A practice buys an electronic health record once and then lives inside it for a decade, because every chart, prescription and claim it produces ends up stored there. That makes the first purchase unusually hard to undo, and it is why this ranking cares less about feature counts than about what a clinic can learn before it signs. We looked at fourteen systems sold to outpatient practices in the United States, from a free plan for a part-time clinician to incumbents that serve large medical groups, plus one open source platform. For each we read the vendor's own pricing, product and legal pages and asked five things: how long until the first patient is charted, what the monthly bill really includes, how the records come back out, who owns the vendor, and which kind of practice the product was built around. Hospital inpatient systems are out of scope.
Visibility in this ranking can be paid for. Payment moves a vendor's position within the
shortlist; it never adds a vendor, and it never changes a word of the review. The largest vendors in EHR software
cannot hold places 1 to 3. How it works: placement disclosure ·
editorial process.
How we ranked these
Setup: from signed order to the first charted visit
Getting an EHR live is a clinical project, not an install. Templates have to match how each clinician writes a note, every prescriber needs identity proofing before controlled substances can be sent, lab and pharmacy connections have to be switched on, and the old charts have to arrive from somewhere. Vendors differ in how much of that they state in advance. RXNT publishes onboarding windows of 45 days for its EHR and 60 for the full suite, Canvas Medical says two to eight weeks, and eClinicalWorks includes training for practices of up to nine providers. A self-serve trial, as Practice Fusion and SimplePractice offer, lets a clinician write a test note before any of this starts. OpenMRS sits at the other end: the practice, or a contractor it hires, builds the deployment.
The real price: per provider, per encounter, and the prescribing extras
Most ambulatory systems bill per prescribing provider per month and leave front-desk staff free, which is why a published rate such as $199 at Practice Fusion or $499 at eClinicalWorks is a fair basis for comparison only if the same things are inside it. They rarely are. CharmHealth lists e-prescribing, controlled-substance credentials and telehealth as separate add-ons; Tebra discloses per-provider and per-facility charges for controlled-substance prescribing; Healthie routes prescribing and claims through partners with their own fees. Then come setup charges, which AdvancedMD puts anywhere from free to $6,000, and revenue-cycle services priced as a percentage of collections. A buyer should rebuild each quote as one provider, prescribing, with telehealth and claims, for twelve months.
Getting your data out: charts, not just a patient list
Leaving an EHR means moving medical records that a practice is legally obliged to keep, so export is not a convenience feature. US rules on certified health IT require a way to export electronic health information, and Practice Fusion, for one, lists EHI export documentation and FHIR APIs on its site. What matters in practice is the detail around it: how long the account stays readable after cancellation, whether scanned documents and images come along with structured data, and whether the vendor charges for the extract. CharmHealth states that data is retained for two months after cancellation and can be exported or migrated in that window. Few other vendors on this list put a retention period on a public page, so it belongs in the contract.
Independence from the vendor: ownership, contract length and open code
An EHR vendor holds a practice's clinical history and its route to getting paid, so who controls the vendor is a fair question. Several brands here answer to a parent: Practice Fusion is a Veradigm company, DrChrono is a trading name of EverHealth Solutions Inc., and Tebra was assembled from Kareo and PatientPop. eClinicalWorks states that it is privately held. Contract terms vary as much as ownership does. Practice Fusion requires an annual commitment, Canvas Medical describes an initial two-year term, and Carepatron says it has no minimum contract at all. OpenMRS removes the vendor entirely, with open source code and a nonprofit steward, and hands the practice the hosting, security and upgrade work in exchange.
Who it's for: specialty and payment model decide more than size
Two practices with the same headcount can need different systems. A primary care office that bills insurers wants lab interfaces, e-prescribing and quality reporting in the base product, which is the ground Practice Fusion, Elation Health and eClinicalWorks cover. A membership or cash practice cares more about how patients are counted and charged, and Elation asks about that model on its quote form. Therapists and other behavioral health clinicians are served by SimplePractice, and nutrition, wellness and virtual-first care by Healthie and Carepatron. Specialty groups should look at AdvancedMD, which prices by field, and NextGen Office. A company building a new care model with its own engineers is the only buyer for whom Canvas Medical makes sense.
The 14 tools, reviewed
#1 CharmHealth
Cloud EHR priced per encounter or per provider · United States · charmhealth.com
Free up to 50 encounters Per-encounter billing option Add-ons priced in the open
CharmHealth takes first place because its price list answers the question a two-room clinic asks first: what does this cost if we see few patients? The free plan covers 50 encounters a month for one provider and five users. Past that, the Encounter plan bills $0.50 per recorded visit with a $25 monthly minimum and no cap on providers or users, and the Provider plan is a flat $200 per provider per month with unlimited encounters. The vendor also puts its cancellation terms in writing: account data is kept for two months after cancellation and can be exported or migrated during that window.
Where it falls short
The base price buys less than it first appears to. E-prescribing is listed as an add-on at $15 per provider per month, a one-year EPCS credential at $250 per provider, telehealth at $20 per provider per month and the AI scribe at $125 per provider per month or $2 per encounter, so a prescribing physician on the Provider plan pays more than $200. The free plan stops at 1,000 patients and crossing 50 encounters moves the account to the Encounter plan.
Wrong for
A busy group that wants prescribing, telehealth and documentation help inside one quoted number. Practice Fusion bundles e-prescribing into its per-provider fee, and eClinicalWorks lists e-prescribing inside its published per-provider price.
Pricing: Free plan limited to 50 encounters per month, 1 provider, 5 users and 1,000 patients; the Encounter plan is $0.50 per encounter per month with a $25 monthly minimum; the Provider plan is $200 per provider per month. (free plan)
Visit CharmHealth →
#2 Practice Fusion
Single-price cloud EHR for independent practices · United States · practicefusion.com
One published price Unlimited non-signing staff Owned by Veradigm
Practice Fusion is the easiest product here to budget for. A provider license costs $199 a month, and the vendor spells out what a license is: one practitioner who can e-prescribe, sign charts, report for MIPS and submit claims, plus three signing staff and as many front-desk and billing users as the office has. Controlled-substance prescribing and connections to labs and imaging centers are listed as included rather than as extras. The product is ONC-certified, runs in a browser with nothing to install, and can be tried for two weeks without a card.
Where it falls short
The $199 rate comes with a required annual commitment, so the monthly billing is a payment schedule and not a month-to-month contract. Practice Fusion, Inc. describes itself as a Veradigm Network solution, which means a parent company sets its direction. Billing is sold either as software or as a service layered on top, and the pricing page we read shows a figure for neither, so the revenue-cycle half of the purchase still needs a conversation.
Wrong for
A clinic that refuses a twelve-month commitment before it has lived with the software. CharmHealth lets a practice start free and scale by encounter, and Carepatron states it has no minimum contract.
Pricing: $199 per month per provider with a required annual commitment, billed monthly; includes 3 signing staff licenses and unlimited non-signing staff licenses. A complimentary 2-week trial is offered. (free trial)
Visit Practice Fusion →
#3 RXNT
Modular EHR, billing and e-prescribing · United States · rxnt.com
Buy modules separately Data transfer included Operating since 1999
RXNT lets a practice buy the piece it is missing. Electronic Prescribing, the EHR Bundle, Practice Management and the Full Suite are separate line items, each with monthly or annual billing, and the vendor says support, upgrades, training and data transfers carry no additional cost. That last point matters to anyone arriving with charts in another system. The EHR is ONC-certified, includes an AI scribe, and has iOS and Android apps. Networking Technology, Inc., which trades as RXNT, has operated since 1999, and its onboarding windows are stated up front: 45 days for the EHR, 60 for the Full Suite.
Where it falls short
Two different starting figures appear on the vendor site, $118 per month on the pricing page and $126 per month on the EHR page, and neither page we read explains the gap, so the quote is what counts. Non-prescribing staff carry an additional fee, controlled-substance prescribing adds $85 a year for identity proofing, and the standalone e-prescribing plan is sold on a yearly subscription only. No free plan or trial is advertised on the pricing page.
Wrong for
A clinician who wants to click around a live system alone before talking to anyone. Practice Fusion and SimplePractice both open a self-serve trial, and CharmHealth has a free plan.
Pricing: A-la-carte plans billed monthly or annually per provider; the pricing page advertises plans starting at $118 per month and the EHR page quotes $126 per month, with a 10% discount for annual payment. (none)
Visit RXNT →
#4 Elation Health
Primary care EHR with integrated billing · United States · elationhealth.com
Primary care focus Supports membership models Prices by quote
Elation has picked a lane. The vendor describes the product as built for primary care, names family medicine, internal medicine, pediatrics, gynecology, geriatrics and direct primary care as the practice types it supports, and asks on its quote form whether a practice is insurance-only, hybrid, membership-based or cash. That last question tells a membership clinic the vendor has thought about its billing. The EHR is ONC-certified and cloud-based, shows the chart in a three-panel view, and comes with a patient portal called Patient Passport, a mobile app called Elation Go, and more than 300 integrations by the vendor count.
Where it falls short
There is no price list. The pricing page is a form that ends with a specialist calling back, and what it offers instead of a trial is a product tour. The only postal address we found on the site is a mailing address in Claymont, Delaware, given in the privacy policy, so a buyer who cares where the team sits has to ask. Surgical and procedural specialties are not among the practice types the vendor lists.
Wrong for
An orthopedic, dermatology or other specialty group that needs templates for its own field. AdvancedMD prices by specialty and NextGen Office advertises more than forty specialty markets.
Pricing: Elation does not publish prices; a practice submits its specialty, payment model and clinician count through a form and receives a tailored quote. (none)
Visit Elation Health →
#5 Tebra
EHR, billing and practice marketing in one suite · United States · tebra.com
Formed from Kareo and PatientPop Non-clinical staff not billed Five packages, no list price
Tebra sells the clinical record and the front door together. The company was formed by merging Kareo and PatientPop, and its site now lists reputation management and practice marketing next to the EHR and billing, packaged as All in One, EHR+, Patient Experience + Marketing, EHR Starter and Billing Starter. The EHR is ONC-certified and cloud-based, with AI Note Assist, e-prescribing, lab ordering and telehealth, and the vendor aims it at solo and small group practices of one to ten providers. Charging per clinical provider while leaving non-clinical staff unbilled keeps the seat count honest for an office with more schedulers than doctors.
Where it falls short
None of the five packages has a published price; the page tells buyers to request a personalized quote or call. What the site does disclose are the prescribing extras: roughly $75 per provider as a one-time EPCS setup, $500 per facility, and around $50 per user per year for PDMP integration. No free plan or trial is advertised on the pricing page. A practice that wants only a chart pays attention to a suite whose best deal is the full bundle.
Wrong for
A clinic with a marketing agency and a billing company already under contract, which would be buying two thirds of Tebra to use one third. Practice Fusion or RXNT sell the record on its own at a published rate.
Pricing: Quote only; Tebra says pricing varies with provider count, features and implementation, and is charged per clinical provider with unlimited non-clinical staff access at no extra cost. (none)
Visit Tebra →
#6 eClinicalWorks
Large ambulatory EHR with published flat pricing · United States · eclinicalworks.com
Published incumbent pricing No start-up costs Runs on Microsoft Azure
eClinicalWorks is the rare large vendor that prints its price. EHR Only costs $499 per month per provider and the version with practice management $599, each marked no start-up costs and including mobile apps, the patient portal, document management, e-prescribing, support, hosting and disaster recovery. Training is included for practices of one to nine providers. The company says it is privately held and was founded in 1999, the cloud runs on Microsoft Azure, and the EHR is ONC-certified. For a five-doctor group that wants a vendor its hospital partners have heard of, this is the incumbent with the fewest unknowns in the quote.
Where it falls short
At $499 a provider the entry price is more than double Practice Fusion or CharmHealth. The pricing page adds that practices with more than nine providers pay additional implementation fees, that trainer airfare is billed separately, and that patient statements and eClinicalMessenger transactions carry extra charges. No free plan or trial is advertised there. The AI tools the vendor leads with, Sunoh.ai among them, are not itemized on the pricing page we read.
Wrong for
A solo clinician or a part-time practice, for whom $499 a month buys breadth that will sit unused. CharmHealth, Practice Fusion and RXNT all start far lower.
Pricing: EHR Only is $499 per month per provider and EHR with Practice Management is $599 per month per provider, both with no start-up costs; RCM as a Service is 2.9% of practice collections. (none)
Visit eClinicalWorks →
#7 AdvancedMD
Cloud EHR and billing priced by specialty · United States · advancedmd.com
Priced by specialty Per-claim option Serves billing companies
AdvancedMD grew out of billing, and the price sheet shows it. The vendor traces its start to the mid-1990s delivering billing for private practices, says it now serves 13,000 practices and 850 medical billing companies from South Jordan, Utah, and offers an encounter-based model where the combined EHR and practice management software costs $1.08 to $2.17 per claim. Subscription ranges are broken out by field, including mental health, physical medicine, addiction medicine and medspa. Bundling EHR, practice management and patient engagement earns a discount the vendor puts at up to 40 percent.
Where it falls short
A range of $429 to $1,070 per provider per month for medical specialties is a published number that still requires a quote to pin down. Setup fees run from free to $1,000 for smaller practices and up to $6,000 for complex clients, AI tools are a further $100 per provider per month or $0.99 per encounter, and outsourced RCM takes 4 to 8 percent of collections. No free plan or trial is advertised on the pricing page.
Wrong for
A new practice with a thin first-year budget and no biller on staff. The setup fee and the width of the range make CharmHealth or Practice Fusion safer first systems.
Pricing: Published ranges per provider per month: medical specialties $429-$1,070, mental health $130-$399, physical medicine $399; an encounter-based option bundled with EHR runs $1.08 to $2.17 per claim. (none)
Visit AdvancedMD →
#8 SimplePractice
Practice management and records for therapists · United States · simplepractice.com
Built for mental health 30-day trial HITRUST certified
SimplePractice earns its place for one kind of buyer. The vendor says the software is built for therapists and mental health professionals, solo or in groups, and the three solo tiers at $49, $79 and $99 a month come with a 30-day free trial. A group pays $99 for its first practitioner and $74 for each one after, and the site lists HIPAA, HITRUST and PCI compliance. Scheduling, a client portal, telehealth, secure messaging and billing are the core, and the company puts "made in Santa Monica, CA" in its footer.
Where it falls short
This is a behavioral health tool being asked about in an EHR ranking. Prescribing is an add-on with an $89 one-time setup fee on top of a monthly charge, the AI note taker is a separate monthly add-on, and practices of six or more practitioners leave the published price list for a sales consultant. We did not see ONC certification claimed on the pricing or features pages we read, so a practice that reports to Medicare programs should ask.
Wrong for
A family medicine or internal medicine office that orders labs and prescribes all day. Practice Fusion, Elation Health and CharmHealth are built around that workflow.
Pricing: Solo plans are Starter at $49 per month, Essential at $79 and Plus at $99; group Plus is $99 per month for the first practitioner and $74 for each additional one, with custom pricing from six practitioners. (free trial)
Visit SimplePractice →
#9 Carepatron
Low-cost practice management with a free plan · United States · carepatron.com
Free with unlimited clients No minimum contract iOS and Android apps
Carepatron costs nothing to begin with and says so without an asterisk about client count: the Free plan covers unlimited clients, telehealth, the client portal, payments and an AI scribe, limited by 1GB of storage and a token allowance. Plus, at a listed $31 a month, lifts those limits and adds group telehealth and a shared inbox; Advanced, at $39, adds roles and permissions and white labeling. The vendor states there is no cancellation term or minimum contract, lists iOS and Android apps, and describes itself as HIPAA audited and SOC 2 Type II compliant.
Where it falls short
The professions the vendor lists run from therapists and physicians to coaches, massage therapists and personal trainers across more than 120 countries, which is a wide net for a clinical record. Roles and permissions arrive only on the top tier. Insurance billing for US practices is described as a managed service, not a line on the price list. The only postal address in the privacy policy is care of another firm, TQ Ventures, in New York.
Wrong for
A physician practice that needs a system a payer or hospital will recognize, with staff permissions from day one. Practice Fusion states ONC certification and includes signing and non-signing staff licenses in its provider fee.
Pricing: Free plan at $0 per month with unlimited clients and 1GB of storage; Plus is listed at $31 per month and Advanced at $39 per month, with a 20% discount for annual billing. (free plan)
Visit Carepatron →
#10 Healthie
Client-count-priced EHR for virtual care · United States · gethealthie.com
Priced by active clients 14-day trial, no card API on Healthie+
Healthie charges for how many people a practice is actively treating. Core covers ten active clients for $19 a month, Essentials 250 for $49 and Plus an unlimited number for $129, so a new practice pays little until it has a panel. Charting, scheduling, payment processing, telehealth, a client portal and a mobile app are in every tier, and there is a 14-day trial with no card. The vendor names behavioral health, family care, women's health, nutrition and chronic care among its specialties and sells an edition called Healthie+ with API and SDK access.
Where it falls short
Several things a medical office assumes are separate purchases here. E-prescribing runs through DoseSpot at $40 per clinician per month, claims through ClaimMD from $25 a month, and AI charting tools carry additional fees. Team member management sits on the Group tier, from $149 a month plus $50 per clinician. The privacy policy gives a private mailbox in Beaverton, Oregon as the company address. ONC certification was not mentioned on the pages we read.
Wrong for
An insurance-billing medical group that prescribes daily and wants prescribing and claims inside the base fee. Practice Fusion includes e-prescribing in its provider license.
Pricing: Billed monthly: Core $19 for 10 active clients, Essentials $49 for 250, Plus $129 for unlimited clients, Group from $149 plus $50 per month per clinician; annual billing is slightly lower. (free trial)
Visit Healthie →
#11 DrChrono
Mobile-first EHR with revenue cycle services · United States · drchrono.com
Charts on iPad and iPhone Part of EverHealth Three quote-only tiers
DrChrono has described itself as mobile-first since 2009, and charting from an iPad or iPhone is still the reason to shortlist it. The three tiers are laid out plainly: Foundation covers the EHR, patient engagement, practice management and billing tools, Growth adds automated revenue-cycle workflows, and Premium adds AI features. The plan comparison even lists allowances, such as 250 text reminders and 500 e-faxes on Foundation against 1,000 and 2,000 on Premium. The legal entity is EverHealth Solutions Inc., whose privacy policy gives a Denver address and whose sister brands include CollaborateMD, iSalus and Updox.
Where it falls short
The tiers are documented down to the fax count but the prices are not; every route ends at Request A Quote. Medical speech-to-text and the EverHealth Scribe are add-ons on Foundation and Growth and included only in Premium. Communication allowances are metered, with overage billed per text, fax page and call. No free plan or trial is advertised on the pricing page, and the DrChrono site itself does not give a postal address.
Wrong for
An office that charts at a desktop and wants a price before a sales call. eClinicalWorks, Practice Fusion and AdvancedMD all put numbers on their sites.
Pricing: Three tiers, Foundation, Growth and Premium, with no published prices; buyers request a quote, and overage fees apply at $0.05 per text, $0.07 per fax page and $0.10 per call. (none)
Visit DrChrono →
#12 OpenMRS
Open source medical record platform · United States · openmrs.org
No license fees Nonprofit steward REST and FHIR APIs
OpenMRS is what independence looks like when taken all the way. The project says its source code is open and free with no license fees or vendor lock-in, and it is stewarded by OpenMRS Inc, a registered 501(c)(3) nonprofit with a mailing address in Carmel, Indiana. The current reference application covers registration, appointments, queues, clinical documentation, billing and stock, exposes REST and FHIR APIs, and can be downloaded as a standalone archive, a WAR file or a containerized stack. By the project's own count it runs in more than 70 countries and over 8,000 facilities.
Where it falls short
Nobody sells this to a practice; a practice or its contractor installs, configures and hosts it. The specialties the project highlights are HIV, TB, malaria and maternal care alongside primary care, which reflects where it is deployed. The pages we read did not mention US e-prescribing networks, insurance claims or ONC certification, so a US office should assume those are its own integration work until shown otherwise.
Wrong for
A US practice that bills insurers and has no developer on call. Any hosted product above, starting with CharmHealth or Practice Fusion, will have it charting and prescribing sooner.
Pricing: Free and open source with no license fees; the implementer pays for its own hosting, configuration and support. (open source)
Visit OpenMRS →
#13 NextGen Office
Small-practice EHR from an incumbent · United States · nextgen.com
Under ten providers Upgrade path to Enterprise No published price
NextGen Healthcare splits its line at ten providers. NextGen Office is described as a fully integrated EHR and practice management system for independent practices below that number, and NextGen Enterprise takes over at ten and above, so a growing group can stay with one vendor. The company advertises more than forty specialty markets and over 2,000 clinical templates, and its Ambient Assist feature turns a recorded visit into a structured SOAP note. The legal entity, NXGN Management, LLC, gives an Irvine, California address in its privacy policy.
Where it falls short
We could not find a pricing page on the site, and the homepage and product pages publish no figures; every path leads to a demo or a sales meeting. No free plan or trial is advertised on those pages. As an incumbent it is also barred from the top three here. A buyer should ask directly what moving from Office to Enterprise involves, since the site presents them as two products and not as one with two editions.
Wrong for
A two-doctor practice that wants to compare costs on paper this week. eClinicalWorks is the incumbent that publishes its rate, and Practice Fusion and RXNT do the same at the smaller end.
Pricing: No prices appear on the NextGen pages we read; buyers are routed to a demo request or a sales meeting. (none)
Visit NextGen Office →
#14 Canvas Medical
Programmable EHR for care-delivery companies · United States · canvasmedical.com
Python plugin SDK No per-seat fees Two-year initial term
Canvas is the entry for a team that employs engineers. The SDK runs a customer's Python plugins inside Canvas infrastructure to change workflows, the chart layout, search and the patient portal, and the FHIR API covers 41 resources, 21 of them writable. Pricing is published and unusual: the Builder plan is $4,000 a month for unlimited users and the first 1,000 monthly active patients, with no seat or API fees and standard implementation of two to eight weeks included. Canvas Medical, Inc. lists a San Francisco address and says it maintains ONC certifications. A trial environment is available on request.
Where it falls short
The floor is $4,000 a month before a single extra patient, and the vendor says contracts are generally for an initial two-year term with annual renewal. Active patients above the included number are billed in arrears, so the invoice moves with growth. The trial is arranged through sales, not opened with a sign-up form. Everything distinctive about the product assumes someone on staff who writes Python.
Wrong for
A physician-owned office with no developers, which would pay for an SDK it cannot use. CharmHealth, Practice Fusion or Elation Health deliver a working chart without code.
Pricing: Builder plan is $4,000 per month with unlimited users and the first 1,000 monthly active patients included; Enterprise is by quote with the first 3,000 active patients included. Additional active patients are billed monthly in arrears. (free trial)
Visit Canvas Medical →
What the data says about this market
The fourteen products ranked here all give a United States address on their own sites, which reflects both the keyword and the fact that an ambulatory EHR is tied to one country's prescribing networks, billing codes and certification rules. Nine of the fourteen publish at least one price on their own site: CharmHealth, Practice Fusion, RXNT, eClinicalWorks, AdvancedMD, SimplePractice, Carepatron, Healthie and Canvas Medical. Four, Elation Health, Tebra, DrChrono and NextGen Office, sell by quote, and OpenMRS has no license fee. That is a better disclosure rate than this market is usually given credit for, and it means a small practice can now build a shortlist without sitting through a demo.
Free entry points are scarce. Two vendors, CharmHealth and Carepatron, offer a standing free plan, four more offer a trial (Practice Fusion, SimplePractice, Healthie and, through its sales team, Canvas Medical), and one product is open source. The remaining seven advertise neither on the pricing pages we read. Seven of the fourteen state ONC certification on the pages we fetched: CharmHealth, Practice Fusion, RXNT, Elation Health, Tebra, eClinicalWorks and Canvas Medical. We did not see the claim on the pages we read for the others, which is not proof of absence, so a practice that depends on Medicare reporting should check the federal certified product list itself.
Software delivered as a service now crosses borders more easily than most services do: ICT services rose from 9.1% of world service exports in 2013 to 14.48% in 2023, and North America's share went from 5.57% to 8.54% (World Bank). Health records are a partial exception. Carepatron lists professions in more than 120 countries and OpenMRS reports deployments in over 70, but the systems built for US insurance billing stay in the US. A clinic outside the country should treat most of this list as unavailable unless the vendor says otherwise.
The 14 ranked vendors, counted
- Headquarters by region: North America 14
- By country: United States 14
- Pricing model: Per provider / month 4, Quote only 4, Free + paid tiers 2, Open source 1, Per practitioner / month 1, Tiered monthly 1, Usage-based 1
- Free option: None 7, Free trial 4, Free plan 2, Open source 1
Counted from the 14 vendors on this page. More in our market data.
For the wider market behind EHR software, read our report The Global Shift to ICT Services,
or browse all industry reports.
Questions and answers
What is the best EHR software in 2026?
CharmHealth ranks first for small practices because it has a free plan for up to 50 encounters a month, a choice between paying $0.50 per encounter or $200 per provider per month, and a stated two-month export window after cancellation. Practice Fusion, in second place, is the better pick for a full-time practice that wants e-prescribing and unlimited non-signing staff inside one $199 rate. RXNT, third, suits an office that needs only some modules, such as e-prescribing or billing, and wants its data transfer included.
Is there a free EHR that a real practice can use?
Two ranked products have a standing free plan. CharmHealth's covers one provider, five users, 1,000 patients and 50 encounters a month, after which the account moves to per-encounter billing. Carepatron's covers unlimited clients with 1GB of storage and is aimed mostly at therapy, allied health and wellness. OpenMRS is free in the open source sense: no license fee, but the practice supplies hosting and technical staff. A free tier is a fair way to start a part-time practice, less so a busy one.
What is the difference between an EHR and an EMR?
In everyday sales language there is none, and vendors use both. Where people do draw a line, an EMR is the digital chart inside one practice and an EHR is a record designed to be shared with labs, pharmacies, hospitals and the patient. OpenMRS calls itself an EMR and still exposes REST and FHIR interfaces for exchange. When comparing products, ignore the label and ask what the system can send and receive.
How much does EHR software cost per provider?
Among vendors that publish a rate, the spread is wide. CharmHealth charges $200 per provider per month on its fixed plan, Practice Fusion $199 with an annual commitment, eClinicalWorks $499 for the EHR alone and $599 with practice management, and AdvancedMD lists $429 to $1,070 for medical specialties. RXNT advertises plans from $118 a month. These are not like-for-like: prescribing add-ons, setup fees and billing services sit outside some of those numbers and inside others.
Does a small practice need an ONC-certified EHR?
Certification matters most to practices that take part in Medicare quality programs, which expect certified technology, and to anyone who wants assurance that export and interoperability functions exist. Seven vendors here state ONC certification on the pages we read: CharmHealth, Practice Fusion, RXNT, Elation Health, Tebra, eClinicalWorks and Canvas Medical. A cash-only therapy or wellness practice may not need it. Whatever a sales page says, the federal Certified Health IT Product List is the place to confirm a specific product and version.
Why are Epic, athenahealth and Oracle Health not ranked here?
Every ranked product needed a pricing model and a company address we could read on the vendor's own site. Epic publishes no prices, and when it announced Garden Plot, its hosted offering for independent groups, it said the service was available to groups with more than 40 providers, above the size this guide is written for. The athenahealth and Oracle Health sites refused our page requests, so nothing about them could be checked. Their absence is a limit of our method, not a judgment of the products.
Is there an open source EHR?
Yes. OpenMRS, ranked here, has no license fee and is stewarded by a US nonprofit, though it is used mainly by clinics and health programs outside the US insurance system. OpenEMR is the other well-known project; its site describes GPL-licensed software with ONC ambulatory certification, e-prescribing and billing. We left it out of the ranking only because the foundation behind it publishes no postal address on its site, which our listing rules require. A US practice with technical help should look at both.
Do these systems include medical billing?
Some do, some sell it next to the chart. eClinicalWorks prices an EHR-only tier and a tier with practice management, plus a revenue-cycle service at 2.9% of collections. AdvancedMD and DrChrono sell revenue-cycle services as well as software, and Tebra and RXNT sell billing or practice management modules. Practice Fusion offers billing software or billing services alongside its EHR. Healthie connects claims through a partner for an added monthly fee. A practice should decide whether it wants software for its own biller or a service that does the work.
Which EHR fits a therapy or behavioral health practice?
SimplePractice is built for therapists and mental health clinicians, with solo plans from $49 a month and a 30-day trial. Carepatron and Healthie serve the same ground with a free plan and client-count pricing respectively. AdvancedMD publishes a separate mental health price range of $130 to $399 per provider per month for groups that want a fuller billing system. A psychiatric practice that prescribes should check how each handles e-prescribing, since it is an add-on in several of these.
Can we move patient records from our current EHR?
Usually, but the quality depends on what the old system will export and what the new vendor will import. RXNT states that data transfers are included at no additional cost, and its plans list patient demographic and insurance imports. CharmHealth describes export and migration during the two months after cancellation. For any other vendor, ask whether full chart notes, scanned documents and medication histories come across or only demographics, and who pays for the work.
How long are EHR contracts?
It varies more than the monthly prices suggest. Practice Fusion requires an annual commitment even though it bills monthly. Canvas Medical says its contracts are generally an initial two-year term with annual renewal. Carepatron states it has no minimum contract, and CharmHealth offers a discount for choosing an annual contract, which implies monthly terms are available. Quote-only vendors set terms in the proposal, so ask for the length and the renewal clause along with the price.
