TheraNest vs TherapyNotes

Compare Mental Health EHRs for Insurance-Based Practices

TheraNest and TherapyNotes are both mental health EHR and practice management platforms that cover scheduling, clinical documentation, and insurance billing. TherapyNotes charges separately for claims, eligibility checks, and reminders. TheraNest Premier bundles them so a busier month doesn’t automatically mean a bigger bill. Here’s a look at how they compare.

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See how TheraNest stacks up against TherapyNotes”

Pricing update: TherapyNotes has announced new Group and Enterprise subscription rates and electronic billing fees for billing cycles beginning December 1, 2026. The comparison below reflects those announced rates.

TheraNest

TherapyNotes

Base pricing

Essentials: $29/therapist/mo Advanced: $59/therapist/mo Premier: $89/therapist/mo 21-day free trial, no credit card required

Solo: $69/month for one user. Effective with billing cycles beginning December 1, 2026, Group and Enterprise subscriptions are $89/month for the first clinician plus $60/month for each additional clinician. Unlimited non-clinical users are included. 30-day free trial, no credit card required.

Claims, eligibility & reminders

Premier bundles claims processing, eligibility checks, and text and phone reminders within fair usage thresholds. No per-transaction fees at typical business volume

Effective with billing cycles beginning December 1, 2026: $0.25 per electronic claim, $0.09 per claim in an ERA, $0.14 per eligibility request, and $0.14 per text or voice reminder. Email reminders are free. Total monthly cost varies with usage.

Monthly cost predictability

One plan price covers the core billing workflows most insurance-based practices use every month

Per-use billing means monthly total varies, which makes it harder to predict your monthly total until after the month is over

AI-powered notes

Ensai notes enhancement included on all plans at no extra cost. Ensai Session Assistant available as optional add-on at $35/mo per provider

TherapyFuel AI scribe is $40/mo per provider. Not included in any base plan

Options for billing support

Optional Ensora RCM makes it easy to handle billing operations without leaving TheraNest – same company, same workflow

Full-service billing available through a third-party billing partner (not operated by TherapyNotes)

Working with minors and families

Client contact network handles guardian relationships, dependent profiles, and family billing natively – no workarounds needed

Client portal is strong, but guardian and dependent workflows are structured differently and may require more manual management

Additional staff

Unlimited non-clinical users (practice administrators, schedulers, and billers) at no extra cost on all plans

Unlimited non-clinical users (practice administrators, schedulers, and billers) at no extra cost. Effective with billing cycles beginning December 1, 2026, additional clinicians are $60/month each.

Customer support

Phone, email, and live chat support. Knowledge base and onboarding resources available anytime

24/7 live phone and email support for every user.

Telehealth

Included on Advanced and Premier at no extra cost. $12/mo per therapist add-on on Essentials.

Basic telehealth included on all plans. Premium telehealth (HD, screen sharing, larger groups): $15/mo per clinician

Supported

Limited

Plus Add-on

Not Available

*TherapyNotes pricing is based on publicly available information accessed October 20, 2026. Announced Group and Enterprise subscription rates and updated claim and ERA fees take effect with billing cycles beginning December 1, 2026. Optional-feature and usage charges may vary. Visit each company’s pricing page for current terms.

Why practices choose
TheraNest over TherapyNotes

TheraNest is purpose-built for insurance-based practices, growing teams, and clinicians who treat children and families. Where TherapyNotes covers the fundamentals, TheraNest goes deeper on the workflows that define these practice types.

Billing help when you need it

If billing has become a time sink, TheraNest’s optional Ensora RCM lets you hand off as much or as little of it as you want without leaving your existing workflow or managing a separate vendor relationship. It’s built to grow with your practice, not route you somewhere else.

Built for families and minors

TheraNest’s client contact network handles guardian relationships, dependent profiles, and family billing natively. If minors make up a significant share of your caseload, this is one of the more practical differences to evaluate side by side before you decide.

Set up right from day one

TherapyNotes’ self-directed setup works great for solo therapists, but group practices often discover configuration mistakes when they start costing money. TheraNest pairs you with an Implementation Specialist to guide your setup so roles, billing settings, and workflows are structured correctly from the start.

21 days to see for yourself

Full Premier access, no credit card required. Explore the platform with your actual practice in mind before committing to anything.

Start a free trial

Heard from therapists like you

We’re not going to tell you TheraNest is perfect for every practice. Here’s what clinicians with real insurance volume and growing practices have said after making the switch.

Ashley Williams, Cardinal Hope Mental Health Counseling Services

“Overall, I’ve seen a lot of areas where I’ve been able to save time, money, and help grow my practice with TheraNest.”

Kyle M.

“TheraNest makes the end of my session a 10 min wrap up with documentation, and the end of my day a 5 min wrap up to submit ALL billing.”

Teresssa B.

“I appreciate the simplicity of TheraNest by Ensora Mental Health, which influenced my decision to choose it over other vendors. The setup process was straightforward, making it easy to start using the software without unnecessary complexities. […] Overall, the fluidity of the software, coupled with its straightforwardness and efficient features, makes it a highly effective tool for managing my schedule and notes.”

Raymeka M.

“TheraNest has everything a mental health provider needs in one place. It’s easy to use, convenient and cost effective! There are always helpful updates being added which makes processes even more useful.”

Clarence S.

“I find TheraNest exceptionally valuable for writing my case management notes due to its high level of professionalism in design and functionality. The software is easy to navigate, making the completion of tasks more straightforward and efficient.[…] Furthermore, I regard this software highly recommendable; in my opinion, it stands out as the best, and I would suggest it to anyone without hesitation. The thoughtful design ensures that everything functions harmoniously, reflecting a well-built and professionally done product.”

Corinna D.

“I have used TheraNest for many years now. It allows me to manage my entire practice in just one site. I do my billing, scheduling, communication, clinical notes. They are Always striving to improve the site, introducing new features.”

FAQs

Is TheraNest actually cheaper than TherapyNotes?

TheraNest Essentials starts at $29 per therapist per month, while TherapyNotes Solo remains $69 per month. For group practices, TherapyNotes has announced pricing of $89 per month for the first clinician and $60 for each additional clinician beginning December 1, 2026. TherapyNotes will charge $0.25 per electronic claim, $0.09 per claim in an ERA, and $0.14 per eligibility request or text/voice reminder. TheraNest Premier is $89 per therapist per month and includes claims processing, eligibility checks, and text and phone reminders within fair usage thresholds. Compare the total cost using your actual clinician count and monthly usage.

What is TheraNest’s fair usage policy?

Fair usage means the bundled billing features on TheraNest Premier are designed for typical business volume, so practices operating within normal usage won’t hit a ceiling. You can review the full policy at ensorahealth.com/legal/fair-usage before committing. If your practice processes unusually high volume relative to your therapist count, contact the TheraNest team for specifics.

Does TheraNest work for solo therapists, or is it better for group practices?

TheraNest serves both solo and group practices. The Essentials plan at $29/month is designed for solo therapists starting out. That said, if you’re a solo clinician with low, stable insurance volume and no plans to grow, TherapyNotes may be worth a side-by-side trial. TheraNest’s cost advantages become clearer when billing volume increases, you start adding clinicians, or your caseload includes families and minors.

TherapyNotes includes unlimited non-clinical users. Does TheraNest?

Yes. Like TherapyNotes, TheraNest includes unlimited practice administrators, schedulers, and billers at no extra cost on every plan.

What is Ensora RCM and how is it different from TherapyNotes’ billing service?

Ensora RCM is an optional revenue cycle management service provided by Ensora Health, the same company that makes TheraNest. TherapyNotes connects practices with a third-party managed billing partner. With Ensora RCM, you keep your TheraNest workflow and choose how much billing work to hand off. The TheraNest path keeps billing operations within one company relationship; the TherapyNotes path routes you to an external provider. If you want billing help without switching systems or managing a separate vendor relationship, the integrated approach may simplify things.

How does TheraNest handle guardians and minors?

TheraNest uses a client contact network model that lets you link guardian contacts to minor client profiles, manage consent and communication across relationships, and handle billing for dependent clients natively. If a significant portion of your caseload includes children and families, this is one of the more practical differences to evaluate directly in a trial. TherapyNotes handles client relationships through its portal, but the workflow is structured differently and may require more manual management for complex family configurations.

Can I migrate my data from TherapyNotes to TheraNest?

Yes. TheraNest can import client demographic records from TherapyNotes. Clinical notes, intake forms, and stored payment information are not included in the data import. You can export billing history and documentation from TherapyNotes for your own records before switching. TheraNest pairs you with an implementation team and a scheduled data migration call, and guided implementation options are available; our team will walk you through the current options and what your specific move involves.

What if I try TheraNest and it’s not the right fit?

The 21-day free trial gives you full Premier access with no credit card required, so there’s no financial risk in exploring. If you’d rather talk through whether TheraNest makes sense for your specific practice before starting a trial, our team will give you a direct answer, including if TherapyNotes is genuinely the better fit for where you are today.

How does TheraNest compare to TherapyNotes on customer support?

TherapyNotes offers 24/7 live phone and email support. TheraNest provides 24/7 phone support, email support, live chat during published hours, and a knowledge base and onboarding resources available anytime. Compare the support channels and experience that matter most to your practice.”

Does TheraNest include telehealth?

Yes. Telehealth is included at no extra cost on TheraNest Advanced ($59/therapist/month) and TheraNest Premier ($89/therapist/month) plans. On TheraNest Essentials ($29/therapist/month), telehealth is a $12/month per therapist add-on. TherapyNotes includes basic telehealth on all plans, with premium telehealth (HD video, screen sharing, larger group sessions) at $15/month per clinician. Both platforms offer HIPAA-compliant video that launches from the calendar and connects to documentation.

Is TheraNest HIPAA compliant?

Yes. TheraNest is fully HIPAA-compliant with multi-factor authentication (MFA) on all plans, encrypted data storage, and a signed Business Associate Agreement (BAA). TherapyNotes is also HIPAA-compliant and additionally holds PCI DSS certification for payment processing. Both platforms meet the security and privacy requirements for handling protected health information in a mental health practice.

What is the best EHR for a mental health private practice?

The best mental health EHR depends on your practice size, billing model, and clinical needs. For insurance-heavy practices that want predictable monthly costs and built-in family/minor workflows, TheraNest is a strong fit. For solo therapists who prioritize 24/7 support and structured documentation templates, TherapyNotes is worth evaluating. There are many other platforms with various pricing and focus (like SimplePractice). We’d recommend starting a free trial with the one or two platforms that best match your practice profile and comparing them with real workflows.