TheraNest has established itself as one of the most accessible practice management solutions in the mental health space, serving over 30,000 practices with its user-friendly approach to electronic health records and billing. The platform’s intuitive interface and comprehensive feature set have made it a popular choice for therapists looking to streamline their administrative tasks without wrestling with complex software.
To create this TheraNest review, I’ve analyzed the platform extensively. I believe it’s the ideal choice if:
However, TheraNest might not be the best choice if:
In this case, you should consider CarePaths: a comprehensive practice management platform with over 6,000 users, founded by clinical psychologists that puts advanced Measurement-Based Care at its core, enabling therapists to automatically track patient progress, visualize outcomes, and continuously improve their clinical effectiveness while achieving better patient outcomes (all while handling the administrative tasks you expect from a modern EHR).
Because of that, I’ve included a detailed look at CarePaths later in this TheraNest review, as the best alternative for practices prioritizing clinical outcomes and evidence-based care. If you’re ready to explore a more clinically-focused approach, you can start with CarePaths’ 30-day free trial here.
Table of contents:
TheraNest was founded in 2013 by Shegun Otulana in Birmingham, Alabama, emerging from his software consulting company as a solution to help behavioral health providers manage their practices more efficiently. The platform was conceived to handle the managerial and administrative tasks of therapy practices, allowing practitioners to dedicate more time to their clients rather than paperwork.
Today, TheraNest operates as part of Ensora Health (formerly Therapy Brands) following significant growth and investment, including an approximately $1.2 billion acquisition by KKR. The platform positions itself as an all-in-one practice management solution that combines scheduling, billing, clinical documentation, and telehealth into a single, web-based system.
The software serves a wide range of mental health professionals including therapists, counselors, social workers, and psychologists. With features like a client portal, automated appointment reminders, and integrated telehealth, TheraNest aims to modernize how practices operate while maintaining simplicity. The platform is particularly well-suited for solo practitioners and small to medium-sized group practices who want comprehensive functionality without the complexity often found in enterprise-level systems.
| Pros | Cons |
|---|---|
| ✅ Intuitive, user-friendly interface that's easy to learn | ❌ Limited customization options for templates and forms |
| ✅ Flexible pricing based on caseload size | ❌ Basic measurement tools lack advanced tracking features |
| ✅ Comprehensive all-in-one feature set | ❌ May face challenges with larger practice scaling |
| ✅ Available customer support and training resources | ❌ Mobile app lacks full desktop functionality |
| ✅ Free 21-day trial with full feature access | ❌ Workflow inefficiencies requiring multiple clicks |
| ✅ Integration with Wiley Treatment Planners | ❌ No permanent free plan available |
TheraNest’s scheduling system serves as the operational backbone of the platform.
The calendar supports individual, group, and recurring appointments with color-coding options for service types and filtering by providers and locations. When creating appointments, users can specify service types, locations, and even assign specific rooms to prevent double-booking in multi-therapist practices. The system includes a client self-scheduling option through the portal, where clients can view available time slots and request appointments that therapists then confirm.
The platform’s appointment reminder system operates through multiple channels: email, SMS text, and automated phone calls. Practices can customize when reminders are sent at various intervals and clients can respond to confirm or cancel. The text reminder system, which according to industry statistics have over 90% open rates within three minutes, includes response capabilities where clients can confirm attendance directly through their reply.
The electronic health record system in TheraNest includes standard templates for progress notes, treatment plans, initial assessments, and discharge summaries. Notes are DSM-5 ready, and the platform offers both standard note formats and SOAP note options.
A notable feature is the Dynamic Form Builder, which allows practices to create custom forms by dragging and dropping elements like text fields, checkboxes, and dropdown menus.
TheraNest integrates with Wiley Treatment Planners as an optional add-on for $25 per therapist monthly. This integration provides access to pre-written treatment goals, objectives, and interventions based on specific diagnoses. The system also includes features for supervisor review, where notes can be sent for co-signing. Progress notes can copy content from previous sessions, though users note this feature has limitations as diagnosis codes don’t copy automatically.
The billing module streamlines the financial workflow with features for creating charges and generating claims. The platform creates electronic claims (EDI/837) for submission to insurance companies. TheraNest integrates with Apex EDI and supports connections to non-partnered clearinghouses like Waystar and Availity for claim submission to various payers including Medicare and Medicaid.
TheraNest processes Electronic Remittance Advice (ERA) files automatically, posting payments and adjustments to patient ledgers without manual entry. The platform offers credit card processing through Stripe, though specific rates vary by card type.
Source: Ensorahealth
For practices wanting to completely outsource billing, TheraNest offers a managed billing service where their team handles the entire claims cycle, though pricing for this service isn’t publicly listed. The platform includes batch invoicing capabilities and can generate superbills for clients who submit their own insurance claims.
The client portal provides patients with 24/7 access to schedule appointments, complete intake paperwork, view statements, and make payments. New clients can complete all necessary forms online before their first appointment, with the information automatically populating their electronic record. The portal includes secure messaging functionality for HIPAA-compliant communication between providers and clients.
TheraNest’s telehealth feature is integrated directly into the platform as an add-on ($12 per therapist monthly for individual sessions, $25 for group sessions supporting up to 20 participants). Sessions launch directly from the calendar with no downloads required for clients. The platform includes a virtual waiting room where clients wait until admitted by the therapist.
For practices looking to modernize further, TheraNest offers e-prescribing capabilities through a partnership with NewCrop, though this requires additional fees including $45 monthly per clinician plus setup costs.
While TheraNest excels at providing an accessible entry point into practice management, several limitations become apparent for practices with more sophisticated clinical needs. These constraints reveal a platform deliberately optimized for operational simplicity rather than clinical depth.
The most significant gap is the limited scope of measurement-based care capabilities. While TheraNest includes basic assessment tools like PHQ-9 and GAD-7, it lacks the advanced automated systems for systematically collecting patient-reported outcomes, tracking symptom changes over time with visual dashboards, or integrating progress monitoring throughout the clinical workflow.
Practices committed to comprehensive data-driven care must rely on manual processes or external tools to implement routine outcome monitoring beyond basic assessments. This is particularly limiting as insurers increasingly reimburse for measurement-based care through codes like CPT 96127, potentially turning comprehensive MBC into a revenue generator for practices equipped with advanced tools.
Customization limitations frustrate practices with specific workflow needs. While the Dynamic Form Builder exists, users consistently report wanting more flexibility in creating templates, particularly for treatment plans and clinical assessments. The inability to extensively modify pre-built templates means practices often must adapt their processes to fit the software rather than the reverse.
Source: GetApp
The platform may face challenges as practices grow significantly. With performance concerns reported by some larger organizations, TheraNest seems optimized for smaller operations. The mobile app’s limited functionality compared to the desktop version creates workflow disruptions for providers who need full access while moving between locations.
For practices looking to grow through supervision arrangements, TheraNest’s pricing model can become complex as you add various per-therapist add-ons for features like telehealth and Wiley integration. Organizations requiring specialized tracking and reporting features may find the platform’s capabilities insufficient for their needs.
Workflow inefficiencies persist throughout the system, with users reporting excessive clicks required for common tasks. The lack of sophisticated automation in areas like treatment plan integration with progress notes means clinicians spend more time on administrative tasks than necessary. These limitations aren’t failures but rather the natural result of prioritizing broad accessibility over specialized clinical functionality.
CarePaths addresses many of TheraNest’s clinical limitations by building a practice management platform with advanced Measurement-Based Care at its foundation. Founded in 2000 by clinical psychologists Dr. Geoff Gray and Dr. Maureen Hart, the platform was designed specifically to integrate data-driven approaches into everyday clinical practice.
CarePaths’ standout differentiator is its automated Measurement-Based Care system, developed under the supervision of Dr. Bruce Wampold, one of the world’s leading psychotherapy researchers. The platform automatically sends assessments to patients weekly through the CarePaths Connect mobile app, covering psychological distress, well-being, loneliness, and therapeutic alliance. These assessments are strategically distributed across different days to avoid overwhelming patients: symptom measures on Mondays, well-being on Wednesdays, and relationship quality on Fridays.
Results appear immediately as visual progress graphs at the top of each patient’s chart, providing clinicians with real-time insights into treatment effectiveness. Patients can also view their own progress graphs through the mobile app, fostering transparency and collaborative treatment planning. The system includes over 40 available assessments beyond the standard battery, and clinicians can customize which measures to use for specific clients.
This evidence-based approach represents a validated improvement in psychotherapy practice. Research demonstrates that discussing these metrics with patients leads to improved therapy outcomes. For training programs and clinics focused on therapist development, this feature provides valuable objective data for supervision and skill improvement.
As insurers increasingly reimburse for measurement-based care through codes like CPT 98980 for remote therapeutic monitoring, this functionality can potentially become a revenue source for practices. The MBC functionality is free for up to 30 clients per therapist, making evidence-based practice accessible even for small practices.
By automating outcome tracking through weekly digital assessments, CarePaths helps clinicians identify clients at risk of early dropout — enabling timely interventions that improve retention and therapeutic alliance.
The EHR system includes standard templates for progress notes, treatment plans, and assessments, with documents that can be customized using the forms maker. A significant innovation is CarePaths’ free AI-powered session summary feature for teletherapy sessions. With patient consent, the system can generate accurate summaries that import directly into clinical notes, dramatically reducing documentation burden while maintaining HIPAA compliance.
The platform supports batch documentation for group sessions, allowing clinicians to create one note with general observations, then add individual comments and billing codes for each participant. The system also supports supervision workflows with streamlined processes for note review and co-signing, which is valuable for practices with supervision arrangements where recent graduates practice under licensed therapists.
CarePaths provides all essential practice management features within its transparent $49 monthly per-clinician subscription. This pricing model includes features that many competitors charge separately for, potentially offering cost advantages for practices. The platform supports practices of various sizes with unlimited users included in the base subscription.
The scheduling system handles individual, group, and recurring appointments with automated reminders via SMS, email, and voice calls included at no extra charge. The billing module automates charge posting from clinical notes and includes free electronic claims submission to all payers, including Medicare and Medicaid.
The platform’s “Digital Front Door” concept through CarePaths Connect allows new patients to find therapists, verify insurance coverage, and self-schedule initial appointments directly through the mobile app. This patient acquisition tool goes beyond a basic portal to actively help practices grow their client base. Telehealth functionality is integrated at no additional cost, supporting both individual and group sessions.
CarePaths’ pricing structure emphasizes accessibility and predictable costs. The standard EHR plan at $49 per month per licensed therapist includes most features, including AI session summaries, electronic claims, eligibility verification, and teletherapy (though some add-ons like e-prescribing carry additional fees).
For practices growing through supervision, the pricing model offers predictability. Group practices benefit from discounted rates for part-time therapists ($34/month) and students ($5.75/month), with unlimited administrative staff accounts included at no extra cost. For practitioners just starting out or with lower session volumes, a $10 monthly plan is available for up to 15 sessions. The 30-day free trial requires no credit card, allowing practices to fully evaluate the platform before committing.
By Bruce Wampold PhD
Complete Practice Management System
Getting Started?
| Aspect | TheraNest | CarePaths |
|---|---|---|
| Primary Focus | User-friendly practice management | Evidence-based care with integrated advanced MBC |
| Measurement-Based Care | ⭐⭐ Basic tools (PHQ-9, GAD-7) | ⭐⭐⭐⭐⭐ Comprehensive, automated system |
| Starting Price | $42/month (30 clients) | $49/month per therapist all-inclusive |
| User Interface | ⭐⭐⭐⭐⭐ Intuitive and polished | ⭐⭐⭐ Functional but less refined |
| Customization | ⭐⭐⭐ Limited flexibility | ⭐⭐⭐⭐ Extensive forms customization |
| AI Features | AI note enhancement available | Free AI session summaries for teletherapy |
| Practice Scaling | May face challenges with very large practices | Supports practices of various sizes |
| Supervision Support | Basic supervisor features | Optimized for supervision workflows |
| Customer Support | Mixed reviews on effectiveness | Mixed reviews, primarily ticket-based |
| Free Trial | 21 days | 30 days |
| Best For | Practices prioritizing ease of use | Practices prioritizing clinical outcomes and data |
CarePaths integrates AI-powered documentation at no additional cost — a feature most competitors, including TheraNest, offer only through premium add-ons.
The choice between TheraNest and CarePaths ultimately reflects your practice’s priorities and clinical philosophy.
👉Choose TheraNest if your primary goal is getting a practice management system up and running quickly with minimal learning curve.
It’s ideal for practices that value polished interfaces, straightforward workflows, and having all the basics covered without complexity. The platform excels when simplicity and user experience are paramount, making it perfect for therapists who want technology to fade into the background while they focus on traditional therapeutic approaches.
Try TheraNest today and experience effortless practice management!
👉Choose CarePaths if you believe that comprehensive outcome tracking should be central to modern therapy practice.
It’s designed for clinicians who want data to inform their treatment decisions, who value transparency with clients about progress, and who see technology as a tool for improving clinical effectiveness, not just administrative efficiency.
The integrated advanced Measurement-Based Care system transforms therapy from an art into an art informed by science, while the transparent pricing supports predictable practice growth. CarePaths is particularly suitable for practices that value systematic outcome measurement, training programs that benefit from objective progress data, and practices looking to optimize their supervision arrangements.
Start using CarePaths today and let data drive your clinical impact.
Both platforms competently handle the administrative foundations of practice management. The distinction lies in their vision for what modern behavioral health practice should be: TheraNest makes traditional practice more efficient, while CarePaths (with over 6,000 users) enables practices to evolve toward data-driven, continuously improving care delivery that can benefit both patients and the practice's clinical effectiveness.
