Comparison
Metanoa vs TheraNest: which fits your pediatric therapy practice?
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TheraNest, now part of Ensora Health, is a full mental health EHR with insurance billing, telehealth, treatment planners and family profiles, priced per therapist. Metanoa is built for pediatric speech, OT, ABA and PT, from a solo therapist starting out to a clinic with several departments, with goals, session plans and AI notes at the center.
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Built for speech, OT, ABA and PT
Therapists pull goals from a bank filtered by discipline and turn the day's goals into a session plan. TheraNest is built around mental health, with Wiley treatment planners as an add-on.
Parents see progress on every goal
Parents read the session reports you share and can comment on a specific goal, so they know what to practise at home.
$15 a month, AI note drafts included
Metanoa's Solo plan includes full AI note drafts. TheraNest's Advanced plan, the first with online booking and custom notes, is $59 per therapist, and its AI Session Assistant is a $35 add-on.
Metanoa vs TheraNest at a glance
| Compare | Metanoa | TheraNest |
|---|---|---|
| Built for | Pediatric therapists and clinics serving children with developmental needs, from solo practices to multi-location centers | Mental health practices, including clinicians who treat children and families |
| Clinic structure | Branches and departments, with department-level access | Therapists plus unlimited admin users, billers and schedulers |
| Goals | Shared goal bank filtered by discipline, with baselines and session plans from goals | Treatment plans, with the Wiley Treatment Planner on Advanced (add-on) and Premier |
| AI notes | Full drafts included on every plan | Notes enhancement included, Session Assistant $35 a month per provider |
| Parent access | Family Portal: session reports, comments on a specific goal, one login for siblings | Secure client portal, guardian and dependent profiles, family billing |
| Reminders | Included | 50 texts and calls a month on Advanced, then $0.10 each. Included on Premier |
| Online booking | Online appointment form | Advanced and Premier |
| Telehealth | Not supported | Included on Advanced and Premier |
| Insurance claims | Not supported | 50 a month on Advanced, then $0.23 each. Unlimited on Premier |
| Solo price | $15 a month | $29, $59 or $89 per therapist a month |
| Team of five | Quoted for your clinic | $295 a month on Advanced, $445 on Premier |
| Free trial | 15 days, no credit card | 21 days of Premier, no credit card |
Which one should you choose?
Choose Metanoa if:
- You run a pediatric speech, OT, ABA or PT practice and want goals and session plans set up for those sessions.
- You want every therapist writing goals from the same bank, with each department keeping its own team, prices and forms.
- You want parents reading session reports and commenting on specific goals.
- You want full AI note drafts included, including dictation in Spanish, Arabic or Hindi.
- You're starting solo and want notes, scheduling, billing, reminders and a parent portal for $15 a month.
Choose TheraNest if:
- You bill insurance. Premier includes unlimited claims and eligibility checks within fair use.
- Your practice is mainly counseling, psychology or family therapy, and you want built-in measures like the PHQ-9 and GAD-7.
- You see clients over video. Telehealth is included on Advanced and Premier.
- You want structured treatment planning with the Wiley Treatment Planner.
- You manage families with guardian profiles, dependents and family billing.
How they compare, feature by feature
Goals and treatment plans
Metanoa
Therapists pull goals from a shared bank filtered by discipline, record baselines and generate a session plan from the goals they pick for that day. Because therapists in the same discipline start from the same bank, goals are worded the same way across your team.
TheraNest
Treatment plans sit in each client's record, and the Wiley Treatment Planner is a $25 add-on on Advanced and included in Premier (Ensora). Some users say treatment plans became harder to find after layout changes (Capterra), so ask in the demo to walk through a child's plan from goal to progress note.
AI notes
Metanoa
Dictation or jottings from a session become a SOAP, DAP, GIRP or BIRP draft, and nothing is saved until the therapist reviews and confirms it. It captures speech in languages such as Spanish, Arabic and Hindi and writes the note in your clinic's language. AI notes are included on every plan.
TheraNest
Every plan includes Ensai notes enhancement. The Ensai Session Assistant is a separate add-on at $35 a month per provider (Ensora). Ask in the demo which one drafts a full note from a session.
Keeping parents in the loop
Metanoa
The Family Portal is built around the child's goals. Parents get session reports, comment on a specific goal, sign forms on their phone and see photos or moments the therapist shares. A parent with two children in therapy uses one login for both.
TheraNest
Its secure client portal lets clients complete paperwork and message you, and users praise how easy it is (Capterra). Ensora says TheraNest handles guardian relationships, dependent profiles and family billing (Ensora). Ask in the demo what a parent can see after each session.
Running a team or more than one location
Metanoa
A clinic is organized into branches and departments, with department-level access, rate plans and form libraries by department, and billing analytics broken down by department.
TheraNest
Every plan includes unlimited admin users, billers and schedulers at no extra charge, and Advanced adds group practice reports. Pricing is per therapist, with custom pricing for larger groups. Its pricing page doesn't mention multiple locations.
Scheduling and reminders
Metanoa
Reminders are included on every plan, families can request appointments through an online form, and it runs in the browser on any phone, tablet or laptop.
TheraNest
Online booking starts on Advanced. Advanced includes 50 text and 50 phone reminders a month, then $0.10 each, Premier includes them within fair use, and Essentials has none (Ensora). Several users report bugs after updates (Capterra), so test scheduling well during the trial.
Insurance and telehealth
Metanoa
Metanoa doesn't file insurance claims or offer telehealth. Its billing is built for families who pay directly, with each signed session priced from a rate plan and a wallet for each client.
TheraNest
Premier automates insurance billing with unlimited claims and eligibility checks within fair use. Advanced includes 50 claims a month, then $0.23 each, and telehealth for individuals and groups (Ensora). If your practice depends on payers or video sessions, choose TheraNest or another tool that has them.
Try it with your own goals
Set up your practice in the trial, add a few goals and invite a parent to the Family Portal.
What each costs
| Compare | Metanoa | TheraNest |
|---|---|---|
| Solo | $15 a month | Essentials $29, Advanced $59, Premier $89 a month |
| Team of five | Quoted for your clinic | Advanced $295, Premier $445 a month |
| Admin users | Ask for your quote | Unlimited |
| AI notes | Included | Session Assistant $35 a month per provider |
| Text reminders | Included | 50 a month on Advanced, then $0.10. Included on Premier |
| Telehealth | Not supported | Advanced and Premier, or $12 on Essentials |
| Insurance claims | Not supported | 50 a month on Advanced, then $0.23. Unlimited on Premier |
| Free trial | 15 days, no credit card | 21 days of Premier, no credit card |
Frequently asked questions
Can Metanoa bill insurance?
No. Metanoa doesn't file claims, post ERAs, check eligibility or connect to a clearinghouse. If insurance is a large part of your income, TheraNest or another system with claims is the better fit.
Does Metanoa have telehealth?
No. Metanoa is built for in-clinic sessions. TheraNest includes telehealth on its Advanced and Premier plans.
Is TheraNest good for speech or occupational therapy?
TheraNest is built for mental health practices, with measures like the PHQ-9 and GAD-7 and Wiley treatment planners. It can work for a practice that also offers counseling, but ask to see a speech or OT note and how goals are tracked before you commit.
Which is better for a solo pediatric therapist?
If you bill insurance or offer counseling, TheraNest. If families pay you directly and you run speech, OT, ABA or PT sessions, Metanoa's Solo plan is $15 a month with AI notes, reminders, the goal bank and the Family Portal included.
How much does each cost for a team of five?
TheraNest's Advanced plan is $295 a month for five therapists and Premier is $445, before add-ons. Metanoa quotes team plans for each clinic, with AI notes and reminders included.
Can parents manage more than one child?
In Metanoa, a parent with two children in therapy uses one Family Portal login and sees each child's goals and session reports. TheraNest supports guardian and dependent profiles, so ask in its demo how a parent with two children signs in.
Is Metanoa HIPAA compliant?
Yes. Metanoa is HIPAA compliant, with encrypted storage, access controls and audit logs.
See how your practice would run on Metanoa
If you work with children in speech, OT, ABA or PT and want therapists and parents working from the same goals, start with a few of your own goals in the trial.
No credit card needed.
How we compared
We compared both products using Ensora's TheraNest pricing and comparison pages, user reviews on Capterra and Metanoa's own docs, all checked on October 29, 2026. Metanoa is our product, so we've linked every TheraNest fact to its source and named the areas where TheraNest is the better choice. Prices change often, so confirm them with each vendor before you decide.