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

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

Pick TherapyNotes if

• Fits if you're a solo therapist billing insurance who wants a phone line answered at any hour
• Works for behavioral health groups with many billers and schedulers, as non-clinical users aren't charged

Look elsewhere if

• Pricey if you're solo, as $69 a month is near the top of what this category charges
• Watch out: Group and Enterprise rise to $89 plus $60 per extra clinician from 1 December 2026
• Watch out: eligibility checks and reminders are 14¢ each, e-claims 25¢ from December, mailed claims $1, cards 3.1% + 30¢
• Pricey if you want more than the basics: TherapyFuel AI is $40 a clinician, ePrescribe $65, and HD or group telehealth $15
• Watch out: Enterprise needs at least 30 users, and full medical billing and credentialing go through partners at unpublished prices

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.

TherapyNotes

• Group and Enterprise rates rise to $89 for the first clinician plus $60 per additional from 1 December 2026; Solo stays at $69.
• Much is billed per use: 14¢ per eligibility check or text and voice reminder, 25¢ per e-claim from December, $1 per mailed claim, 3.1% + 30¢ per card payment.
• TherapyFuel AI is $40 per clinician a month, ePrescribe $65 per prescriber a month, and Premium Telehealth $15 per clinician a month.
• Enterprise needs at least 30 users. Full medical billing and credentialing come through partners, at prices not published.

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.

TherapyNotes

Clinical notes and outcome measures

Progress, intake and consultation notes whose sections can be rearranged or added to, a group progress note wizard, a play therapy template and an outcome measure library.

TherapyFuel AI tools

A $40-per-clinician add-on whose Scribe transcribes sessions to draft notes. Once one clinician has it, the whole practice can generate client history summaries and contact notes.

Insurance billing

Electronic and paper claims, secondary claims, real-time eligibility checks and electronic remittance advice, each charged per use, with card payments that can be charged automatically overnight.

TherapyPortal

A custom client portal for secure messages, documents, forms and outcome measures, which can be sent to every active client at once.

Telehealth

Basic telehealth is free for two participants in standard definition. Premium, at $15 per clinician a month, allows 16 participants in full HD with screen sharing and captions.

Mobile app and support

An iPhone, iPad and Android companion app for the agenda, client details offline, messaging and telehealth, plus 24/7 live phone and email support for every user.

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.

TherapyNotes

• Solo$69

  per month for 1 user

  For a provider who is the only user on the account. Unlimited clients, appointments and notes, client portal, basic telehealth and 24/7 support.

• Group$79

  per month, plus $50 per additional clinician

  Unlimited non-clinical users such as billers and schedulers. Rises to $89 plus $60 per additional clinician from 1 December 2026.

• Enterprise$79

  per month, plus $50 per additional clinician

  Group rates for accounts of at least 30 users, with a designated account manager. Same 1 December 2026 rise as Group.

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.

TherapyNotes

• Education

  Free classroom accounts

  TherapyNotes is free for simulated practices in a classroom, whatever the class size; these accounts leave out insurance and other billing features.