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Veterinary · head to head

IDEXX Cornerstone vs TheraNest

IDEXX Cornerstone logo

IDEXX Cornerstone

Veterinary

On-premise veterinary practice management software tied to the IDEXX diagnostics ecosystem

From
On request
Rated
-
Full reviewWebsite
TheraNest logo

TheraNest

Healthcare

Mental health EHR and practice management priced per therapist

From
$29/month
Rated
-
Full reviewWebsite

The short version

  • Each has a real cost: IDEXX Cornerstone the system runs on a server in the building, so the practice pays for hardware, backups and an IT provider, costs that never appear in a comparison against browser based competitors.; TheraNest the Essentials plan includes no insurance claims at all, so any practice that bills a payer is effectively on the 59 USD tier or above and the advertised 29 USD entry price does not apply to it.
  • They diverge on capability: IDEXX Cornerstone covers Medical records, TheraNest covers Progress notes and treatment plans.
  • Prices and features above were last checked on 31 August 2026.

Where they differ

Only the attributes on which IDEXX Cornerstone and TheraNest actually diverge.

Attributes where IDEXX Cornerstone and TheraNest differ
AttributeIDEXX CornerstoneTheraNest
Starting priceOn request$29/month
Pricing modelquotePer user per month
PlatformsWindowsWeb, iOS, Android
CategoryVeterinaryHealthcare

Identical on both: free tier (No), user rating (Not yet rated).

What each one covers

Drawn from each product's published feature list. An absence here means we hold no record of it - not that the product lacks it.

Only in IDEXX Cornerstone

  • Medical records
  • Diagnostics integration
  • Estimates and invoicing
  • Inventory control
  • Boarding and grooming
  • Wellness plans

Only in TheraNest

  • Progress notes and treatment plans
  • Insurance claims
  • Client portal
  • Telehealth
  • Group and family sessions
  • Payroll and staff reporting

What people use each for

The jobs each tool is most often brought in to do.

IDEXX Cornerstone

  • A multi-doctor general practice already running IDEXX in-house analysers that wants results in the record automaticallynot TheraNest
  • A clinic with unreliable internet where an on-site server keeps the practice working during an outagenot TheraNest
  • A practice that boards and grooms as well as treating, and wants those bookings on the same invoicenot TheraNest
  • A group needing consolidated reporting across a small number of owned locationsnot TheraNest

TheraNest

  • A solo therapist who needs a HIPAA aligned note and scheduling system and does not bill insurance, where the 29 USD entry tier is genuinely sufficientnot IDEXX Cornerstone
  • A group practice of six to twenty clinicians that wants per clinician productivity and payroll reporting without buying a separate practice management layernot IDEXX Cornerstone
  • A practice moving off paper or a general purpose calendar that needs a client portal for intake forms and consent signaturesnot IDEXX Cornerstone
  • A behavioural health organisation that bills a steady volume of insurance claims each month and can size the Advanced allowance against its actual claim countnot IDEXX Cornerstone

Where each one falls short

Documented limitations, not opinions. Every one is a constraint you would hit in normal use.

IDEXX Cornerstone

  • The system runs on a server in the building, so the practice pays for hardware, backups and an IT provider, costs that never appear in a comparison against browser based competitors.
  • It is Windows only with no meaningful mobile access, which rules it out for house call and ambulatory work and leaves staff tied to workstations.
  • The interface is dense and dated, so training a new receptionist or technician takes materially longer than on newer systems.
  • Commercial gravity runs towards IDEXX diagnostics, and a practice that later moves its laboratory work to a competitor loses the automation that justified the software.
  • IDEXX is directing new customers towards its cloud products, so investment in Cornerstone is maintenance oriented and buyers should assume a migration conversation within the life of the purchase.

TheraNest

  • The Essentials plan includes no insurance claims at all, so any practice that bills a payer is effectively on the 59 USD tier or above and the advertised 29 USD entry price does not apply to it.
  • Telehealth is only in the Premier plan, so a practice that wants video sessions pays 89 USD per therapist per month even if it needs nothing else from that tier.
  • An annual AMA CPT licence fee is billed separately each December on top of subscription cost, which surprises practices that budgeted only the monthly figure.
  • Additional administrative users are chargeable, so a practice with front desk and billing staff who never see clients still pays 19 to 29 USD per head for people who generate no revenue.
  • The product sits inside a consolidated portfolio that has already renamed the parent company from Therapy Brands to Ensora Health, and product investment in a portfolio is directed by the owner rather than by this product line, so roadmap commitments are worth less than they would be from a single product vendor.

Pricing, plan by plan

IDEXX Cornerstone

On request
  • Cornerstone$undefined/year
    • Licence priced by number of workstations and modules
    • Annual support and maintenance charged separately
    • Server hardware and IT support are the responsibility of the practice

TheraNest

$29/month
  • Essentials$29/month
    • Per therapist
    • Scheduling and client portal
    • HIPAA aligned notes and documentation
  • Advanced$59/month
    • Per therapist
    • 30 insurance claims per month included
    • Custom forms
  • Premier$89/month
    • Per therapist
    • Unlimited insurance claims
    • Billing automation

Which should you pick?

Choose IDEXX Cornerstone if

  • You need medical records.
  • You work on Windows.
  • You also want diagnostics integration.
IDEXX Cornerstone review

Choose TheraNest if

  • You need progress notes and treatment plans.
  • You work on Web, iOS, Android.
  • You also want insurance claims.
TheraNest review

Questions people ask

Is IDEXX Cornerstone or TheraNest better?
Neither clearly leads. IDEXX Cornerstone starts at On request and TheraNest at $29/month, and user ratings are close enough to be indistinguishable. Choose on capability and platform support.
Which is cheaper, IDEXX Cornerstone or TheraNest?
IDEXX Cornerstone starts at On request and TheraNest at $29/month.
Does IDEXX Cornerstone or TheraNest run on more platforms?
IDEXX Cornerstone runs on Windows. TheraNest runs on Web, iOS, Android.
What is IDEXX Cornerstone best used for?
IDEXX Cornerstone is most often used for a multi-doctor general practice already running idexx in-house analysers that wants results in the record automatically, a clinic with unreliable internet where an on-site server keeps the practice working during an outage, a practice that boards and grooms as well as treating, and wants those bookings on the same invoice, a group needing consolidated reporting across a small number of owned locations. Of those, a multi-doctor general practice already running idexx in-house analysers that wants results in the record automatically and a clinic with unreliable internet where an on-site server keeps the practice working during an outage are not what TheraNest is typically brought in for.
What can IDEXX Cornerstone do that TheraNest cannot?
IDEXX Cornerstone covers Medical records, Diagnostics integration, Estimates and invoicing, Inventory control. TheraNest covers Progress notes and treatment plans, Insurance claims, Client portal, Telehealth.

Answered from the vendors’ own pages

IDEXX Cornerstone: Is Cornerstone cloud based?

No. It is installed on a server at the practice. IDEXX sells separate browser based products for clinics that want cloud.

TheraNest: Is TheraNest still sold under that name?

Yes. The company rebranded from Therapy Brands to Ensora Health and the product is now marketed as TheraNest by Ensora Health, but you still buy TheraNest.

IDEXX Cornerstone: Does it work with laboratories other than IDEXX?

Results can be handled, but the automatic requisition and result return that make Cornerstone worth its price are built around IDEXX.

TheraNest: Can I bill insurance on the cheapest plan?

No. Essentials includes no claims. Advanced includes 30 claims a month and Premier is unlimited.

IDEXX Cornerstone: What is the real total cost?

The licence and annual support are only part of it. Add the server, backup, workstation refreshes and an IT contract before comparing with cloud systems.

TheraNest: Are there hidden costs?

Two. Additional admin users are charged per head, and an AMA CPT licence fee is billed annually in December per therapist.

IDEXX Cornerstone: Can it be accessed from home?

Only through remote desktop or similar, set up and secured by the practice IT provider.

TheraNest: Does it support group practices?

Yes, with per clinician reporting and payroll figures, though every clinician and every admin is a paid seat.

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