Upheal vs TherapyNotes: Billing, AI Notes, and EHR pricing compared
If you are comparing TherapyNotes and Upheal, the honest starting point is that both now have real AI. The question is what shape it takes and what it costs you.
TherapyNotes handles billing, scheduling and compliance well, and has earned a loyal following for it. Its AI, TherapyFuel, is a genuine suite rather than a bolt-on scribe: it drafts notes, builds treatment plans, summarises client history, and prepares you for your next session. It costs $40 per clinician per month on top of your plan.
Upheal took a different bet. The AI is the interface rather than a feature inside it, and it is conversational. You ask it questions in your own words, about any client, at any point.
Verified against TherapyNotes' published pricing page and support documentation, 5 September 2026; plan and TherapyFuel prices re-checked 30 September 2026.
Quick verdict
- Choose TherapyNotes if insurance billing is the engine of your practice, you prescribe, or you need MIPS reporting.
- Choose Upheal if you want AI you can talk to rather than trigger, and you would rather pay for sessions than seats. At $1 per session a 50-session month is $50, against $109 for a solo TherapyNotes clinician with TherapyFuel. At a full caseload, $99 a month covers unlimited sessions and includes Assistant Pro.
Two different bets on AI
TherapyFuel generates at fixed points. You open a note and it drafts one. You open a treatment plan and it fills it. Ahead of an appointment, Session Assist produces a summary. Each is a good tool, and each does its job when you arrive at the place it lives.
Upheal's Assistant is conversational and agentic. You ask it in your own words, about any client, at any time, and it answers from your session history. Assistant Pro, $39 a month or included in the $99 plan, removes the usage limits on agentic actions and routines, and adds custom reports. The Assistant's free tier comes with every plan.
The practical difference shows up when you have a question that does not match a screen. "Which of my Thursday clients has missed two sessions running?" is a question, not a note field, and it spans your whole caseload rather than one client's chart.
Differences between Upheal and TherapyNotes
| Feature | Upheal | TherapyNotes + TherapyFuel |
|---|---|---|
| AI notes plan | $39/moUpheal AI Notes, alongside any EHR | +$40/moTherapyFuel, on top of a TherapyNotes plan |
| EHR plan | $1/sessionAI notes included; no seat fee$99/mo unlimitedAssistant Pro included | Solo $69/moGroup $79 first clinician + $50 each additional |
| AI documentation | Included | TherapyFuel add-on$40/mo per clinician |
| AI progress notes | Yes | YesFrom a typed summary or from Scribe |
| AI treatment plans | Yes | YesUses diagnoses, presenting problems and prior plans |
| Session prep | Ask about any client, any time | Session AssistIndividual sessions only, 72-hour window |
| Conversational AI assistant | Yes | No |
| Compliance checker | YesAetna and Optum standards | No |
| Note templates | Custom, including from PDF | Custom progress note templatesNo PDF import |
| Client messaging | With AI drafts | Adjust Tone on messages you writeContact Notes generated from threads |
| Session capture | Video, audio, text or upload | In person and TherapyNotes Telehealth onlyNo transcript upload |
| Couples, family, intake, psychiatry notes | Supported | Not yet supported by TherapyFuel |
| AI group therapy notes | Not yet | Not yetTherapyFuel only; manual group notes not assessed |
| Insurance billing | $0.30/claim incl. ERA, $0.15/eligibility | $0.14 claim + $0.14 ERA, $0.14 eligibility |
| Telehealth | Included | Basic free, 2 participantsPremium $15/mo per clinician |
| ePrescribe | No | $65/mo per prescriber |
| MIPS reporting | No | $359/yr per clinician |
| Card processing | 2.9% + $0.30 | 3.1% + $0.30 |
| Jurisdictions covered | HIPAA, PHIPA and PIPEDA, GDPR and DPA | HIPAAThe jurisdiction TherapyNotes names |
| Independent attestation | SOC 2 Type IIContinuously externally tested | HITRUST i1Platform; TherapyFuel holds a separate HITRUST AI Security certification |
| Free option | Free plan, unlimited notesFree AI chart migration | 30-day trial, no cardFree EMR import, no free plan |
Billing
TherapyNotes handles ERA and EOB processing, claims management and insurance portals. The infrastructure is mature and it works, and 24/7 phone and email support is included on every plan. Electronic claims, ERA claims and eligibility requests are each $0.14, so a claim and its remittance come to $0.28. Paper claims are $1.
Upheal handles billing alongside everything else. Invoices generate when the session ends and superbills pull from your notes. Claims are $0.30 each, which covers the claim and its ERA, eligibility checks are $0.15, and there is no monthly billing fee. A rejected claim that you fix and resubmit is not charged again.
On claim fees the two are effectively level, with TherapyNotes two cents cheaper per claim. The difference is the subscription around it. Start the free plan to migrate your records and get set up.
AI documentation
TherapyFuel is a suite, and it is worth being specific about what it covers. Progress notes from a typed summary or from a recorded session. Treatment plans that draw on diagnoses, presenting problems, demographics and the client's prior plans. Client history summaries. Contact notes generated from secure message threads. Insurance card capture. Tone and voice settings. Dictation. ReFuel, which regenerates individual sections of a draft. And Session Assist, which reads your last three signed notes and the current treatment plan to brief you before an appointment.
Enable it for one clinician and the whole practice gets history summaries, contact notes and insurance capture at no extra cost.
Its limits are real and worth knowing before you buy. Scribe works only inside TherapyNotes, so it cannot listen to a session on another telehealth platform, and you cannot upload a transcript from one. TherapyFuel does not yet support group therapy, couples or family work, psychiatry or medication management notes, or intake notes. Medication management users get TherapyFuel free in the meantime. Session Assist covers individual sessions only, generates within 72 hours of an appointment, needs the previous note signed and attached to an appointment in the last 45 days, and does not run for a session straight after an intake.
Upheal's documentation connects to the client's full record: diagnosis, treatment goals, what came up last week. The compliance checker audits a note against Aetna and Optum standards before you sign it. Sessions can be captured by video, audio, text or upload, and couples, family, intake, psychiatry and medication management notes are all supported. Neither platform generates group therapy notes with AI yet.
TherapyNotes pricing vs Upheal pricing
A solo TherapyNotes clinician pays $69 a month. TherapyFuel adds $40, and Premium Telehealth another $15, so all three come to $124. Basic telehealth is one-on-one only; Premium adds sessions of up to 16 participants and HD video, so couples or family sessions need the Premium tier.
Group practices are priced differently: $79 for the first clinician and $50 for each additional one, plus $40 per clinician for TherapyFuel. A three-clinician practice wanting AI for everyone is $179 in base fees plus $120, so $299 a month. Non-clinical staff are free, which is a genuine advantage if you have administrators and billers.
Upheal is $1 per session. A 50-session month is $50. A quieter month costs less rather than the same. At a full caseload, the $99 plan covers unlimited sessions and includes Assistant Pro, against $124 for a solo TherapyNotes clinician with TherapyFuel and Premium Telehealth, or $109 without Premium. Pricing for group practices depends on the size of the practice, and associates are discounted, so talk to us about group pricing rather than working it out from a per-seat figure. For roles, supervision, and what a 10 clinician practice pays across Upheal, TherapyNotes, and SimplePractice, see our guide to the best EHR for group practices.
Both platforms have a trial. TherapyNotes offers 30 days with no credit card and free data import from another EMR. Upheal offers a 30-day full trial with no card and a 30-day money-back guarantee, and a free plan with unlimited notes and HIPAA-compliant telehealth if you decide not to subscribe. Migration is free and handled by the AI Assistant, chart files included. Students and associates get 50% off the first 12 months, and nonprofits can request a discount.
Privacy and data
Both platforms are HIPAA compliant.
Upheal is HIPAA, PHIPA, PIPEDA, GDPR, and DPA compliant, has completed a SOC 2 Type II audit, and is continuously externally tested. Upheal signs a BAA with every practice. Control status is published at trust.upheal.io.
TherapyNotes holds HITRUST i1 certification for its platform, and TherapyFuel holds a separate HITRUST AI Security certification announced in April 2026. If your organization requires HITRUST specifically, TherapyNotes meets that requirement and Upheal does not. TherapyFuel runs on a stock model that their vendor is contractually barred from training on, it retains nothing once a note is generated, Scribe audio is deleted as soon as the transcript succeeds, and transcripts are removed at signing or after 30 days. Their BAA is built into their terms of service, so there is nothing separate to sign. They do not train on your data at all.
Upheal does not use session data to train AI unless you and your client both choose it. Clients who never see the request are opted out. Consent can be withdrawn and the data is deleted, and therapists on paid plans can switch the request off for every client. Where a client has opted in, de-identified session data is kept for a year and derived datasets for five.
On legal requests, Upheal notifies the provider, and keeps notes separate from transcripts so that any disclosure reaches less.
What therapists think about Upheal and TherapyNotes
The question that comes up most in therapist reviews is trust. One graduate student and care coordinator wrote:
"I am truly impressed with Upheal. It makes documentation so much more efficient and captures key information during sessions... Everyone in our practice who uses Upheal has had nothing but positive things to say." -Reem Alkaabi
The privacy conversation surfaces repeatedly. One Upheal user highlighted:
"I really like how easy Upheal is to use and that it allows therapists to turn off opting in to training the LLM." -TS
Who should choose TherapyNotes vs Upheal
TherapyNotes is the better platform for a practice built around insurance. If you prescribe, it has ePrescribe and Upheal does not. If you report MIPS, it sells that and Upheal does not. If you run a group practice with several administrators and billers, free non-clinical seats add up.
Upheal is the better fit if documentation and admin are what you want to hand off. The comparison is not that TherapyNotes lacks AI. It is that theirs generates when you arrive somewhere, and ours answers when you ask.
Also comparing other options? See how Upheal compares to SimplePractice.
Frequently asked questions about Upheal vs TherapyNotes
Does TherapyNotes have AI notes?
Yes. TherapyNotes offers TherapyFuel at $40 per clinician per month. It generates progress notes from a typed session summary or from a recorded session, drafts treatment plans, and summarises client history. It does not include compliance checking against payer criteria, and it does not yet support group, couples, family, psychiatry or intake notes.
What is TherapyFuel?
TherapyFuel is TherapyNotes' AI suite, $40 per clinician per month. It covers progress notes, treatment plans, client history summaries, contact notes from message threads, insurance card capture, dictation, tone settings, section-level regeneration, and Session Assist for pre-session briefing. Scribe works only inside TherapyNotes and cannot record on a third-party telehealth platform.
How does TherapyNotes pricing compare to Upheal?
TherapyNotes is $69 a month for a solo clinician, or $79 for the first clinician plus $50 for each additional one in a group, with TherapyFuel at $40 per clinician. Basic Telehealth for one-on-one sessions is included, and Premium Telehealth is $15. Upheal is $1 per session, so a 50-session month is $50, and for a full caseload the $99 plan covers unlimited sessions and includes Assistant Pro. On claim fees TherapyNotes is slightly cheaper at $0.28 for a claim and its ERA against $0.30 on Upheal. Verified against each vendor's pricing page, September 2026.
Is TherapyNotes good for private-pay practices?
TherapyNotes was built around insurance billing. For private-pay practices, Upheal's per-session pricing, automated invoicing and AI-native documentation are a better fit.
Can I switch from TherapyNotes to Upheal?
Yes, for most therapy practices. Upheal covers scheduling, billing, client records, AI notes, treatment plans, compliance checking, telehealth and intake forms, replacing both TherapyNotes and TherapyFuel. Migration is free and handled by the AI Assistant, chart files included. If you prescribe or report MIPS, TherapyNotes has ePrescribe and MIPS reporting and Upheal does not.
How do Upheal and TherapyNotes compare on compliance and security?
Upheal is HIPAA, PHIPA, PIPEDA, GDPR, and DPA compliant, has completed a SOC 2 Type II audit, and is continuously externally tested, and it signs a BAA with every practice. TherapyNotes holds HITRUST i1 certification for its platform and a separate HITRUST AI Security certification for TherapyFuel. If your organization requires HITRUST specifically, TherapyNotes meets that requirement and Upheal does not.
What is the best TherapyNotes alternative?
Upheal is a strong alternative for practices that want conversational AI built into the EHR rather than added on. TherapyNotes remains the stronger choice for prescribers and insurance-heavy practices.
Sources: TherapyNotes claims are taken from its pricing page, Pricing and Subscription Options, TherapyFuel Overview, TherapyFuel FAQs and Pro Tips, Session Assist, Terms of Service and privacy FAQ and its Consumer Health Privacy Policy, all checked on 5 September 2026, with plan and TherapyFuel prices re-checked on 30 September 2026. Telehealth tiers were rechecked on its pricing page and telehealth page on 15 September 2026. The HITRUST i1 and TherapyFuel HITRUST AI Security certifications were checked on TherapyNotes' own blog on 15 September 2026. Where this page says TherapyNotes does not have something, that rests on four surfaces: its site navigation, its rendered plan grid, the TherapyFuel help-centre index and the TherapyFuel FAQ taxonomy. Upheal claims are taken from the Upheal support center and pricing page on the same date. Pricing and features change; confirm current terms with each vendor before deciding.
