The recent evolution of European health policies and tourism market trends highlights the increasing attention to health promotion strategies along with healthcare tourism innovation. Thermal industry, considered as a set of places of care, represents a possible field for the integration of territorial health tourism services, thanks to its border-crossing connotation and its recognition by the European Commission as main subsector of health tourism. Although Italy represents one of the most attractive European health tourism destination, the thermal sector is still underdeveloped, in extremely heterogeneous and fragmented conditions, unable to catalyze socioeconomic potentialities as well as optimize the use of relevant built heritage. Therefore, it is necessary to develop reliable tools and decision-making models for improving the sector in terms of health, tourism and territorial qualities. Starting from previous studies, the aim of the article is to present the development of archiTHERMability tool and discuss the results of the application on different typologies of thermal facilities. The methodological path followed three steps: (a) a review was conducted among different assessment tools to understand the state of the art; (b) the existing Italian thermal heritage was mapped, and appropriate criteria and macroareas were selected and weighted based on interviews structured with multidisciplinary experts in architecture/territory/management areas; (c) the tool was tested on two different categories of thermal facilities. The tool application on four different thermal facilities highlighted, as expected, the relevance of the managerial field. Nevertheless, the importance of the territorial context and its levels of accessibility plays a fundamental role in the structure's characterization. ArchiTHERMability hence represents an innovative tool for analyzing and understanding the Italian thermal heritage potentialities. Further investigation is necessary to test the tool on a wider sample and with different weights of criteria.