What speech therapists need from their software, from sources outside QuickBooks and outside Nexa:
QuickBooks covers the money side of a practice well. It has invoicing, bank feed reconciliation, comprehensive reporting, 800+ integrations and phone support on a paid plan, and accountants already know it. It does not cover what Medicare asks of a private-practice SLP. Those requirements come from Medicare's own rules and your state licensing board, so check them there instead of taking our word for it. They include your own enrollment, each client's Medicare status, physician plan-of-care approval within 30 days and periodically after, a place-of-service code on every visit, and a license record for each clinician. Mobile practices must also keep mileage and travel time out of billed services. QuickBooks has no fields built for any of this, so it ends up in spreadsheets or other software. Most business software is built for employees or larger clinics, because self-employed SLPs are only about 5% of the field.
Nexa covers the general business work: invoices, a client pay portal through your own Stripe account, a CRM with tags and notes, a booking page with intake forms, time tracking, expenses, bank reconciliation, profit and loss, and 1099 summaries. For home visits, it also has jobs with costing and a day's stops sent to Google Maps in time order. Tags and notes could hold a client's Medicare status or a certification date, but that is a workaround with no reminders and no signature tracking. Nothing in Nexa is a place-of-service field, a certification tracker or a license tracker. It has no QuickBooks import or sync, so moving means re-entering your books by hand. Its automated emails, such as appointment 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 or vendor-run onboarding. We make Nexa, and for a Medicare-billing SLP we are not saying it closes the gap QuickBooks leaves.
Over three years QuickBooks at $38 a month comes to $1,368 ($456 a year). Nexa is $279 once, or 3 payments of $99, and runs on one device. With optional Cloud Sync at $4.99 a month, three years comes to $458.64. That saving is real, but price is not the issue for this trade. If you bill Medicare, use a practice-management and billing system built for therapy practices, one that tracks enrollment, plan-of-care certification, place of service and licensure. Keep QuickBooks for the books if your accountant works in it, since switching just to save money would give up that familiarity and fix nothing. Only a solo SLP with no Medicare patients, who is comfortable running their own software and has no accountant tied to QuickBooks, has a reasonable case for Nexa.
Our read for speech therapists: If you bill Medicare, neither tool tracks enrollment, plan-of-care certification, place of service or licensure, so you need a practice-management and billing system built for therapy practices.
Read on each linked page in October 2026. Check them again before you decide; vendors change plans often.
QuickBooks costs speech therapists $456/year at today's list price. Nexa is $279 once for invoicing, scheduling, CRM, time tracking and accounting in one suite — so after 7.3 months it has cost less than QuickBooks, 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 QuickBooks 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 speech therapists: Neither QuickBooks nor Nexa is the main system for this work; start with software built for it. Nexa only makes sense beside it, at $279 once against $1,368 for QuickBooks over three years.
Scheduling, client records, invoicing and time tracking 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. QuickBooks solves some of it. So does Nexa. The difference is what you are left holding in three years.
Today's list price is $38/month — $456 a year, from QuickBooks'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 $1,089 less.
If QuickBooks 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.
Today's sticker price only tells you what a subscription costs today. These are dated changes, each linked to the announcement or report it comes from. Tap one for the numbers.
For renewals on or after February 1, 2026, Pro Plus and Mac Plus went from $999 to $1,149 a year for one user, and each extra seat from $200 to $230.
Source: SWK Technologies, Insightful Accountant (Dec 2, 2025)
From July 1, 2025: Simple Start $35 to $38, Essentials $65 to $75, Plus $99 to $115, Advanced $235 to $275 a month.
Source: Woodard Report (May 27, 2025)
After September 30, 2024, new US customers can no longer buy these Desktop editions. Existing subscribers can keep renewing.
Source: Intuit
Only changes we can link to a vendor announcement or a named publication are listed. Plans, add-ons and discounts vary, so check the vendor's current pricing page before you decide.
| Feature | QuickBooks | Nexa |
|---|---|---|
| Invoicing | ✓ | ✓ |
| Scheduling | ✗ | ✓ |
| CRM | ✗ | ✓ |
| Time Tracking | — | ✓ |
| Full Accounting | ✓ | ✓ (SIMPL) |
| Task Management | ✗ | ✓ |
| Works offline | — | ✓ |
| Price | $38/mo | $279 once or 3 × $99 |
| 3-Year Total | $1,368 | $279 |
| You own it? | No — stop paying, lose access | Yes — forever |
✓ and ✗ for QuickBooks come from its own published feature list. — means the feature isn't in that list, which is not the same as QuickBooks lacking it: check with them. Three years is at today's price.
Straight from QuickBooks's own feature set. If one of these is the reason you pay them, that reason does not disappear because Nexa is cheaper.
QuickBooks is the better call if you need industry standard - accountants know it specifically, or if your team is large enough that per-seat pricing still beats buying software outright.
QuickBooks Online is aimed at freelancers and new businesses, small and mid-size businesses, product-based businesses, and nonprofits. Larger or more complex operations are pointed to Desktop Enterprise (up to 40 users) or Intuit Enterprise Suite (multi-entity). (quickbooks.intuit.com)
What people outside QuickBooks 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 speech 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 speech 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.
QuickBooks plus whatever else you're paying for:
Email yourself this comparison?
The median speech therapist earns $55,000/year. At $456/year, QuickBooks 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 speech therapists. You own it like you own your Assessment tools and materials.
An honest fit check — because the wrong tool is worse than no tool.
The honest fit: if you're a solo or small speech 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 →Scheduling, client records, invoicing and time tracking 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.
Most of my caseload is children, with some adults recovering from strokes or working on voice and fluency. A new client starts with an evaluation: standardised tests, observation and a conversation with parents or family about what they're seeing, which takes an hour and a written report. From that I set goals, specific and measurable, like producing a sound correctly in words or following two-step directions, and plan therapy around them. Sessions are usually thirty to forty-five minutes, and with young children therapy looks like play, because a game keeps them practising far longer than drills. I take data every session on how often they get it right, because progress has to be shown, not assumed. Families get home practice after each session, since what happens between visits matters as much as the session itself. Documentation is heavy: session notes, progress reports and plan updates, especially where insurance pays. Billing means checking coverage, submitting claims and handling denials, or private pay. I keep my licence and certification current with continuing education.
Real speech therapists near you who run their business on Nexa — book directly, no platform fee. Are you a speech therapist? Post your business and get found in your area — $2.99 one-time. Or browse every speech 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 speech 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 speech 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 speech therapists and small teams, yes. invoicing, scheduling, CRM, time tracking, task management, and full accounting — all for $279 once. QuickBooks may be better if you have a large team (10+) or need enterprise-specific features.
QuickBooks has features like Industry standard - accountants know it and 800+ app integrations that some businesses rely on. For most solo speech therapists, these aren't dealbreakers.
At $38/month, Nexa pays for itself in 7.3 months. After that: $456 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