sign in by an emailed code, "for up to three sign-ins", and offers "Remember this device for 30 days."

Practice Pillar's security page says "Any staff account can add a second step: a six-digit code from an authenticator app, with 10 single-use recovery codes. A practice can require it for everyone."

How does each one handle supervision and the practice's own operations?

Both support supervision, and Practice Pillar adds dates and counts. SimplePractice's supervision article (updated September 9, 2026) says "Supervisees can sign and send their documentation to their supervisors for review." Its Insights tab article (updated October 21, 2026) describes practice reports and says "The Clinician snapshot page is only available to group practices."

Practice Pillar's clinical record page says "Each cosignature a supervisor owes has a due date, and supervision hours are counted against your licensing board's schedule." For a Texas practice with LPC Associates, the supervision guide explains what the board asks you to track.

Practice Pillar also keeps the practice's operations beside the chart. Its operations and front office pages say:

• "A license counts as current only when the board's status and the expiration date both say so."
• "Each new clinician's onboarding carries their own caseload ramp, from the offer to a full caseload."
• "A scorecard shows each clinician on their own, and leaves a week blank when nobody entered its number."
• "An urgent inquiry stays where it is until someone records what was done about the client's safety."

The SimplePractice pages read for this guide showed no license tracking and no onboarding checklist. That is a reading of those pages, so ask in a demo.

What happens to the records when a practice leaves?

SimplePractice ends access the moment you cancel. Its cancellation article (updated June 24, 2026) says "your account is canceled immediately and you'll no longer be able to access your account." Its HIPAA article (updated March 9, 2026) cites "a retention period of no more than 64 days after an account is terminated", adds "We are in the process of updating this policy and practice" and recommends exporting first.

The export has limits too. SimplePractice's export article (updated August 26, 2026) says access to the file "will expire after a week", and that for a client shared between clinicians "the data export may also include another clinician's information with the client."

Federal law sets one floor for every vendor that holds a practice's client records. Under 45 CFR §164.504(e)(2)(ii)(J), the business associate contract the vendor signs must provide that "At termination of the contract, if feasible, return or destroy all protected health information" it holds. The rule sets no window for the practice to export first, so ask each vendor how long that window is before you sign.

Practice Pillar's pricing page says "Export every record at any time, and for 90 days after you cancel." Its access page adds "Your practice exports its whole record itself, at any time, without asking anyone."

Where is SimplePractice the better choice today?

SimplePractice is ahead wherever money or prescriptions move, and on its track record. It sends claims electronically and takes card payments today, and Practice Pillar connects neither yet. It sells ePrescribe. Practice Pillar opens prescribing from the chart in a certified partner's screen, and that partner is not chosen yet. It sells an AI Note Taker, which this guide did not compare. And its home page says "Over 20M clients and 250k practitioners trust the SimplePractice platform." Practice Pillar is new and publishes no customer count.

If most of your sessions are billed to insurance and the claims have to go electronically this month, that settles it. Stay on SimplePractice, and look at Practice Pillar again at your next software review.

What does moving from SimplePractice involve?

Moving starts with SimplePractice's export, which comes in three types, Complete, Sessions and Contacts. Practice Pillar's switching page says "You import clients, appointments with their outcomes and balances yourself, and check every row before anything is saved." It gives two steps.

• "Ask SimplePractice for every export it offers, and open each file to count its rows."
• "If the client list arrives as a folder of contact cards, choose the whole folder at once. Practice Pillar reads the cards as your clients file."

Run your own export through the import's preview before you pick a date.

What to do this week

1. Count your clinicians, insured sessions a week, claims a month and card payments. Both products price on those numbers.
2. With 6 or more clinicians, ask SimplePractice for its quote in writing, add the claim and card fees, and set it beside an estimate from Practice Pillar's pricing page.
3. Read SimplePractice's access and messaging articles, then write down who in your practice can reach which clients.
4. Run a SimplePractice export now, even if you stay, and count the rows in each file.
5. List each supervisee, their supervisor and when the next cosignature and supervision hours are due. Note whether your system shows those dates or a spreadsheet does.
6. If claims, card payments or prescribing must work this month, stay put and set a date to look again.

Where Practice Pillar fits

Practice Pillar, software for therapy group practices, keeps intake, the chart, client balances and the practice's operations in one system. Its switching page for SimplePractice sets these rows side by side, each with the day SimplePractice's page was read.

Sources

• SimplePractice pricing, SimplePractice. Plan, group, claim, card processing, ePrescribe and Note Taker prices. No update date shown. Checked October 22, 2026.
• SimplePractice home page, SimplePractice. The customer count. Checked October 22, 2026.
• Deactivating and deleting a client profile, SimplePractice help center. Updated August 26, 2026. Checked October 22, 2026.
• Managing client contacts, SimplePractice help center. Updated August 26, 2026. Checked October 22, 2026.
• Creating invoices, SimplePractice help center. Updated June 10, 2026. Checked October 22, 2026.
• Granting and revoking access to a client's profile, SimplePractice help center. Updated August 27, 2026. Checked October 22, 2026.
• Using Secure Messaging with your team, SimplePractice help center. Updated October 12, 2026. Checked October 22, 2026.
• Protecting your account with two-factor authentication (2FA), SimplePractice help center. Updated October 22, 2026. Checked October 22, 2026.
• Reviewing and signing documentation under supervision, SimplePractice help center. Updated September 9, 2026. Checked October 22, 2026.
• Introducing the Insights tab, SimplePractice help center. Updated October 21, 2026. Checked October 22, 2026.
• Canceling your SimplePractice account, SimplePractice help center. Updated June 24, 2026. Checked October 22, 2026.
• SimplePractice's help center article on HIPAA, SimplePractice help center. Updated March 9, 2026. Checked October 22, 2026.
• Exporting client information through data exports, SimplePractice help center. Updated August 26, 2026. Checked October 22, 2026.
• 45 CFR §164.504, Code of Federal Regulations, paragraph (e)(2)(ii)(J). Checked October 23, 2026.
• Practice Pillar's product, pricing, security and switching pages. Checked October 22, 2026.
• Not checked: SimplePractice's terms of service, its business associate agreement and any page behind a sign-in.