TherapyNotes costs $69 a month for a solo user, but that is only the first row. A practice may also pay for TherapyFuel, premium telehealth, ePrescribe, eligibility checks, claims, ERA items, reminders, MIPS reporting, and card processing.
None of those charges is hidden. The mistake is leaving them outside the comparison.
Price snapshot, rechecked August 11, 2026
- Solo: $69 monthly for one user.
- Group: $79 for the first clinician and $50 for each additional clinician.
- TherapyFuel: $40 per enabled clinician monthly.
- Premium Telehealth: $15 per clinician monthly; Basic Telehealth is included.
- ePrescribe: $65 per prescriber monthly.
- Electronic claim, ERA claim, eligibility request, and text or voice reminder: $0.14 each.
The current TherapyNotes rate card
The first-party support article is unusually useful because it lists both subscription and usage charges. Keep the date beside your spreadsheet. Prices and agreements can change.
| Line item | Current public rate | Billable unit |
|---|---|---|
| Solo subscription | $69/month | One solo user |
| Group subscription | $79 + $50 for each additional clinician | Clinician seats |
| Enterprise | Same group rates, 30-user minimum | Account and clinician mix |
| Non-clinical users | Included, unlimited | Practice admins, schedulers, billers |
| TherapyFuel | $40/month | Each enabled clinician |
| Basic Telehealth | Included | Up to two participants per official page |
| Premium Telehealth | $15/month | Each enabled clinician |
| ePrescribe | $65/month | Each prescriber |
| Electronic claim | $0.14 | Each claim |
| Mailed paper claim | $1.00 | Each claim |
| ERA | $0.14 | Each claim in an ERA |
| Real-time eligibility | $0.14 | Each request |
| Text or voice reminder | $0.14 | Each reminder |
| Email reminder | Included | Each reminder |
| Card processing | 3.1% + $0.30 | Each transaction, plus possible agreement fees |
| MIPS reporting | $359/year | Each clinician |
| Storage-only account | $9 + $3 for each additional user monthly | Read-only record access |
TherapyNotes says every standard plan includes a 30-day trial, client data import, unlimited clients, appointments and notes, messaging, a custom portal, Basic Telehealth, file storage, backups, and 24/7 phone and email support. Those inclusions make the base plan materially different from a scheduler or note-only tool.
The calculator
Use a normal month, not the quietest one in the year. Let:
- C = number of clinicians;
- A = clinicians using TherapyFuel;
- T = clinicians using Premium Telehealth;
- P = ePrescribe users;
- Q = electronic claims;
- E = claims represented in ERA files;
- R = real-time eligibility requests;
- M = paid text or voice reminders;
- V = card volume in dollars;
- N = number of card transactions.
For a group with at least one clinician:
Monthly cost = $79 + $50 × (C - 1) + $40A + $15T + $65P + $0.14(Q + E + R + M) + 3.1%V + $0.30N
Add MIPS at $359 per participating clinician per year. Add $1 for every mailed paper claim. Do not include card processing when the practice does not use the integrated merchant service.
For a solo user, replace the group base with $69.
Three worked examples
These are buyer-entered scenarios, not typical bills.
Solo, cash pay, AI notes
A solo therapist uses TherapyFuel, Basic Telehealth, email reminders, and no insurance or integrated cards:
$69 + $40 = $109 per month.
The comparison is clean because usage charges are zero.
Solo psychiatric prescriber
One prescriber uses TherapyFuel, Premium Telehealth, and ePrescribe:
$69 + $40 + $15 + $65 = $189 per month before claims, ERA, eligibility, reminders, cards, or MIPS.
That $65 ePrescribe row may be decisive. Patient Square creates a prescription draft for clinician review but does not transmit it to a pharmacy.
Three-clinician insurance group
Three clinicians use TherapyFuel; two use Premium Telehealth; one uses ePrescribe. Before transaction fees:
$79 + (2 × $50) + (3 × $40) + (2 × $15) + $65 = $394 per month.
Now add the group’s actual claims, ERA items, eligibility checks, reminders, and payments. If a claim later appears in an ERA, those are two separate 14-cent units in the official rate card. Count both.
What TherapyFuel changes
TherapyFuel is the AI line item. The current support article prices it at $40 per clinician per month. It also says that enabling TherapyFuel for at least one clinician lets the whole practice use Generate Client History Summaries and Generate Contact Notes at no additional charge.
That does not make every AI function practice-wide. During a trial, name the clinician-specific functions you need and confirm which seats must be enabled. Also test the note type, group-session workflow, corrections, consent, and export. A $40 add-on is inexpensive only if it handles the sessions that create the work.
Claims and payment costs are usage based
Fourteen cents sounds negligible until it is multiplied across several events. An insurance visit can create an eligibility request, an electronic claim, an ERA line, and a reminder. TherapyNotes may still be a strong value because those events remain inside its behavioral-health workflow. The calculator simply prevents the $69 headline from standing in for the invoice.
Card processing needs a separate read. The Help Center lists 3.1% plus 30 cents per transaction, says CardConnect manages the service, and warns that card-network and incidental fees can apply. The merchant agreement controls. For $20,000 in monthly integrated card volume across 200 transactions, the displayed formula alone is $680:
3.1% × $20,000 + $0.30 × 200 = $680.
That is a payment-processing cost, not an EHR subscription. Keep it in the total only when comparing payment workflows.
TherapyNotes versus Patient Square
The products overlap on documentation and practice workflow, but they are not substitutes row for row.
| Buyer need | TherapyNotes | Patient Square |
|---|---|---|
| Behavioral-health EHR base | Included in subscription | AI Copilot EHR begins on Copilot |
| AI note workflow | TherapyFuel at $40 per clinician | Scribe included on every plan |
| Scheduling | Included | Begins on Assist |
| Client portal | Included | Not publicly listed as a module |
| Claims, ERA, eligibility | Built in with published usage fees | Not a full claims, clearinghouse, or eligibility system |
| Pharmacy transmission | ePrescribe, $65 per prescriber | Prescription draft only; no transmission |
| Premium telehealth | $15 per clinician | Not publicly listed as a module |
| Starting published price | $69 solo | Assist $99 monthly or $79 annual monthly equivalent |
| Bundled-EHR tier | Base product is an EHR | Copilot $149 monthly or $119 annual monthly equivalent |
TherapyNotes is the stronger fit when behavioral billing, portal, telehealth, or ePrescribe is central. Patient Square is worth testing when the main purchase is ambient documentation with scheduling, or when a practice wants the bundled AI Copilot EHR and WhatsApp at the Copilot tier.
The free trials answer different questions. TherapyNotes lists a 30-day trial on its standard plans. Patient Square has a 7-day free trial. Use each one to test the job you would actually replace. For TherapyNotes, that may mean claims, reminders, portal activity, and a prescribing workflow. For Patient Square, it means the review quality of the structured SOAP note and the work around it. A trial is useful only when the team records what still has to happen after the note is generated.
Patient Square’s public output is a structured SOAP note, ICD-10 suggestions, and a prescription draft for review. It does not promise DAP or BIRP output on the pricing page. A therapist should test whether the output and specialty-aware templates fit, rather than infer behavioral depth from the word EHR.
Compare the cost against the job
The relevant alternative is not always a cheaper product. TherapyNotes can be worth its full monthly cost when the practice uses its behavioral-health billing, client portal, telehealth, ePrescribe, and record workflow. Those are not incidental extras for an insurance-heavy group. A lower note-tool subscription would not replace them.
The comparison changes for a practice that already has a working billing and pharmacy path and is shopping because notes are consuming evenings. In that case, price the exact documentation seats rather than treating a complete therapy platform as the baseline. Patient Square Assist is $99 month-to-month or $79 per clinician per month as an annual monthly equivalent. Copilot is $149 month-to-month or $119 annual monthly equivalent and adds the bundled AI Copilot EHR and WhatsApp messaging. Autopilot is $249 month-to-month or $199 annual monthly equivalent. Those prices cover different scopes from TherapyNotes.
Patient Square’s prescription output remains a draft for clinician review. It is not pharmacy transmission. Its EHR-ready export (PDF · HL7 · FHIR) is an export statement, not a claim that it will write back into TherapyNotes or another record. Keep the existing record path where it owns work Patient Square does not publicly list.
Contract and PHI questions to settle
HHS explains that selling software alone does not make a vendor a business associate, while hosting or support access to PHI can. Establish the role and execute the required BAA before that access begins.
For TherapyNotes, get these answers in the order form and agreements:
- Which users count as clinicians, non-clinical staff, interns, or prescribers?
- Which TherapyFuel functions require a paid seat?
- Which transaction types can trigger more than once per encounter?
- What do the merchant and ePrescribe agreements add?
- What happens to price and data access when users leave?
- What is included in migration, and how is a sample export validated?
The best EHR for therapists uses those answers as disqualifiers. The AI scribe for therapists covers consent and sessions that should not be recorded.
Patient Square and your existing record system
Practice Copilot can use the bundled AI Copilot EHR from the Copilot tier, or work alongside an existing EHR. Neither route promises automatic filing or write-back into a third-party EHR.