If you use SimplePractice to submit insurance claims, there is an important pricing change coming on October 1, 2026.
SimplePractice is changing how insurance billing is charged across its subscription plans. The biggest change is straightforward: Essential Plus will no longer include free insurance claims, and electronically submitted claims will instead be charged using a volume-based pricing structure.
For a practice that submits a handful of claims each month, the difference may be relatively small.
For a busy practice submitting hundreds of claims, however, the numbers deserve a closer look.
So how much will SimplePractice insurance billing actually cost?
And should you use the standard Insurance Essentials option or consider the new Insurance Navigator?
Let’s break down the numbers.
SimplePractice Insurance Billing: What’s Changing?
Starting October 1, 2026, SimplePractice will standardize insurance claim pricing across its Starter and Essential Plus plans.
Your regular SimplePractice subscription price isn’t changing.
The change applies to the cost of electronically submitting insurance claims.
Under the new structure:
- Free monthly claims on Essential Plus will end.
- Insurance Essentials will start at $0.39 per submitted claim.
- Higher monthly claim volumes receive lower per-claim rates.
- Insurance Navigator will be available as an optional upgrade at $1.79 per submitted claim.
- Manual insurance status checks will also change in price on some plans.
That means your actual SimplePractice cost depends partly on how many insurance claims your practice submits each month.
How Much Does SimplePractice Charge Per Insurance Claim?
Under the new Insurance Essentials pricing structure, the rates are:
| Monthly submitted claims | Cost per claim |
|---|---|
| First 250 claims | $0.39 |
| Claims 251–600 | $0.37 |
| Claims 601–1,000 | $0.35 |
| Claims above 1,000 | $0.33 |
The rates are applied progressively as claim volume increases. In other words, reaching 300 claims doesn’t mean all 300 claims suddenly cost $0.37 each. The first 250 remain at $0.39, while claims 251–300 use the $0.37 rate.
That’s an important distinction when estimating your monthly bill.
What Will Your SimplePractice Insurance Billing Cost?
Let’s make the numbers easier to understand.
50 claims per month
50 × $0.39 = $19.50
100 claims per month
100 × $0.39 = $39
200 claims per month
200 × $0.39 = $78
250 claims per month
250 × $0.39 = $97.50
300 claims per month
The calculation changes once you pass 250 claims:
250 × $0.39 = $97.50
50 × $0.37 = $18.50
Total = $116
SimplePractice provides the same 300-claim example in its current pricing documentation.
600 claims per month
250 × $0.39 = $97.50
350 × $0.37 = $129.50
Total = $227
1,000 claims per month
250 × $0.39 = $97.50
350 × $0.37 = $129.50
400 × $0.35 = $140
Total = $367
The higher-volume rates can therefore reduce the marginal cost of additional claims.
SimplePractice Insurance Cost Calculator
How many insurance claims does your practice submit each month?
[ Enter monthly claims ]
Estimated Insurance Essentials claim cost:
$— / month
The calculation uses SimplePractice’s announced October 1, 2026 volume-based rates.
This estimate covers the per-claim insurance billing charge only. Your SimplePractice subscription, payment processing, optional add-ons, and other charges are separate.
What Happens to Free Insurance Claims?
This is one of the biggest changes for existing SimplePractice customers.
Under the current structure through September 30, 2026, Essential includes 10 claims per month plus 35 claims per month before per-claim charges apply. Starter currently charges $0.50 per claim.
Starting October 1:
Free claims disappear from Essential.
Instead, submitted claims are charged using the new volume-based rates.
So if you currently rely on those included claims, it makes sense to calculate what the new structure means for your practice rather than assuming your existing subscription price tells the whole story.
Does the SimplePractice Subscription Price Increase?
No.
This is an important distinction.
The standard monthly subscription prices for the three main SimplePractice plans remain:
- Starter: $49/month
- Essential: $79/month
- Plus: $99/month
The October insurance change affects insurance billing charges, not the standard subscription price.
That means a practice using SimplePractice for scheduling, documentation, telehealth, or client management but not electronically submitting insurance claims through SimplePractice won’t pay the new per-claim fee.
SimplePractice says the per-claim charge applies when you submit a claim electronically through the platform.
What Is SimplePractice Insurance Essentials?
Insurance Essentials is the standard insurance billing offering.
It includes core insurance functionality such as:
- Electronic submission of primary and secondary claims
- Electronic payment report enrollment
- Insurance reporting
- Manual insurance payment posting
- Billing Hub
- Claim rule automations
- Corrected claim workflows
- Simple Invoicing
The per-claim pricing starts at $0.39 under the new October 2026 structure.
For practices that are comfortable managing their own insurance workflow, this may be all they need.
But there is another option.
What Is SimplePractice Insurance Navigator?
SimplePractice is also introducing Insurance Navigator, an optional insurance-billing upgrade beginning October 1, 2026.
Instead of the Insurance Essentials per-claim rates, Insurance Navigator charges $1.79 per submitted claim. There is no separate monthly add-on fee for Navigator; the higher per-claim rate is the pricing mechanism.
Insurance Navigator adds features such as:
- Verification of benefits
- Claim Assistant
- AI-powered suggestions for common claim errors
- EOB upload assistance
- Personalized insurance onboarding
- Direct access to SimplePractice Insurance Specialists
SimplePractice says Insurance Navigator is intended for practices that want more automation and guidance around insurance billing.
Insurance Essentials vs. Insurance Navigator
| Insurance Essentials | Insurance Navigator | |
|---|---|---|
| Starting claim cost | $0.39 | $1.79 |
| Electronic claims | Yes | Yes |
| Billing Hub | Yes | Yes |
| Claim rule automation | Yes | Yes |
| Benefits verification | — | Yes |
| Claim Assistant | — | Yes |
| EOB upload assistance | — | Yes |
| Insurance specialist access | — | Yes |
| Personalized onboarding | — | Yes |
The important question isn’t simply which option has more features.
It’s:
How much is your practice willing to pay for additional insurance-billing assistance and automation?
For a practice that wants to keep per-claim costs lower and is comfortable handling its own billing workflow, Insurance Essentials may be the more natural fit.
For a practice dealing with complex insurance workflows and wanting additional support, Navigator may be worth investigating. SimplePractice itself describes these as different fits rather than requiring every practice to use Navigator.
How Much More Does Insurance Navigator Cost?
The difference becomes significant as claim volume increases.
For example, at 100 claims per month:
Insurance Essentials
100 × $0.39 = $39
Insurance Navigator
100 × $1.79 = $179
Difference:
$140/month
At 250 claims:
Insurance Essentials: $97.50
Insurance Navigator: $447.50
Difference:
$350/month
At 500 claims:
Insurance Essentials:
250 × $0.39 = $97.50
250 × $0.37 = $92.50
Total = $190
Insurance Navigator:
500 × $1.79 = $895
Difference:
$705/month
These numbers don’t tell you which option to choose.
They show why claim volume and the value of the additional Navigator services matter when making the decision.
What About Insurance Status Checks?
Insurance claim fees aren’t the only billing-related change.
Beginning October 1, 2026, manual insurance status checks will cost $0.15 per check on Starter and Essential.
SimplePractice says manual checks will remain free on Plus until the following year, when the pricing will be standardized.
If your practice regularly checks insurance eligibility manually, include this cost when estimating your total expenses.
Is SimplePractice Still Worth It for Insurance Billing?
This depends on how you use the platform.
If you primarily want an inexpensive way to submit a small number of insurance claims, the new per-claim structure should be included in your comparison.
But insurance billing is only one part of SimplePractice.
The platform also combines practice-management functions such as:
- Scheduling
- Documentation
- Telehealth
- Client communication
- Billing
- Payments
- Practice management
- Client portal functionality
That means comparing SimplePractice solely on the price of an insurance claim doesn’t tell the whole story.
The more relevant calculation is:
Subscription + insurance billing + add-ons + payment costs
versus
The cost of the separate tools and administrative work your practice would otherwise need.
SimplePractice Costs Beyond Insurance Billing
The standard plans currently start at $49/month for Starter, $79/month for Essential and $99/month for Plus.
There are also optional add-ons.
Note Taker
$35/month per clinician
ePrescribe
$49/month per clinician + $89 one-time setup fee
Group appointments with telehealth
Included on Plus, or available as a $20/month per clinician add-on on Essential.
Credit card processing is another consideration. SimplePractice currently lists its integrated payment processing at 3.15% + $0.30 per successful transaction.
So before choosing a plan, calculate the features your practice actually needs.
A Simple Example: What Could a Practice Pay?
Imagine a practice using the Essential plan and submitting 300 insurance claims per month.
Subscription:
$79/month
Insurance Essentials:
$116/month
Subtotal:
$195/month
That’s before other applicable services, payment processing, or optional add-ons.
If the same practice added a note taker:
+$35/month
The total would become:
$230/month
This is why looking at the headline “$79/month” isn’t enough when you’re estimating the real cost of running your practice on the platform.
Should You Choose SimplePractice Insurance Essentials or Navigator?
Consider Insurance Essentials if:
- You want lower per-claim costs.
- You are comfortable managing insurance billing yourself.
- You don’t need direct insurance specialist support.
- You want the core insurance features without the higher Navigator claim rate.
Consider investigating Insurance Navigator if:
- Insurance billing is complicated for your practice.
- You frequently deal with claim errors.
- Benefits verification is important to your workflow.
- You want additional automation.
- You value direct access to insurance specialists.
- You want more guidance during insurance setup.
SimplePractice says practices can switch between the two offerings based on their needs.
Is SimplePractice Worth Trying?
If you’re already comparing practice-management software, the best way to evaluate SimplePractice isn’t to look at one price number.
Look at your complete workflow.
How many insurance claims do you submit?
How much time do you spend on billing?
Do you need telehealth?
Do you need documentation and scheduling in the same system?
Would an AI-assisted documentation tool be useful?
Do you need a team-management solution?
Once you answer those questions, the monthly subscription becomes much easier to evaluate.
SimplePractice currently offers a 30-day free trial, allowing eligible users to explore the platform before moving to a paid subscription.
Frequently Asked Questions
When does SimplePractice change its insurance billing pricing?
The new insurance pricing structure begins October 1, 2026.
How much is a SimplePractice insurance claim?
Under Insurance Essentials, the first 250 submitted claims each month are $0.39 per claim. Higher claim volumes receive progressively lower rates.
Does SimplePractice still offer free insurance claims?
Beginning October 1, 2026, free claims will no longer be included with Essential and Plus plans.
How much is SimplePractice Insurance Navigator?
Insurance Navigator is priced at $1.79 per submitted claim beginning October 1, 2026.
Does the SimplePractice monthly subscription price increase?
No. SimplePractice says the standard subscription prices remain unchanged.
Does SimplePractice have a free trial?
Yes. SimplePractice currently offers a 30-day free trial.
Can I use SimplePractice without submitting insurance claims?
Yes. The new per-claim charge applies when you submit claims electronically through SimplePractice.
Final Takeaway
The October 2026 SimplePractice insurance billing change makes it more important than ever to calculate your actual costs instead of looking only at the monthly subscription price.
For Insurance Essentials, the new structure starts at $0.39 per claim, with lower rates at higher claim volumes.
Insurance Navigator costs more at $1.79 per submitted claim, but adds additional insurance-billing automation and access to insurance specialists.
For some practices, the lower-cost self-service option may make more sense.
For others, paying more for additional billing support may be worth investigating.
The important thing is to calculate the numbers against your own claim volume and workflow.
If you’re already considering SimplePractice, check the current plans and use the trial to determine whether the platform’s complete set of practice-management tools justifies the cost for your practice.