In this comparison, we take a detailed look at TherapyNotes and Ensora Mental health (formerly TheraNest), two of the most widely used EHR platforms in mental health care. We’ve used both firsthand, testing their worth in real clinical scenarios. From note-taking and billing to telehealth and client engagement tools, we were impressed by what both platforms have to offer.
While Ensora and TherapyNotes are two of our top recommendations, its worth weighing all your options. Visit our full breakdown of the best mental health EHRs for more platforms we’ve tested firsthand.
TherapyNotes Vs. TheraNest (Ensora Mental Health)
| Monthly Cost | $59-$69+ monthly | $29-$89+ monthly |
| Free Trial | 30 days | 21 days |
| Unlimited Clients on All Subscription Levels |  | |
| Cost Per Additional Clinician | $40 monthly, must be on $69 monthly group plan | Monthly plan cost per clinician |
| Insurance Billing Costs | $0.14 per claim/eligibility check | Varies by plan |
| Client Data Import | | |
| eRx Features | | |
| Estimated Annual Cost | $708-$1,308+ annually | $348-$1,068+ annually |
| Monthly Cost | |
| $59-$69+ monthly | $29-$89+ monthly |
| Free Trial | |
| 30 days | 21 days |
| Unlimited Clients on All Subscription Levels | |
| | |
| Cost Per Additional Clinician | |
| $40 monthly, must be on $69 monthly group plan | Monthly plan cost per clinician |
| Insurance Billing Costs | |
| $0.14 per claim/eligibility check | Varies by plan |
| Client Data Import | |
| | |
| eRx Features | |
| | |
| Estimated Annual Cost | |
| $708-$1,308+ annually | $348-$1,068+ annually |
When to Choose TherapyNotes or TheraNest (Ensora Mental Health)
Choose TherapyNotes if you want a highly structured, intuitive EHR with top-tier billing features, task management, and customer support. It’s best for solo providers and larger practices alike who value efficiency, reliability, and an organized workflow.
Choose Ensora (TheraNest) if you want a customizable and cost-effective EHR with a flexible forms builder, strong client engagement tools, and an approachable learning curve. It’s a great fit for solo providers or group practices that prioritize documentation flexibility and affordability.
SimplePractice’s EHR for therapists has everything you need to run your practice easily and efficiently. From booking and scheduling to insurance billing, SimplePractice does it all.
My Best Practice is an EHR designed by therapists to support therapists using evidence-based treatments. From online booking to note taking to insurance billing, My Best Practice makes running your practice easy. Starting at just $39 per month.
Ensora Mental Health (formerly TheraNest) Vs. TherapyNotes: What Are The Differences?
Both TherapyNotes and Ensora (TheraNest) are widely used EHR platforms among mental health professionals, but they offer very different experiences. Below, we break down how they compare across key areas like documentation, billing, client engagement, and overall usability to help you decide which one is the best fit for your practice.
Cost: $59-$69+ monthly
Telehealth: Yes
Insurance Billing: Yes
TherapyNotes stands out for its intuitive, highly structured interface that keeps solo and group practices organized and on track. Its features include excelle nt billing and insurance tools, reliable telehealth, strong task management, and good customer support. It’s a go-to choice for providers who want efficiency, compliance, and clarity in their daily workflow.
Pros & Cons
Pros - One-month free trial
- Excellent user experience
- Basic telehealth platform included in all plans
- Easy to learn and quick to implement
- Supports e-prescriptions
Cons - No mobile app available
- Fewer automation features than some competitors
- Limited reporting capability
Cost
TherapyNotes costs $59 monthly for solo practitioners and $69 monthly for the first clinician in a group practice, with an additional $40 monthly for each additional clinician. A 30-day free trial is available, with no credit card required.
The standard TherapyNotes subscription includes:
- Telehealth platform (basic plan with up to 2 participants)
- Client portal for secure document sharing and scheduling
- Unlimited active and archived clients
- Documentation tools, including progress notes and treatment plans
- Pre-generated forms (e.g., GAD-7, PHQ-9, consents, etc.)
- Additional administrative staff (billers, schedulers) at no extra cost
A handful of features require extra costs:
- Premium telehealth – $15 monthly per clinician (adds HD video, screen sharing, and up to 16 participants)
- Electronic insurance claims – $0.14 per claim ($0.49 for paper claims)
- Credit card processing – 2.9% + $0.30 per transaction
- Real-time eligibility checks – $0.14 each
- Appointment reminders (SMS/phone) – $0.14 each
- MIPS Reporting – $359 annually per practitioner
- Electronic prescriptions – $65/month
Overview
TherapyNotes offers one of the most polished and thoughtfully organized EHR experiences we’ve tested. From the moment you log in, the platform guides your workflow with a built-in to-do list, clearly labeled tabs, and seamless navigation across features. The layout prioritizes efficiency and compliance, making it especially appealing to clinicians who want structure and clarity without sacrificing functionality.
Documentation in TherapyNotes is highly streamlined, with prebuilt templates tailored to different disciplines and session types. Progress notes, treatment plans, and psychological evaluations are easy to create and automatically link to scheduled appointments. The system is also tightly integrated with scheduling and billing, which reduces duplicate data entry and keeps everything in sync. Insurance billing tools are particularly robust, offering claim scrubbing, ERA support, and automated payment posting that can be a major time-saver.
What really sets TherapyNotes apart, though, is its consistency and reliability. Whether you’re using telehealth, managing a group practice, or tracking insurance payments, the platform delivers a cohesive experience backed by responsive customer support. It may not offer the same level of customization as some competitors, but for providers who value structure, dependable performance, and strong administrative tools, TherapyNotes is a standout choice.
Visit our full review of TherapyNotes for more details, or, check out our full list of the best mental health EHRs for more great options we’ve tested firsthand.
Cost: $29-$89+ monthly
Telehealth: Yes
Insurance Billing: Yes
Ensora (formerly TheraNest) earned our recommendation thanks to its flexibility and customization options. Its strengths lie in the intuitive form builder, generous user limits on all plans, solid client engagement tools, and affordable pricing. It’s well-suited for practices that want to tailor their documentation and client experience without a steep learning curve.
Pros & Cons
Pros - All-in-one design with scheduling, notes, billing, and telehealth built in
- Transparent pricing model with unlimited clients at every tier
- Customizable documentation with powerful dynamic forms
- Responsive onboarding and support team
Cons - Some automation tools locked behind higher-tier plans
- Relatively small library of prebuilt forms
- Plans can get expensive quickly for larger practices
Cost
Ensora uses a per-therapist pricing model with no client limits across any plan, making it an appealing option for both solo and group practices. Plans include:
- Essentials – $29 monthly per therapist
Best for solo providers. Includes unlimited clients, scheduling tools, basic notes and intake forms, client portal access, and optional telehealth (+$12 monthly). - Advanced – $59 monthly per therapist
Adds custom forms, secure messaging, group practice reports, and 30 monthly insurance-related actions (claims, eligibility checks, reminders). - Premier – $89 monthly per therapist
Includes full automation: unlimited insurance billing, Wiley Practice Planners, unlimited telehealth, advanced reporting, and productivity tools.
Add-on Costs:
- Telehealth (Essentials & Advanced): $12 monthly per therapist
- Wiley Practice Planners: $25 monthly (included in Premier)
- eRx + PDMP: $135 one-time setup + $45 monthly per therapist
- Additional admins: $19–$29 monthly depending on plan
- Credit card processing: 2.99% + $0.30 per transaction
- AMA CPT license: $19.50 annually per therapist
- Overages on Advanced plan:
- $0.23 per claim, $0.25 per eligibility check, $0.10 per reminder
Overview
Ensora Mental Health, formerly known as TheraNest, has evolved into a flexible, modern EHR platform built for mental health practices of all sizes. The updated design feels cleaner and more intuitive, making it approachable even for providers who aren’t tech-savvy. While it doesn’t guide users as rigidly as TherapyNotes, it offers more freedom to customize your workflow, especially when it comes to forms, documentation, and client communication.
One of Ensora’s standout features is its custom form builder, which allows therapists to tailor intake documents, progress notes, and assessments to fit their style and clinical approach. The platform also includes client engagement tools like secure messaging, appointment reminders, and a client portal with a smooth scheduling experience. Telehealth and billing features are available on all plans, and the system integrates securely with insurance and payment tools to support solo providers and group practices alike.
The platform’s pricing structure is competitive, with unlimited clients on all plans and generous included features even at entry level. While some advanced capabilities—like full automation or unlimited insurance claims—require a higher-tier plan or add-ons, Ensora offers meaningful value without locking key features behind high paywalls. For practices that want flexibility and customization without sacrificing core functionality, Ensora makes a strong case.
Visit our full review of Ensora Health for more details. Or, check out our full list of the best mental health EHRs for even more options.
Who Might Need an Alternative?
While TherapyNotes and Ensora Health are both strong contenders in the mental health EHR space, they may not be the perfect fit for every practice. Some clinicians may need a platform with more automation, stronger marketing tools, or more accessible insurance billing support. If you’re looking for something different, here are some alternatives worth considering.
EHRs With More Automation
If reducing administrative workload is a top priority, these platforms offer advanced automation for scheduling, documentation, and client management:
- My Best Practice – Provides deep customization and automation for progress notes, treatment plans, and intake forms. Read our full My Best Practice review.
- Practice Better – Offers a unique wellness-focused EHR with plenty of automation options. Read our full Practice Better review.
- SimplePractice – A very popular all-in-one option covering documentation, billing, and marketing. Read our full SimplePractice review.
See our list of the best mental health EHRs for a full breakdown of our favorites.
Support for In-Network Insurance Billing
If in-network billing is a key part of your practice, these platforms provide extra support for insurance credentialing and managing billing from start to finish:
- Alma – Helps therapists get credentialed with major insurance payers while also handling billing and client referrals. Read our full review of Alma for therapists.
- Headway – Manages insurance billing, claims submission, and credentialing at no cost to clinicians. See if it is right for you in our full review of Headway for Therapists.
Or, read our full list of the best insurance credentialing services for therapists for even more options.
Options for Marketing & Client Growth
If you’re looking to improve your practice’s marketing, these directories can help therapists attract new clients more effectively:
- Choosing Therapy’s Directory – A free, high-traffic directory that helps therapists expand their reach. Learn more about Choosing Therapy’s directory here.
- GoodTherapy – Focused on ethical therapy practices and offers CEUs alongside directory listings. Read my GoodTherapy review.
- Open Path Collective – A great option for reaching underserved clients through sliding-scale therapy. Explore Open Path Collective for therapists in our full review.
See our list of the best therapist directories for more options.
SimplePractice’s EHR for therapists has everything you need to run your practice easily and efficiently. From booking and scheduling to insurance billing, SimplePractice does it all.
My Best Practice is an EHR designed by therapists to support therapists using evidence-based treatments. From online booking to note taking to insurance billing, My Best Practice makes running your practice easy. Starting at just $39 per month.
Why You Can Trust My Review
I’ve used both TherapyNotes and Ensora (TheraNest) firsthand, multiple times, to understand how they actually perform in real-world practice settings. From setting up accounts and creating custom forms to running billing workflows and testing telehealth sessions, we explored each platform’s strengths and quirks from a clinician’s point of view.
Both platforms impressed our team in different ways: TherapyNotes offers unmatched structure and reliability, while Ensora stands out for its flexibility, customization, and generous pricing model. Both are standout options worth considering for your practice.
We regularly update the articles on ChoosingTherapy.com to ensure we continue to reflect scientific consensus on the topics we cover, to incorporate new research into our articles, and to better answer our audience’s questions. When our content undergoes a significant revision, we summarize the changes that were made and the date on which they occurred. We also record the authors and medical reviewers who contributed to previous versions of the article. Read more about our editorial policies here.
Author: Matthew Church, MS (No change)
Medical Reviewer: Melissa Boudin, PsyD (No change)
Primary Changes: Reviewed and fact-checked entire article, clarified TheraNest’s rebrand to Ensora Mental Health, updated all pricing and feature information. Updated style and format throughout.
Author: Matthew Church, MS
Medical Reviewer: Melissa Boudin, PsyD
Your Voice Matters
Leave your own reviews!
Have you used an online therapy company? Have you tried an online psychiatry service? Do you use a meditation or mindfulness app? We’d love to hear about your experience!
We want to hear about the companies you love and the companies you wish you never used.
Leave your feedback for our editors.
Share your feedback on this article with ChoosingTherapy.com’s editors. If there’s something we missed or something we could improve on, we’d love to hear it.
Our writers and editors love compliments, too. :)