How much does Valence cost?

There's no monthly fee and no per-seat license. You pay for what you use: $0.01 per video minute, $0.008 per minute for AI notes on video sessions, $0.012 per minute for in-person AI notes, and $0.03 per SMS reminder. It's capped at $69 per clinician per month. New practices start with a $100 credit and no card on file.

How are AI session notes kept private?

Transcription runs on our own servers, so session audio never goes to a third-party service. The audio is processed for the note and then deleted. We don't store it, and we don't train AI on it. Sessions aren't recorded by default.

How is Valence different from Blueprint or SimplePractice?

SimplePractice charges a monthly per-seat subscription whether you see patients or not. Blueprint is an AI-notes add-on that sits next to your EHR. Valence runs the whole practice: scheduling, reminders, telehealth, notes, intake, and billing. It only charges when you're with a patient, and the AI notes never leave our servers.

Does Valence support group sessions?

Yes. Group telehealth is built in. An appointment can hold multiple patients and co-facilitating providers, the video room is roster-based, and patients never see each other's records.

Can patients book and pay online?

Yes. Patients book from your public scheduling page (you can require provider approval), get SMS and email reminders they can confirm or reschedule from, and pay by card on file. Valence generates superbills for out-of-network reimbursement.

How long does it take to get started?

Most practices are up and running in a few minutes. Signup is self-serve, with a $100 credit and no card required. Create your practice, upload your logo, and try AI notes on a mock session right away.

I'm leaving another platform. Can you help me switch?

Yes, and it's free. Send us your client list, forms, and availability from SimplePractice, Blueprint, Headway, or Alma. We set up your patients, intake templates, assessments, services, and logo for you. You keep seeing patients while we handle the move, and we never take a cut of your rate.

Will Pathways spam my patients?

No. Texts go out between 8am and 9pm in the patient's own time zone, each patient has a weekly cap, and a patient who has opted out of texting is skipped while the rest of the pathway continues. Every send and every skip is recorded in the log.

Do I have to build automations myself?

You start from a template (new-patient intake, no-show follow-up, re-engagement, measurement-based care) and adjust the timing if you want. Every step reads as a plain sentence. Setting one up takes a few minutes.

Do I need an EHR before I see my first client?

You need a HIPAA-compliant place to store notes and a way to take payment. That is it. Scheduling, forms, telehealth, and outcome measures can all come later. Do not spend three weeks configuring software for a caseload you do not have yet. What you should avoid is starting notes in a document app and migrating them later, because that migration is genuinely painful and nobody enjoys it.

How much should a solo therapist pay for an EHR?

In month one, close to nothing, because you have four clients. Flat-rate plans run $49 to $79 a month per their published pricing (July 2026) whether you see forty clients or four, which is why a ramping practice overpays for the first half year. Metered pricing tracks your actual volume. A clinician at 16 sessions a month on usage-based pricing pays under $10.

Should I use Headway or Alma instead of my own EHR?

They solve a different problem. Headway and Alma are insurance billing platforms that also happen to give you a calendar, so if your bottleneck is credentialing and claims, they are worth considering. The tradeoff is that your practice infrastructure belongs to them. If their 2026 rate changes have you rethinking the model, that dependency is the reason it is hard to unwind quickly. Many clinicians run both: a panel through a platform, and their own software for cash-pay clients and their own records.

Is AI note taking worth it for a new practice?

Probably, once you are past about ten clients a week and the documentation backlog starts eating your evenings. Before that it is a solution looking for a problem. When you do turn it on, ask exactly where transcription happens, whether audio is retained, and whether your sessions get used to train models. If the vendor cannot answer those three questions in one sentence each, keep shopping.

Notes from Valence

Best EHR for private practice therapists starting out

Picking an EHR for private practice therapists opening solo: what you need on day one, six months of real cost math, and what you can safely defer.

7 min read

Choosing an EHR for private practice therapists who are just opening is a different problem from switching one. You do not have a caseload yet. You have a lease or a laptop, a license, and maybe four clients who followed you from your last job. Every piece of advice written for established group practices is wrong for you, because it assumes the thing you are missing: volume.

So this is about the first six months specifically. What you need on day one, what the software will actually cost while you ramp, and the things you can safely put off until you are busy enough to care.

What you actually need on day one

A HIPAA-compliant place to write and store notes. A way to get paid. A signed BAA from whoever holds the data. Everything else is optional in month one, and I mean that literally.

You do not need a client portal for four clients. You do not need automated intake sequences before you have an intake pipeline. Outcome measures matter enormously once you are running twenty clients, and barely at all when you can hold every case in your head. New practice owners lose entire weeks to configuration, then look up and realize they have not done any marketing.

The one thing worth getting right immediately is where the notes live. Starting in a word processor and migrating later is the classic regret, and the cleanup is tedious in a way that is hard to appreciate in advance.

The subscription math nobody warns you about

Here is the trap. Flat-rate practice software charges the same in your first month as your fiftieth. Per their published pricing (July 2026), that is $79 a month for SimplePractice Essential, which is the cheapest SimplePractice plan that includes client reminders, or $59 for the first TherapyNotes clinician plus $0.14 for every SMS or voice reminder you send.

Now picture a realistic ramp: 4 clients a week in month one, doubling to 8, then 12, 16, and settling around 20 by month five. All telehealth, 50 minute sessions, one text reminder each. Six months of software:

Month	Sessions	SimplePractice	TherapyNotes + SMS	Valence
1	16	$79.00	$61.24	$8.48
2	32	$79.00	$63.48	$16.96
3	48	$79.00	$65.72	$25.44
4	64	$79.00	$67.96	$33.92
5	80	$79.00	$70.20	$42.40
6	80	$79.00	$70.20	$42.40
Total	320	$474.00	$398.80	$169.60

The Valence column is $0.01 per minute of video session plus $0.03 per SMS, with unlimited free email reminders. Since we start you with a $100 credit and no card, that ramp is covered through month four before you pay anything. Your actual cash out in the first half year is under $70.

Turn AI notes on and the numbers rise, but they are still bounded: the bill can never exceed $69 per clinician in a month no matter what you run. Worst case at full caseload with AI on every session, you are at the cap and still under the SimplePractice Essential price. Play with your own numbers on the pricing calculator rather than trusting my example caseload, which is not yours.

What to look for in an EHR for private practice therapists

Whether the entry plan includes reminders

Check this first, because it is the most common surprise. Per SimplePractice's published documentation (July 2026), the $49 Starter plan does not include client email, text, or voice reminders. They start at $79. Reminders are also capped at one offset chosen from 24, 36, 48, or 72 hours, so you cannot send both a week-ahead note and a morning-of text.

Whether you control the timing

TherapyNotes fixes the reminder send windows on the vendor side, per their support documentation, so you pick neither the timing nor the count. That is fine at first. It becomes irritating the day you want to chase an unfinished intake packet or follow up on a no-show.

What happens when volume drops

Everyone plans for growth. New practices also have Augusts, medical leaves, and the month a referral source dries up. Ask yourself what the bill looks like in your worst month, not your best one. Flat plans answer that question badly.

Whether you can get your data out

Ask specifically whether note bodies export as readable documents or as a single spreadsheet column. This question separates vendors who expect you to stay from vendors who expect to earn it. Ask the same question about appointment history and client demographics, since those often come out cleanly when notes do not.

Cash pay or insurance changes the answer

If you are going the insurance route, your bottleneck is credentialing and claims, not software features. Headway and Alma exist to solve that, and plenty of new clinicians start there because getting on panels alone can eat six months. The catch is dependency: your calendar, your clients, and your billing all sit inside someone else's platform. If Headway's or Alma's 2026 rate changes have you rethinking the model, that dependency is the reason it is hard to unwind in a hurry.

A common setup is running both. Take the panel through a platform, keep cash-pay clients and your own records in your own system. If you go that way, make sure your EHR generates superbills without charging for it, because out-of-network clients will ask constantly. Ours does, at no cost, and we will migrate you off Headway or Alma for free if you decide to consolidate later.

Three mistakes worth avoiding

Buying for the practice you will have in three years. You will switch anyway when you hire your first clinician, because group workflows are a different product. Optimize for the next twelve months.

Paying for an AI notes add-on on top of an EHR subscription. Blueprint, for example, positions itself on its own site as an AI documentation layer you run alongside an EHR, so pairing it with SimplePractice means two bills for one workflow. If AI documentation is something you want, look for it built into the system you already pay for.

Skipping the trial and buying on the demo. Demos are performed by people who use the software daily. Run four real sessions through a trial, including one where something goes wrong, before you commit.

What I would actually do

If you are risk averse and want the safest possible default, SimplePractice is genuinely mature and you will not be the first person to hit any problem you hit. That is worth something real, and I am not going to pretend a newer product has covered as many edge cases.

If documentation quality is what worries you, TherapyNotes templates will make you a better note writer, and their support has a reputation people vouch for.

If what you care about is not paying $79 a month during the six months when you are earning the least, start metered. We built Valence for exactly that shape: no monthly fee, no per-seat charge, unlimited staff and forms and appointments, a hard $69 per clinician ceiling so a busy month cannot surprise you, and card processing passed through at 2.9% plus 30 cents rather than marked up. We are new, which is a real tradeoff, and the $100 credit with no card is there so you can find out whether it fits without any of your money being at stake.

Whichever way you lean, do one thing before you sign: build the same six-month ramp table above with your own projected caseload and the current published price of whatever you are considering. It takes fifteen minutes in a spreadsheet and it is the only version of this comparison that is about your practice. If the two incumbents are your shortlist, the TherapyNotes vs SimplePractice head to head has the numbers already worked out.