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What’s changing with insurance pricing?

Henry
Updated

Beginning October 1, 2026, we're introducing new insurance billing offerings and updating how insurance billing is priced in SimplePractice.  

Here's what you need to know:

  • Your subscription plan fee stays the same: Whether you're on the Starter, Essential, or Plus plan, your monthly subscription price isn’t changing.
  • Insurance claim fees are changing: Beginning October 1, claim fees will no longer be determined by your subscription plan and will start at $0.39 per submitted claim.
  • No action is needed to keep using your current insurance features: You'll continue to have access to the insurance features you use today at the new rate.
  • Free claims for Essential and Plus plans are ending: Currently, Essential and Plus plans include a certain number of free claims each month. Starting October 1, submitted claims will be charged at the applicable per-claim rate.
  • Volume discounts still apply: Practices will still benefit from lower per-claim rates as monthly claim volume increases.

Optional upgrade: Insurance Navigator, a new insurance billing offering with additional smart billing features and personalized guidance, will be available as an upgrade beginning October 1, 2026. With Insurance Navigator, claims fees are $1.79 per submitted claim. Join the waitlist for a 30-day trial.   

In this guide, you’ll find answers to the following questions about this pricing change:

How will this affect my costs?

This update standardizes the claim processing fee across all SimplePractice subscription plans. Per-claim rates will start at $0.39, regardless of whether you’re on the Starter, Essential, or Plus plan.

Here's how the starting per-claim rate is changing:

Your current plan Current starting rate New starting rate (Oct 1)
Starter $0.50 per claim $0.39 per claim
Essential $0.35 per claim $0.39 per claim
Plus $0.25 per claim $0.39 per claim


Note: The free claims currently included with Essential and Plus plans are ending on October 1. However, volume-based pricing still applies, so your per-claim rate decreases as your monthly claim volume increases.

If I don't submit claims, is my subscription increasing?

No. Your monthly subscription fee isn’t changing. If you don’t submit claims electronically through SimplePractice, the change to claim filing fees won’t affect what you pay.

You'll still benefit from new features like the Billing hub and claim rules if you: 

  • Create and download claims to submit outside of SimplePractice
  • Use SimplePractice only for client billing and scheduling
  • Submit claims by paper or through another system

You're only charged a per-claim rate when you submit a claim electronically through SimplePractice.

Additionally, beginning October 1, 2026, manual insurance status checks will cost $0.15 per check on Starter and Essential plans. They'll remain free for Plus plans until next year, at which point they’ll be standardized at $0.15 across all SimplePractice plans.

Do I still get free claims each month?

No. Beginning October 1, 2026, free claims will no longer be included with any SimplePractice subscription plan.

Does volume-based pricing still apply?

Yes. While free claims are ending, lower per-claim rates at higher monthly claim volumes will continue to be available.

Here's how the new volume-based rates work:

Claims submitted each month Insurance Essentials per-claim rate
First 250 claims $0.39
Claims 251-600 claims $0.37
Claims 601-1,000 claims $0.35
Each claim after 1,000 $0.33

This means:

  • Your first 250 claims each month are billed at $0.39 per claim 
  • As your monthly claim volume increases, claims submitted after your first 250 are billed at lower rates

What features do I keep?

If you don’t upgrade to Insurance Navigator, you’ll continue with Insurance Essentials. Insurance Essentials includes the core insurance features you use today, including:

We’ve also added several new insurance features this year that are included with Insurance Essentials. These include: 

With Insurance Essentials, you’ll continue to have access to these features, and per-claim rates start at $0.39 per submitted claim, regardless of whether you're on the Starter, Essential, or Plus plan.

What's included in the Insurance Navigator upgrade?

Insurance Navigator includes everything in Insurance Essentials, plus: 

  • Verification of benefits: Confirm a client's mental health coverage and benefits before an appointment to help reduce claim denials and surprise bills.
  • Claim Assistant: Get AI-powered suggestions for resolving common claim errors.
  • Autofill payments with EOB uploads: Upload EOBs to autofill payment details and reduce manual entry.
  • Insurance onboarding: Receive personalized setup and guidance for your practice.
  • Direct access to our team of Insurance Specialists: Call our Insurance Specialists by phone for personalized guidance and complex billing questions. 

These features are designed to reduce the time you spend on administrative work, help you address claim errors, and give you additional guidance when you need it. For more information, see Introducing Insurance Navigator. 

Upgrading to Insurance Navigator doesn’t change your monthly SimplePractice subscription fee, and there’s no separate add-on fee. Instead, the per-claim rate is $1.79 per submitted claim.     

Why are you updating insurance fees?

We’re updating insurance fees to support continued investment in features that help practices spend less time managing insurance billing.

Over the last year, we've added features that simplify billing workflows in SimplePractice, including:

Already available:

Coming later in 2026:

  • Verification of benefits (part of Insurance Navigator)
  • Claim Assistant (part of Insurance Navigator)
  • SimplePractice assisted credentialing (available for an additional fee)

These pricing updates help us continue improving the billing experience, with a focus on reducing administrative burden and making insurance billing easier to manage—so you can spend less time on paperwork and more time with clients.

Should I upgrade to Insurance Navigator?

Insurance Navigator is an optional upgrade for practices that want additional automation and direct guidance for insurance billing.

Insurance Navigator may be a good fit if you:

  • Want benefit verifications automatically included in appointment details before seeing clients
  • Frequently need help resolving claim errors or payment issues
  • Prefer direct guidance by phone 
  • Have complex insurance billing needs
  • Want personalized onboarding and setup guidance

Insurance Essentials may be a good fit if you:

  • Prefer to manage insurance billing with self-serve tools
  • Occasionally rely on email support for insurance questions
  • Want to keep your per-claim costs as low as possible

Insurance Navigator will be available as an upgrade beginning October 1, 2026. Join the waitlist for a 30-day trial.

Can I switch between Insurance Essentials and Insurance Navigator?

Yes. You can switch between Insurance Essentials and Insurance Navigator based on your practice’s needs:

  • Upgrade to Insurance Navigator: You can upgrade at any time beginning October 1, 2026. Beginning November 2026, you'll be able to trial Insurance Navigator for 30 days at no additional per-claim cost before deciding whether to continue.
  • Downgrade to Insurance Essentials: If Insurance Navigator isn’t the right fit, you can switch back to Insurance Essentials at any time. The change will take effect at the start of your next billing cycle.

There are no penalties for switching offerings. You can choose the insurance billing offering that works best for your practice.