--- title: "TherapyNotes 4.19: Architectural Upgrades, Improved HSA Card Support, PQRS Deprecated" description: TherapyNotes 4.19 includes major architectural upgrades to support our growing customer base, faster billing pages, and better HSA card support. image: http://blog.therapynotes.com/hubfs/images/blog/topics/160906-sticker-features-150x150.png --- [![TherapyNotes Practice Management and EHR](https://blog.therapynotes.com/hubfs/images/primary/NavLogo@2x.png?noresize)](https://www.therapynotes.com/) - [Try Free](https://www.therapynotes.com/about/signup/) [Log In](https://www.therapynotes.com/app/login/) - - [![Call Us: (215) 658-4550](https://blog.therapynotes.com/hs-fs/hubfs/images/primary/MobileMenuCall@2x.png?noresize&width=25&height=25&name=MobileMenuCall@2x.png)Call Us: (215) 658-4550](tel:+12156584550) - [![](https://blog.therapynotes.com/hs-fs/hubfs/images/primary/MobileMenuTrial@2x.png?noresize&width=25&height=25&name=MobileMenuTrial@2x.png)Start Your Free Trial](https://www.therapynotes.com/about/signup/) - 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This release includes significant performance improvements to all billing pages, decreasing the time TherapyNotes takes to load data. This is especially noticeable when running substantial searches or generating large reports. Although the Submit EDI Claims page is now significantly faster (since 4.18), we have also changed the default search to only show appointments that occurred within the last 30 days which will further speed up the time it takes to load the page. If there are pending items older than 30 days, a convenient message will appear, which you can click to view the older items. **Improved HSA Card Support:** HSA cards are better supported by our credit card processing features. Previously, if a card didn't work, you were required to let us know so that we could add an exception for that card. Now, TherapyNotes will automatically resolve this issue with HSA cards. *An HSA (Health Savings Account) card is provided to an individual by their insurance to be used for out-of-pocket medical expenses. HSA cards are supported by TherapyNotes credit card services. If you aren't already using our credit card services, visit your Patient Credit Card Processing Settings page to sign up.* **PQRS Codes Deprecated:** The option to include PQRS codes will no longer be available for dates of service starting 1/1/2017. Beginning in 2017, the Medicare Access and CHIP Reauthorization Act (MACRA) will phase-out PQRS in favor of the Merit-based Incentive Payment System (MIPS). Behavioral health professionals are not subject to MIPS reporting until 2019, but we are working on plans to add MIPS support in the future. **As with all updates, this version also includes a number of bug fixes and minor improvements.** \* The content of this post is intended to serve as general advice and information. It is not to be taken as legal advice and may not account for all rules and regulations in every jurisdiction. For legal advice, please contact an attorney. Share: Previous Post: [How Out-of-Network Electronic Claims Keep You and Your Clients Happy](https://blog.therapynotes.com/how-out-of-network-electronic-claims-keep-you-and-your-clients-happy) Next Post: [TherapyNotes is Now on Cloudflare](https://blog.therapynotes.com/now-on-cloudflare) ##### Get more content like this, delivered right to your inbox. Subscribe to our newsletter. ## More Content You'll Enjoy ![](https://blog.therapynotes.com/hubfs/Whats%20New%20Images/blog%20images/whats-new/220907-outcomemeasures-1593x1327.png) ##### [What’s New: Secondary Billing Improvements & Enhanced Client Feedback Form](https://blog.therapynotes.com/whats-new-secondary-billing-improvements-enhanced-client-feedback-form) This release introduces easier secondary insurance updates and enhances the Client... ![](https://blog.therapynotes.com/hubfs/Whats%20New%20Images/external/whats-new/2026%20Features/07ReFuel500x277.png) ##### [What’s New: TherapyFuel® ReFuel & ePrescribe Updates](https://blog.therapynotes.com/whats-new-therapyfuel-refuel-eprescribe-updates) This release brings greater flexibility and clinical context to documentation in... ![](https://blog.therapynotes.com/hubfs/Whats%20New%20Images/blog%20images/whats-new/Reusable/200415-whatsnew-456-600x500.png) ##### [Maintenance Release 2026.07](https://blog.therapynotes.com/maintenance-release-2026.07) As with all maintenance releases, TherapyNotes® 2026.07 includes numerous system-wide... ![Phone Icon](https://blog.therapynotes.com/hs-fs/hubfs/images/primary/FooterPhoneIcon@2x.png?noresize&height=20&name=FooterPhoneIcon@2x.png) We're here for you every day of the week. 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