What therapists need from their software, from sources outside Acuity Scheduling and outside Nexa:
Acuity Scheduling covers the booking side of a therapy practice well. It has intake forms, custom client forms, online self-scheduling, cancelation policies, deposits, packages and several payment processors. It also lists HIPAA compliance, and a Business Associate Agreement comes with the Premium plan. That matters if client details pass through your scheduler. It also offers text reminders and Google Calendar sync. Nothing in its feature list covers the rest of what the trade needs. That means keeping psychotherapy notes apart from the main record, recording session length against the time-based billing codes (90832, 90834, 90837, 90791), and producing a written good faith estimate for self-pay clients. Those jobs fall to a separate records or billing tool.
Nexa covers some of the paperwork. It has estimates and invoices, a client pay portal through your own Stripe account, notes linked to a client, intake forms on a public booking page, reschedule and cancel links, time tracking and bookkeeping. It works offline. It has no text messaging, no Google Calendar sync (calendar export is an .ics file) and no QuickBooks sync. Its automated emails, including booking and payment reminders, send only while Nexa is open on one of your devices. It is software you own and run yourself, with no hosted support desk. Nothing in Nexa's list gives you a place to keep psychotherapy notes separate from the chart, or to record session codes.
Over three years Acuity Scheduling costs $1,224 at the $34 monthly plan ($408 a year). The Business Associate Agreement needs the Premium plan, which costs more than that. Nexa costs $279 once, or 3 payments of $99, and runs on one device. Adding optional Cloud Sync at $4.99 a month brings the three-year total to $458.64. If you already use Acuity for client booking, text reminders and calendar sync, stay with it and keep your notes and billing codes in a separate records tool. Nexa fits better only if you want to own your software, can live without texts and calendar sync, and mainly need invoicing and bookkeeping.
Our read for therapists: Stay with Acuity Scheduling if you rely on its HIPAA agreement, text reminders and calendar sync, since Nexa has no texts or Google Calendar sync.
Read on each linked page in October 2026. Check them again before you decide; vendors change plans often.
Acuity Scheduling costs therapists $408/year at today's list price. Nexa is $279 once for invoicing, scheduling, CRM, time tracking and accounting in one suite — so after 8.2 months it has cost less than Acuity Scheduling, and you own it after that. What it is not: hosted-for-you software with a support desk and a roadmap you can lobby. That is the trade, and the rest of this page is the detail behind it.
Nexa is $279 once, about $23 a month over its first year. Its Drain Guard reads your expenses (from a linked bank, an imported statement, or ones you type in), finds the charges that repeat, and adds them up by the month. Keep or Cut then walks you through them one at a time. Cancel $23 a month of charges you'd forgotten about and Nexa has paid for itself inside the first year, before you count the Acuity Scheduling bill you'd stop paying.
It depends on what you find and what you cancel, so we don't promise a number. In our demo data, Drain Guard finds 5 subscriptions adding up to $110.13 a month. That is sample data, not a customer's.
The verdict for therapists: Stay with Acuity Scheduling if the needs in our read above apply to you. If they don't, Nexa covers the core invoicing, scheduling and books for $279 once against $1,224 for Acuity Scheduling over three years.
Scheduling, client records and invoicing are the pieces of that day. Some tools rent you each piece separately. A few — Nexa among them — bundle the lot and carry their own booking link, with no per-appointment cut. The sections below price both routes honestly.
None of that is a software problem you can buy your way out of in one click — it is why the tool you pick matters more than what it costs. Acuity Scheduling solves some of it. So does Nexa. The difference is what you are left holding in three years.
Today's list price is $34/month — $408 a year, from Acuity Scheduling's own pricing page. Every figure below is that price, multiplied. Nothing is projected.
Nexa: $279 once (or 3 × $99). Over the same three years, that is $945 less.
If Acuity Scheduling raises its price, the three-year cost goes up; if it cuts it, the cost comes down. We don't guess which. Add-ons, extra seats and card-processing fees are not included, on either side.
| Feature | Acuity Scheduling | Nexa |
|---|---|---|
| Invoicing | ✗ | ✓ |
| Scheduling | ✓ | ✓ |
| CRM | ✗ | ✓ |
| Time Tracking | ✗ | ✓ |
| Full Accounting | ✗ | ✓ (SIMPL) |
| Task Management | ✗ | ✓ |
| Works offline | — | ✓ |
| Price | $34/mo | $279 once or 3 × $99 |
| 3-Year Total | $1,224 | $279 |
| You own it? | No — stop paying, lose access | Yes — forever |
✓ and ✗ for Acuity Scheduling come from its own published feature list. — means the feature isn't in that list, which is not the same as Acuity Scheduling lacking it: check with them. Three years is at today's price.
Straight from Acuity Scheduling's own feature set. If one of these is the reason you pay them, that reason does not disappear because Nexa is cheaper.
Acuity Scheduling is the better call if you need intake forms specifically, or if your team is large enough that per-seat pricing still beats buying software outright.
Acuity says it is for "anyone in the business of time," from solo practitioners to multi-location teams. It lists beauty, business services (consulting, coaching), wellness, fitness, visual and performing arts, and education. (acuityscheduling.com)
What people outside Acuity Scheduling and outside Nexa say:
Read on each linked page in October 2026. Check them again before you decide; vendors change plans often.
Software doesn't do the actual work — it automates the business around it. And that part is the same for every therapist: find the work, manage it, bill for it, get paid. Each step has a tool — and the right single tool runs the whole loop, so the handoffs are automatic and you get back to the actual work. Tap a step to see what gets automated.
An inquiry becomes a proposal becomes a signed engagement — the terms and the retainer set.
The work you're paid for — with the hours, tasks, and expenses tracked against the engagement instead of reconstructed at month-end.
The work becomes the invoice — the hours, the add-ons, the materials, the deposit credited — totaled and sent, instead of re-typed at 9pm.
Paid by card or link, the deposit credited, and what's overdue chased — without you doing it by hand.
You can stitch four separate subscriptions across these four steps, or run one tool that does the whole flow so a booking becomes a job becomes an invoice becomes a payment without re-typing. Either way the goal is the same: less time on the business of the business, more on the actual work. (Nexa is built to be the one — but the honest options for each step are above and below.)
This is the connection that makes the rest worth it. A therapist's job already holds the services, the hours, the add-ons, and the materials — so the invoice builds itself from the work instead of you re-typing it at 9pm. Toggle an add-on or nudge the hours and watch it recompute.
You didn't write this invoice — the job did.
Acuity Scheduling plus whatever else you're paying for:
Email yourself this comparison?
The median therapist earns $52,000/year. At $408/year, Acuity Scheduling is a recurring slice of that — paid again every year, whether the year was good or not. Owning the same jobs outright is $279 once, and the slice stops.
Nexa is $279 once. Invoicing, scheduling, CRM, time tracking, accounting — all connected, built for therapists. You own it like you own your Private office or teletherapy setup.
An honest fit check — because the wrong tool is worse than no tool.
The honest fit: if you're a solo or small therapists business that owns its tools and is sick of renting software, Nexa replaces your whole stack for $279 once. If you're scaling into a large team with dedicated admin staff, a bigger platform may fit better — and we'd rather tell you that now than sell you the wrong thing.
Your people are already online — swapping real numbers, tool picks, and war stories. Here's where to find them.
Active community — tool picks, pricing, and day-to-day questions.
Open on Reddit →Active community — tool picks, pricing, and day-to-day questions.
Open on Reddit →Active community — tool picks, pricing, and day-to-day questions.
Open on Reddit →Active community — tool picks, pricing, and day-to-day questions.
Open on Reddit →Scheduling, client records and invoicing are the pieces of that day. Some tools rent you each piece separately. A few — Nexa among them — bundle the lot and carry their own booking link, with no per-appointment cut. The sections below price both routes honestly.
I see six to eight clients a day, fifty minutes each, with ten minutes between to write notes while the session is fresh. The notes aren't optional; every session needs documentation that's clinically sound and meets insurance requirements, and a lot of evenings go to catching up on them. Each client has a treatment plan I revisit regularly: what we're working on, what's improved, and whether my approach still fits. Some sessions are routine check-ins, others are a crisis where I'm assessing risk and making a safety plan. Between clients I'm returning calls from prospective clients, screening whether I'm the right fit or should refer them on. Billing is its own job: verifying insurance benefits, submitting claims, handling denials, and collecting co-pays, or running private-pay clients on a sliding scale. Late cancellations and no-shows are a real hit, so my policy is in writing from the first session. Confidentiality shapes everything: how I store records, which platform I use for telehealth, what I say on the phone. I keep up licensing, continuing education and my own supervision or consultation group.
Real therapists near you who run their business on Nexa — book directly, no platform fee. Are you a therapist? Post your business and get found in your area — $2.99 one-time. Or browse every therapist on Nexa →
The tools of the trade — each a one-time buy that earns its keep for years.
You paid for these once because good tools last. That's the bar your software should clear too — priced like a tool you own, $279 once, not a subscription that costs more than your kit every year.
We build a therapist's guide the same way every time, and we'd rather you trust it than take it on faith. Nexa is our product, so the test we hold ourselves to is simple: a tool only "wins" a job here when it genuinely does that job better for a therapist — and where something free, open-source, or buy-once does it better, we say so and link you to it. Where Nexa falls short (payroll is the honest example), we name the alternative outright.
Found something out of date? Prices change and we don't catch every move the day it happens. This guide is published and maintained by the Nexa team; if a figure here is wrong, tell us and we'll fix it — getting it right matters more to us than the sale.
For solo therapists and small teams, yes. invoicing, scheduling, CRM, time tracking, task management, and full accounting — all for $279 once. Acuity Scheduling may be better if you have a large team (10+) or need enterprise-specific features.
Acuity Scheduling has features like Intake forms and Package and subscription billing that some businesses rely on. For most solo therapists, these aren't dealbreakers.
At $34/month, Nexa pays for itself in 8.2 months. After that: $408 saved every year.
Yes. Nexa is $279 as a one-time payment, or 3 payments of $99 ($297 total). Either way it's a one-time purchase — no subscription, no recurring fees ever.
Own your tools. Stop renting your software.
Get Nexa — $279 Once