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. Places 1 to 3 go to challengers, vendors outside the best-known brands in a category,
wherever the category has them; the established names follow from place 4 in their ranked order. How it works: placement disclosure ·
editorial process.
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.
- Pricing: Free + paid tiers. Free plan limited to 50 encounters per month, 1 provider, 5 users and 1,000 patients. Free plan: free plan.
- Best for: Low-volume and part-time practices
- Strengths: SOAP note charting; Appointment scheduling; E-prescribing and EPCS.
Where it falls short
The base price buys less than it first appears to.
Wrong for
A busy group that wants prescribing, telehealth and documentation help inside one quoted number.
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.
- Pricing: Per provider / month. $199 per month per provider with a required annual commitment, billed monthly. Free plan: free trial.
- Best for: Independent practices wanting one flat rate
- Strengths: Customizable charting templates; ePrescribe and EPCS; Lab and imaging center connections.
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.
Wrong for
A clinic that refuses a twelve-month commitment before it has lived with the software.
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.
- Pricing: Per provider / month. A-la-carte plans billed monthly or annually per provider. Free plan: none.
- Best for: Practices buying only the modules they need
- Strengths: ONC-certified EHR; Electronic prescribing; Practice management and billing.
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.
Wrong for
A clinician who wants to click around a live system alone before talking to anyone.
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.
- Pricing: Quote only. Elation does not publish prices. Free plan: none.
- Best for: Independent primary care and DPC practices
- Strengths: Three-panel patient chart; Note Assist AI scribing; ePrescribing.
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.
Wrong for
An orthopedic, dermatology or other specialty group that needs templates for its own field.
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.
- Pricing: Quote only. Quote only. Free plan: none.
- Best for: Small practices that also need marketing
- Strengths: AI Note Assist and SOAP templates; Electronic prescribing; Lab ordering and results.
Where it falls short
None of the five packages has a published price; the page tells buyers to request a personalized quote or call.
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.
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.
- Pricing: Per provider / month. 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. Free plan: none.
- Best for: Multi-provider practices wanting an incumbent
- Strengths: Sunoh.ai ambient scribe; healow patient engagement and telehealth; PRISMA health information search.
Where it falls short
At $499 a provider the entry price is more than double Practice Fusion or CharmHealth.
Wrong for
A solo clinician or a part-time practice, for whom $499 a month buys breadth that will sit unused.
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.
- Pricing: Per provider / month. Published ranges per provider per month: medical specialties $429-$1,070, mental health $130-$399, physical medicine $399. Free plan: none.
- Best for: Specialty practices and billing companies
- Strengths: EHR with AI-enabled documentation; Practice management and scheduling; Claims management.
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.
Wrong for
A new practice with a thin first-year budget and no biller on staff.
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.
- Pricing: Per practitioner / month. Solo plans are Starter at $49 per month, Essential at $79 and Plus at $99. Free plan: free trial.
- Best for: Solo and small-group therapy practices
- Strengths: Scheduling; Billing and insurance claims; Secure messaging.
Where it falls short
This is a behavioral health tool being asked about in an EHR ranking.
Wrong for
A family medicine or internal medicine office that orders labs and prescribes all day.
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.
- Pricing: Free + paid tiers. Free plan at $0 per month with unlimited clients and 1GB of storage. Free plan: free plan.
- Best for: Solo practitioners starting on no budget
- Strengths: Scheduling with online booking; Telehealth video; AI scribe for clinical notes.
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.
Wrong for
A physician practice that needs a system a payer or hospital will recognize, with staff permissions from day one.
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.
- Pricing: Tiered monthly. 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. Free plan: free trial.
- Best for: Virtual-first and wellness practices
- Strengths: Charting and intake; Scheduling and telehealth; Client portal and messaging.
Where it falls short
Several things a medical office assumes are separate purchases here.
Wrong for
An insurance-billing medical group that prescribes daily and wants prescribing and claims inside the base fee.
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.
- Pricing: Quote only. Three tiers, Foundation, Growth and Premium, with no published prices. Free plan: none.
- Best for: Practices charting on iPad
- Strengths: Customizable charting and templates; Specialty template library; Telehealth without downloads.
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.
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.
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.
- Pricing: Open source. Free and open source with no license fees; the implementer pays for its own hosting, configuration and support. Free plan: open source.
- Best for: Clinics with their own technical staff
- Strengths: Clinical documentation and flexible forms; Registration and appointments; Queues, billing and stock.
Where it falls short
Nobody sells this to a practice; a practice or its contractor installs, configures and hosts it.
Wrong for
A US practice that bills insurers and has no developer on call.
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.
- Pricing: Quote only. No prices appear on the NextGen pages we read; buyers are routed to a demo request or a sales meeting. Free plan: none.
- Best for: Practices planning to outgrow ten providers
- Strengths: Integrated EHR and practice management; Ambient Assist AI documentation; Specialty clinical templates.
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.
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.
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: Usage-based. Builder plan is $4,000 per month with unlimited users and the first 1,000 monthly active patients included. Free plan: free trial.
- Best for: Funded startups building care models
- Strengths: Canvas SDK for Python plugins; FHIR API with write access; Specialty EMR templates.
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.
Wrong for
A physician-owned office with no developers, which would pay for an SDK it cannot use.
Visit Canvas Medical →
Questions and answers
What is the best EHR software in 2026?
CharmHealth ranks first of 14, best for low-volume and part-time practices. Practice Fusion is second (independent practices wanting one flat rate) and RXNT third (practices buying only the modules they need). Places 1 to 3 go to challengers, vendors outside the best-known brands, wherever the category has them.
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.
What is the difference between an EHR and an EMR?
In everyday sales language there is none, and vendors use both.
How much does EHR software cost per provider?
Among vendors that publish a rate, the spread is wide.
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.
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.
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.
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.
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.
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.
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.
