Alma vs TheraNest (2026): which should you pick?

Pick Alma if

• Fits if you are a fully licensed therapist who wants to take insurance without doing the credentialing yourself
• Makes sense if you want billing and notes in the same membership as the insurance program

Look elsewhere if

• Not for you if you hold a limited license, as it is open only to fully licensed clinicians
• Skip it if you only take cash-pay clients, since every new member must join the insurance program
• Pricey if you are starting out: $1,140 billed per year, and no monthly price was readable
• Watch out: you must be credentialed with Aetna, Cigna or Optum under Alma's tax ID, and joining goes through an application and a call

Pick TheraNest if

• Fits if you're an insurance-based therapist who wants claims bundled into the plan
• Works for therapists who need help getting in-network, with one or two payer enrollments included

Look elsewhere if

• Tight if you stay on Essentials: online booking, secure messaging, custom forms and bundled claims start on Advanced
• Watch out: Advanced covers 50 claims, checks and reminders a month, then 23¢ a claim, 25¢ a check and 10¢ a reminder
• Pricey if you add the Session Assistant at $35 a month, eRx at $45 plus $135 setup, or Wiley below Premier at $25
• Watch out: each therapist pays a $19.50 yearly CPT fee, cards cost 2.99% + 30¢, and Premier's unlimited has a fair usage policy
• Skip it if you might downgrade soon, as the change only takes effect when your contract ends

Alma

• Alma is open only to fully licensed clinicians, not those with limited licenses.
• All new members must join its insurance program and be credentialed with at least one of Aetna, Cigna or Optum under Alma's Tax ID.
• Joining goes through an application and a call; the monthly billing price was not readable, only the $1,140 annual figure.
• Alma says it takes no cut of cash-pay sessions.

TheraNest

• Advanced includes 50 claims, eligibility checks and reminders a month per practice; then claims cost $0.23, checks $0.25 and reminders $0.10 each.
• Add-ons: Ensai Session Assistant $35 a month per provider, Wiley Treatment Planner $25 a month below Premier, eRx $45 a month per therapist plus a $135 setup fee.
• Each therapist pays an AMA CPT license fee of $19.50 a year, billed in December; card payments cost 2.99% + $0.30.
• Premier's unlimited claims and reminders fall under a fair usage policy, and a downgrade takes effect only when the current contract ends.

Alma

Insurance program

Credentialing in 45 days or less, multi-state credentialing, automated eligibility checks, claims and weekly or bi-weekly payouts. Alma says it negotiates rates.

Billing tools

Claims, invoices and superbills, stored client payment methods with auto-pay, a client cost estimator and reimbursement tracking.

EHR and clinical tools

Over 1,000 pre-written interventions, goals and objectives, PHQ-9 and GAD-7 assessments, high-risk symptom alerts and AI-assisted progress notes.

Treatment planning

A library of Wiley treatment planner goals, objectives and interventions built to meet insurance requirements.

Continuing education

Live and on-demand courses for CE credit and monthly workshops, at no extra cost to members.

Community and support

An operations team for claims, a customer support team, clinical advisors and a members-only community of about 30,000 peers and referrers.

TheraNest

Scheduling and client portal

Calendar management with personal calendar sync and staff availability, and a portal where clients see documents and appointments and pay online. Online booking starts on Advanced.

Notes and case management

Custom client, case and progress notes, built-in clinical case management with ICD-10 tools, and Wiley treatment planning, which is included on Premier.

Insurance claims and eligibility

Primary and secondary claims sent singly or in batches through clearinghouse partners, real-time eligibility checks, and billing automation on Premier.

Telehealth

HIPAA-compliant video for individual and group sessions, unlimited on Advanced and Premier and a $12-a-month add-on per therapist on Essentials.

Ensai AI

Ensai polishes progress notes on every plan. The Ensai Session Assistant, $35 a month per provider, scribes telehealth and office sessions into notes and writes case summaries.

Credentialing

A specialist team prepares and follows up payer enrollments with no commission: one or two payers per therapist by plan, and one more on annual billing.

Alma

• Membership$95

  per month, billed annually at $1,140

  One membership with insurance program, EHR tools, CE courses and community; a monthly billing option exists but its price was not shown.

TheraNest

• Essentials$27

  per therapist / month, billed yearly ($29 billed monthly)

  Scheduling, client portal, calendar sync, basic intake forms and notes, Ensai note polishing and card payments. Telehealth is a $12 add-on.

• Advanced$54

  per therapist / month, billed yearly ($59 billed monthly)

  Adds online booking, secure messaging, custom forms and notes, unlimited individual and group telehealth, and 50 free claims and eligibility checks a month.

• Premier$82

  per therapist / month, billed yearly ($89 billed monthly)

  Adds insurance billing automation, Wiley Practice Planner, and unlimited claims, eligibility checks and text and phone reminders under a fair usage policy.

• GroupCustom

  Custom pricing for group mental health practices, quoted on request.

Alma

No public discounts listed.

TheraNest

• Annual discount

  One month free with yearly billing

  TheraNest's pricing page gives one month free on annual plans: Essentials is $319 a year instead of $348, Advanced $649 instead of $708 and Premier $979 instead of $1,068.