Upheal vs Mentalyc vs Blueprint vs Twofold: The Cheapest Therapy AI Depends on One Number

Every comparison of AI documentation tools for therapists eventually collapses into a feature list, and feature lists are close to useless here. All four of the tools in this piece write a competent SOAP or DAP note. All four sign a BAA. All four claim to save you six hours a week.

What actually separates them in 2026 is that they charge in four incompatible ways — per session, per note tier, flat monthly, and free-with-usage-fees — and none of the four is cheapest across the whole range of caseloads. The tool that is a bargain at 30 sessions a month is the most expensive option at 160. So the honest version of this comparison starts with arithmetic, not features.

All prices below were verified directly on each vendor's own pricing page in August 2026, not from the comparison pages that dominate search results for these queries. That distinction matters more than usual in this category: the top organic results for "Upheal vs Mentalyc" and similar searches are largely published by Upheal, Mentalyc, and Twofold themselves, each ranking its own product first.

These are four different kinds of product

Before the money, the category confusion. Two of these are note generators. Two are electronic health records that happen to write notes.

• Mentalyc is a note generator. It sits alongside whatever EHR you already use, and it goes deeper on note types and therapy modalities than anything else here.
• Twofold Health is also a note generator, deliberately simple, works with any EHR, and sells a single flat price with no tiers.
• Upheal is an AI-native EHR. Notes, scheduling, telehealth video, client portal, forms, payments, and insurance claims are one system.
• Blueprint is a free EHR with AI sold separately per session, plus the deepest measurement-based-care library of the four.

That distinction drives the switching cost. Adding Mentalyc or Twofold to an existing practice is a low-stakes decision you can reverse in a week. Moving onto Upheal or Blueprint means migrating your client records, your calendar, and your billing — a decision you will live with for years. Price it accordingly, and weight the free trial period much more heavily for the two EHRs.

What each one actually costs

Upheal charges $1.00 per session, capped at $69 per month, with a 30-day full-feature trial and a free plan you fall back to rather than losing your records. The cap is per provider, not per practice. Upheal moved to this model in 2026, replacing an older Free/Starter/Premium ladder — if you find a review quoting $19 and $99 tiers, it is out of date. (Upheal's own /pricing-reference page still showed the retired tiers when we checked, so verify at checkout.)

Mentalyc sells four individual tiers, priced monthly with an annual discount, each with a hard monthly note cap:

• Mini — $19.99/mo, or $14.99/mo billed annually — 40 notes
• Basic — $39.99/mo, or $29.99/mo annually — 100 notes
• Pro — $69.99/mo, or $59.99/mo annually — 160 notes
• Super — $119.99/mo, or $99.99/mo annually — 330 notes

The free trial is 14 days at Pro level, 15 notes, no card required.

Blueprint gives the Core EHR away free — scheduling, telehealth, client records, forms, payments, and electronic claims, with no client or session caps — and charges only for AI, per session, with no subscription and no monthly minimum:

• $0.99 per session to run the AI alongside your existing EHR (5 free sessions)
• $1.49 per session for AI inside Blueprint's own all-in-one EHR (30-day trial)

Session credits are bought up front and never expire, and there is a 60-day money-back guarantee.

Twofold charges one flat price for unlimited notes: $69/month billed monthly, or $49/month billed annually ($588/year), with a promotional $19 first month and a 7-day trial that needs no card. There are no tiers — every feature is in the one plan.

The cheapest tool depends on one number

That number is sessions per month. Here is what each option costs at four realistic caseloads, at list price on monthly billing.

At 40 sessions a month (a part-time or building practice):

• Mentalyc Mini — $19.99, but you are exactly at the 40-note ceiling
• Blueprint alongside your EHR — $39.60
• Upheal — $40.00
• Blueprint all-in-one EHR — $59.60
• Twofold — $69.00

At 100 sessions a month (roughly 25 a week, a standard full caseload):

• Mentalyc Basic — $39.99, again exactly at the tier ceiling
• Upheal — $69.00 (capped)
• Twofold — $69.00
• Blueprint alongside — $99.00
• Blueprint all-in-one — $149.00

At 160 sessions a month (a heavy caseload, or shorter sessions):

• Upheal — $69.00
• Twofold — $69.00
• Mentalyc Pro — $69.99
• Blueprint alongside — $158.40
• Blueprint all-in-one — $238.40

At 250 sessions a month (group-practice volume for one very busy clinician):

• Upheal — $69.00
• Twofold — $69.00
• Mentalyc Super — $119.99
• Blueprint alongside — $247.50

Three things fall out of that.

Upheal's cap binds at 69 sessions. Past that point your marginal cost per note is zero. Upheal is the only tool here where a heavy month costs the same as a light one, and it is the cheapest full EHR at every volume above about 70 sessions.

Blueprint's per-session price has no ceiling. At $0.99 it looks like the cheapest AI in the category, and below roughly 40 sessions a month it genuinely is. But it crosses Mentalyc Basic at about 41 sessions, crosses Upheal and Twofold at 70, and by 160 sessions it costs more than twice either. Blueprint's real value proposition is not cheap AI — it is a free EHR, which is worth more than the AI discount to a practice paying $70–$100 a month for SimplePractice or TherapyNotes today.

Mentalyc is cheapest in the middle, if you fit the tier. Between roughly 41 and 160 sessions it undercuts everything, and on annual billing ($29.99 for 100 notes) it is not close. The risk is the hard cap: those are note limits, not soft targets, and a busy month bumps you into the next tier. If your caseload swings month to month, the flat-rate tools price that volatility better.

On annual billing the picture shifts again. Twofold at $49/month for unlimited notes is the cheapest uncapped option in the category above about 165 sessions a month, and it beats Mentalyc Pro's annual $59.99 while removing the cap entirely. Upheal offers no annual discount, because per-session billing does not need one.

The fees the sticker price hides

Both EHRs make money on payments, and those fees are not small relative to the subscription.

• Upheal: 2.9% + $0.30 per card transaction, $0.30 per insurance claim submitted, $0.15 per eligibility check. Claim and eligibility fees were waived through the end of September at the time of writing.
• Blueprint: 3.15% + $0.30 per card transaction, $0.30 per claim — both waived until September 2026.

On a practice collecting $12,000 a month by card, that 2.9% is about $350 — five times the software bill. Neither is out of line with standard payment processing, but if you are comparing an all-in-one EHR against a note generator plus your existing EHR, the processing spread belongs in the comparison.

One more Upheal-specific detail worth knowing before you model your costs: a session counts when a note is generated by any method — including dictated notes, manually uploaded recordings, and non-AI notes — and Upheal telehealth calls count even if you never generate a note, because the fee also covers scheduling, payments, and the AI assistant. No-shows removed from your calendar, failed processing, and sessions imported from another EHR do not count. Given the $69 cap, this only matters below 69 sessions, but it is the kind of thing that makes a first invoice surprising.

What happens to the session after it ends

This is where the four genuinely diverge, and for therapy records it deserves more weight than it usually gets. We covered the underlying legal framework in AI Notes for Therapists in 2026 and the recording-consent rules in Your AI Scribe Is a Recording Device; what follows is how these four specifically behave.

Mentalyc holds HIPAA, SOC 2 Type II, PHIPA, PIPEDA, and PIPA compliance, generates a BAA inside your account, encrypts with AES-256 at rest and in transit, deletes recordings after the note is generated, anonymizes transcripts by default, and states plainly that client data is never used to train AI models.

Blueprint is SOC 2 Type II with annual independent audits, includes the BAA automatically in its Terms of Service (a countersigned copy is available on request), makes recording optional — you can document with or without it — deletes audio immediately after processing with no copies or backups retained, and does not use client data to train AI models.

Twofold signs a BAA with every organization, keeps PHI in US data centers on Azure and GCP with BAAs at both providers, never writes the recording to disk at any point, explicitly excludes PHI from all AI training, and restricts staff from seeing transcripts or clinical content. Its one gap: SOC 2 Type II is still in progress, not completed. For a solo practice that may be immaterial; for a group practice with a procurement checklist, it is the thing that stalls the purchase.

Upheal is SOC 2 Type II, HIPAA, GDPR, PHIPA, and PIPEDA compliant, signs a BAA, and deletes session audio by default once notes are generated — you can retain it for supervision, but only with explicit client consent. It is also the only one of the four that uses session data to improve its AI at all, and the mechanics deserve precision rather than alarm: the data is de-identified, and it is used only for sessions where both the therapist and the client have opted in. Clients are opted out by default and must actively consent. Therapists, however, are opted in by default, and turn it off at Settings → Practice Settings → AI training preferences. A client who consented can withdraw through support, but the withdrawal is not retroactive.

That is a defensible design, and Upheal is more transparent about it than most vendors are. But it is a real difference: three of these four tools will never touch your sessions, and one will unless you and your client both decline. If you practice in a state with an AI disclosure requirement — see our rundown of the 2026 state rules — the default-on setting is worth a deliberate decision rather than a shrug.

Clinical depth, where they actually differ

Pricing aside, each tool is genuinely better than the others at one thing.

Mentalyc has the widest clinical range: SOAP, DAP, BIRP, GIRP and PIE formats, over 100 templates at the Pro tier, plus supervision notes, group therapy notes, and dedicated support for child, couple, family, EMDR, play therapy and psychiatry work. Its Alliance Genie™ analyzes recorded sessions for therapeutic alliance and engagement patterns — the only feature of its kind in this group, and a real supervision tool for group practices. Auto-computed CPT codes arrive at Pro.

Blueprint owns measurement-based care. It began as an outcome-measurement company before repositioning around the AI assistant, and it carries a library of validated instruments — PHQ-9, GAD-7, PCL-5 and hundreds more — that are administered to clients automatically, scored, and pulled into notes and treatment plans. If you bill payers that reward outcome reporting, or you want the "golden thread" from assessment to treatment plan to note to hold up in an audit, nothing else here is close.

Upheal wins on consolidation. One login covers the note, the video call, the calendar, the form, the card payment, and the claim. For a solo clinician tired of stitching four subscriptions together, that is worth more than a few dollars a month.

Twofold wins on predictability. One price, every feature, unlimited notes, works with any EHR, nothing held back in a premium tier. There is no tier math to do and no per-session meter running.

Group practices change the math again

At ten clinicians averaging 100 sessions a month each — 1,000 sessions total — the ordering inverts against the per-session model:

• Mentalyc Team, promotional rate — $599.90/mo ($59.99/seat, new teams; regular rate $119.99/seat)
• Upheal — $690/mo if quoted at the list $69 per-provider cap
• Blueprint alongside your EHR — $990/mo
• Twofold Group — custom quote

Mentalyc's Team plan gives unlimited notes subject to a fair-usage policy, plus team management and note review — which matters, because supervisory review of AI-generated notes is the control that keeps a group practice out of trouble. Upheal and Twofold both quote group pricing only through sales, and Upheal's group tier adds shared templates, EHR migration help, and centralized billing, so treat the $690 above as a list-price ceiling rather than a quote.

If you are evaluating for a group, our AI therapy notes for behavioral health group practices comparison covers the full set of tools in the directory, and solo practitioners have their own shortlist.

How to choose, in one pass

• Under ~40 sessions a month, and you want to keep your EHR — Mentalyc Mini, or Blueprint's $0.99 per session if your volume is irregular enough that a subscription would sit idle.
• 40–160 sessions, keeping your EHR — Mentalyc Basic or Pro, on annual billing, provided you stay under the note cap.
• Volume that swings month to month — Twofold's flat $49–$69, or Upheal's cap. Both price volatility better than tiers do.
• You are paying $70–$100 a month for an EHR you dislike — Blueprint's free Core EHR is the strongest offer in the category, and the per-session AI cost is the smaller half of that decision.
• You want one system for everything — Upheal, with the AI-training default switched off if that matters to you.
• Outcome measurement is a clinical or contractual requirement — Blueprint, on the strength of the assessment library alone.
• Procurement requires completed SOC 2 Type II — Mentalyc, Blueprint, or Upheal. Twofold's certification is still in progress.

Whichever you pick, the accuracy caveats from what the research says about AI scribe accuracy apply in full, and behavioral health is the setting where an unreviewed hallucinated detail does the most damage. Every one of these tools produces a draft. Reading it before you sign it is still the job — and as we covered in the billing side of AI documentation, the note you sign is the note your payer audits.

Browse the full set of AI therapy notes tools in the directory, or narrow by practice type for solo therapy practices and behavioral health group practices.

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This article is informational only and is not legal, clinical, or financial advice. Pricing, features, and privacy policies change frequently — all figures here were verified on vendor pricing pages in August 2026, and promotional rates in particular expire. Confirm current terms, fees, and data-handling practices directly with the vendor and review any BAA with your own counsel before purchasing.