Practice economics: the cost of software, AI, video, and getting paid

PracticeRunner is for therapists who want capable software and expect the economics to make sense.

The monthly price of an EHR is only one part of what a practice pays. A realistic technology stack can also include clinician and associate seats, AI assistance, a BAA-covered video service, and processing fees every time a client pays electronically. Some of those costs are fixed. Others grow with the practice's revenue and payment mix.

This article separates those costs before combining them. It uses detailed PracticeRunner and SimplePractice scenarios, then places their solo-practice stacks in a broader market snapshot alongside TherapyNotes, TheraNest from Ensora Health, and Sessions Health. The products are not identical, and the lowest number is not automatically the best fit.

Two kinds of practice cost

A less expensive subscription can be overwhelmed by payment fees. A lower processing rate can matter more than a small monthly plan difference. Looking at both provides a more useful view of what a practice actually spends.

What each software stack assumes

The PracticeRunner scenarios use the AI writing, appointment-preparation, recording, and transcription tools included with editable plans during PracticeRunner's early stage, plus one external video license for every clinical team member. No separate transcription charge applies today, so these current-price totals do not add one:

• Google configuration: Google Workspace Business Starter at $7 per user per month with an annual commitment, with the practice accepting and configuring the Google Workspace BAA.
• Zoom configuration: Zoom Workplace Pro at $13 per user per month with annual billing, with the practice entering a Zoom BAA.

A free Zoom account, personal Gmail account, Google Workspace Individual subscription, or meeting URL by itself should not be treated as a substitute for the appropriate paid account, BAA, configuration, consent process, and professional review. If the practice already maintains a suitable BAA-covered Google Workspace or Zoom account, its incremental video-subscription cost may be zero.

The SimplePractice scenarios use Telehealth included in the underlying plan, plus either Note Taker or Care Aide for every clinical user. For team scenarios, associates are counted as additional clinicians because they need clinical access, video, and AI assistance.

Monthly software-stack scenarios

The team examples assume every named clinician or associate needs a PracticeRunner seat and an outside video license. Actual staffing, role assignments, annual commitments, promotions, negotiated pricing, and product choices may produce different totals. Future PracticeRunner usage pricing is not included.

A wider solo-practice market snapshot

Base-plan prices alone do not show what a therapist pays for documentation assistance and video. The following snapshot adds the published price of a documentation-focused AI product and a practical video option to each platform's solo plan. Because the products differ, the snapshot compares packaging and published prices without treating every AI or video capability as equivalent.

TheraNest has the lowest base price in this snapshot, and Sessions Health matches PracticeRunner's $39 Professional price. PracticeRunner currently includes AI writing, preparation, recording, and transcription during its early stage, with no separate transcription charge today. Therapists are also free to use an appropriate video service they may already maintain.

The AI products differ in their inputs, outputs, clinical context, limits, and workflow integration. “Included” does not mean unlimited or guarantee that packaging will never change. Payment processing is excluded from this market snapshot because the vendors do not publish sufficiently comparable bank-transfer options and terms. The separate bank-transfer example below uses the two platforms whose published terms support a direct comparison.

These are different products, not interchangeable bundles

SimplePractice includes its own Telehealth on all plans for ordinary individual appointments. Its integrated video workflow can be easier for a practice that wants one vendor, and Care Aide includes live Session Sidekick assistance inside SimplePractice Telehealth, treatment-planning tools, intake summaries, and client-facing session summaries. SimplePractice also offers mature insurance automation, native mobile applications, and Tap to Pay.

PracticeRunner takes a more open approach. A provider can set a Zoom, Google Meet, Teams, or other meeting link at the provider, case, or appointment level. Session Workspace remains independent of the video platform and can work from outside transcripts, pasted notes, supported documents, scans, photographs of handwritten material, recorded audio, or uploaded audio and video. Session Brief, transcription, reusable writing guidance, note drafting and revision, appointment context, and follow-up stay connected without requiring a proprietary video client.

Google Workspace and Zoom also provide broader business communication and productivity capabilities beyond video. Their full subscription price is included in these scenarios even though a practice may already use the same account for professional email, calendars, documents, storage, or other work.

Bank-transfer pricing changes the variable cost

SimplePractice publishes the same integrated-payment rate for cards and bank-account payments: 3.15% + $0.30 per transaction. PracticeRunner charges the same rate for cards, but bank transfers are approximately 1%, capped at $8. This means the difference depends on how many clients pay by bank transfer and the size and frequency of those payments.

The PracticeRunner cap does not affect a $225 bank transfer because 1% is only $2.25. It becomes relevant for larger single payments. Actual fees can also depend on processor rules and the account's configuration.

A combined solo-practice example

Consider a solo private-pay therapist with 40 active clients who averages 20 sessions per week for 46 weeks at $225 per session. Assume 10% of payments are collected manually and the remaining electronic payments are 60% bank transfer and 40% card.

Use the PracticeRunner payment-cost calculator to replace the session fee, payment volume, billing cadence, manual-payment share, and bank-transfer share with assumptions that fit your practice.

What fair practice economics means

PracticeRunner's economics are not only about a lower subscription price. AI writing, preparation, recording, and transcription are included with editable plans during PracticeRunner's early stage, with no separate transcription charge today. Therapists can use a BAA-covered video platform they may already have, clinician and associate pricing is published, and lower-cost bank transfers are priced like a lower-cost payment method. PracticeRunner will explain any future transcription allowance or charge before it applies.

Fair does not mean free or permanently unchanged. It means understandable pricing, substantial value, honest tradeoffs, and respect for the practice behind the subscription. Read the full Fair Practice Pledge.