Twofold Health vs Upheal
Updated October 21, 2026
AI scribes have become a routine purchase for therapists, since a tool that drafts the progress note from a recorded session can hand back hours every week. Twofold Health and Upheal both serve that buyer, but the choice many therapists overlook is whether they want a scribe that sits beside their current records system or a vendor that can replace it: Twofold writes notes and suggests billing codes for the EHR you keep, while Upheal pairs its notes with a full practice EHR. That decision shapes price, setup, and how much of your week moves into a new system, so we compared the two.
Our analysts compared Twofold Health and Upheal on price, what each product covers, session capture, EHR fit, and free options, using the HIR review of each company and each vendor's own pricing page checked this month. In the following sections, we compare them in one table, describe the clinician each one suits, and list what Upheal has released recently.
Twofold Health vs Upheal at a glance, October 2026
| What buyers weigh | Twofold Health | Upheal |
|---|---|---|
| Published price | $69 per month on monthly billing, or $49 per month billed annually, for unlimited notes. The first month costs $19, and groups get custom volume pricing. | A free plan for basic notes, and $39 per month for unlimited AI notes. EHR plans run $1 per session, or a flat $99 per month for EHR Pro with Assistant Pro included. |
| Pricing model | One flat monthly fee per clinician, lower on yearly billing. | Flat monthly plans per clinician, or the EHR paid by the session. |
| What drives cost | Monthly or yearly billing and, for a group, the number of clinicians. | Clinician count, how many sessions run on the per-session EHR, and add-ons such as AI Assistant Pro and insurance claims. |
| What you buy | An AI scribe that writes the note and suggests CPT and ICD-10 codes, used next to the EHR you keep. | AI notes, plus an optional full EHR with scheduling, a client portal, telehealth, payments, and insurance claims. |
| Who it is built for | Therapists first, and now primary care, pediatrics, and hospital medicine too. | Mental health clinicians, from solo therapists to group practices. |
| Session capture | Records in-person or telehealth visits and tells apart several voices in couples and family sessions. | Captures a session by video, audio, dictation, or upload, and keeps a treatment plan that follows progress across sessions. |
| EHR fit | Lists SimplePractice, TherapyNotes, athenahealth, and Epic among the EHRs it works with. | Can become your EHR, with client records moved over from the old system. |
| Free option | A seven-day free trial, with no lasting free plan. | A free plan for basic AI notes, and a free trial of the paid plans with no card needed. Clear edge |
| Note results | Scores 6.8 for note quality after the visit. | Scores 7.6 for time saved on notes. Higher score |
| Product depth | Scores 7.2 for its scribe. | Scores 7.9 for its notes and EHR product. Higher score |
| Getting started | Scores 7.6 for getting clinicians live. | Scores 8.4 for getting a practice started. Higher score |
| What you need first | A clinician who will review and sign each draft note. | Someone who sets up note templates and moves client records over. |
| Deal-breaker | Your health system needs deep EHR integration. | Your clients will not agree to recorded sessions. |
| Pricing clarity score | 8.4 | 9.0 Clearer pricing |
| HIR overall score | 7.3, Recommend. | 8.1, Recommend. Higher score |
| Best for | Therapists and behavioral health clinicians who write many notes. | Solo and small group therapy practices that want notes and an EHR at posted prices. |
| Not a fit for | Health systems that need deep EHR integration. | Residential and addiction treatment programs that need facility tools. |
Which fits which buyer
Decide first whether you are keeping your current EHR.
Choose Twofold Health if
- You plan to keep your current EHR and add AI notes beside it.
- You want CPT and ICD-10 code suggestions with every note.
- You see medical patients as well as therapy clients.
Choose Upheal if
- You want to start on a free plan before you pay.
- You want notes, scheduling, payments, and insurance claims in one system.
- You want treatment plans that follow each client from session to session.
Verdict
Upheal scores higher and fits therapists who want AI notes now and may move the whole practice onto one system later. Twofold Health fits clinicians who will keep their EHR and want notes with billing codes at one flat monthly price.
Clinicians who mostly see medical patients should lean toward Twofold, since Upheal is built for mental health care.
Where the two tools are headed in 2027 and beyond
Upheal: Upheal released its clinician app for iPhone and Android on August 25, 2026, bringing the calendar, client messages, and its AI assistant to the phone. On October 6, 2026, it added routines, which let the assistant run jobs such as a daily billing summary on a schedule for the clinician to approve.
Ask Upheal which of those tools come with the plan you are pricing.
Methodology
Each row comes from the HIR reviews of Twofold Health and Upheal, scored under the HIR method, and from each vendor's public pricing where it exists. Any published price for Twofold Health or Upheal was checked on that vendor's own site on October 21, 2026.
A green check marks a clear edge for Twofold Health or Upheal only where their review scores differ by at least 0.3 points or the two reviews show a plain difference. Rows with nothing published for either Twofold Health or Upheal are left out, and time to full value for each adds up the rollout stages in its review.
Sources
- HIR review of Twofold Health and HIR review of Upheal
- Twofold Health pricing, checked October 21, 2026
- Upheal pricing, checked October 21, 2026
- Upheal App for Clinicians is live, August 25, 2026
- Let Upheal Assistant handle your routine work, October 6, 2026