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

Pick ICANotes if

• Fits if you are a behavioral health clinician who wants menu-driven notes
• Works for prescribers who want e-prescribing in the same chart

Look elsewhere if

• Pricey if you prescribe: $213 a month full-time plus a $99 activation fee
• Watch out: telehealth is $20 per user a month and the AI scribe $49 per user a month on top
• Tight if you are part-time: 60 notes a month on the first two tiers and 100 on Prescribing
• Watch out: text reminders, claims and patient statements are priced by contacting sales

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

ICANotes

• Telehealth is a $20 per user per month add-on; the AI scribe is $49 per user per month.
• Text reminders, claims and patient statements are priced by contacting sales.
• Part-time plans cap notes: 60 a month on the first two tiers and 100 on Prescribing.
• The pricing page also points to a separate ICANotes (Classic) price list that is not covered here.

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.

ICANotes

Menu-driven notes

Template-driven progress notes, assessments and treatment plans, including BIRP and DAP formats, that you can customize.

AI scribe option

AI Clinical Notes are an optional $49 per user per month add-on on top of the base plan.

Scheduling and client portal

Online forms, self-scheduling, automated reminders, secure messaging and a portal for clients come with the Non-Prescribing plan and above.

Billing

Verifies insurance, submits claims electronically and posts payments. Claims pricing is quoted by sales.

E-prescribing and labs

The Prescribing plan adds e-prescribing with medication management, plus lab ordering and results.

Rating scales and treatment plans

Over 100 clinical rating scales live inside the chart, and treatment plans track goals and interventions over time.

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.

ICANotes

• Notes Only$55

  per full-time clinician / month

  Unlimited notes, templates and cloud storage for non-prescribers. Part-time: $35 a month for 60 notes.

• Non-Prescribing$75

  per full-time clinician / month

  Adds scheduling with reminders, a client portal, messaging, billing tools and reporting. Part-time: $45, 60 notes.

• Prescribing$213

  per full-time clinician / month

  Adds e-prescribing, medication management and lab ordering. Part-time: $138, 100 notes. $99 activation fee.

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.

ICANotes

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.