UPDATE ... WHERE key = @key;

IF @@ROWCOUNT = 0
BEGIN
    INSERT ...
END

UPDATE dest SET ...
  FROM dbo.destination AS dest
  INNER JOIN dbo.source AS src
  ON dest.key = src.key;

INSERT dbo.destination SELECT ... FROM dbo.source AS src
  WHERE NOT EXISTS (SELECT 1 FROM dbo.destination WHERE key = src.key);