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The best EHR for a small practice: real published prices at 1, 2 and 3 clinicians

A buyer's guide to EHR systems for small practices, with the published October 2026 prices for SimplePractice, Jane, Practice Better, Carepatron, TherapyNotes, IntakeQ, Healthie, Charm, Tebra and DrinCloud, the arithmetic at 1, 2 and 3 clinicians, and plain answers on ONC certification, BAAs and getting your data out.

October 10, 2026 · 14 min read

Choosing an EHR for a small medical practice looks like a software purchase and behaves like a lease. The data goes in easily and comes out with effort, and the subscription is small enough that nobody in a one to five person practice assigns it to a committee, yet large enough that picking wrong costs four figures a year plus a weekend of re-entry.

Search for an EHR for small medical practice use and you get listicles that rank 40 products without printing a single price. So this post does three things. It lays out what you are actually buying, which is four jobs in one product. It puts the real published prices side by side, taken from each vendor's own pricing page on 10 October 2026, with the total monthly bill worked out at one, two and three clinicians and the arithmetic shown. And it answers the three questions that decide whether a cheap EHR is a bargain or a trap: do you need ONC certification, will the vendor sign a BAA, and can you get your records out on the day you leave.

We make one of these products, so read the fairness section. We name the cases where a competitor is the better buy, and there are several.

What you are actually buying

Every product here sells the same four jobs stapled together, and price differences mostly come down to how many sit in the base plan rather than in add-ons.

1. Scheduling and the front desk. Calendar, online booking, reminders, no-show handling.
2. The chart. Note templates, intake forms, documents, consents, history that carries forward.
3. Getting paid. Card on file, receipts, and either a cash-pay invoice or an insurance claim. This is the fork in the road and the biggest single driver of what you should buy.
4. Everything around it. Patient portal, telehealth, secure messaging, reporting, e-prescribing, AI note drafting.

The fork in job three saves most readers half the market. If you bill commercial insurance or Medicare, you need claim submission, eligibility checks, ERA posting and denial work, so buy from a vendor whose whole business is that. If your patients pay you directly and your only insurance-adjacent task is handing someone a superbill to submit themselves, every dollar spent on a claims engine buys a feature you will never open. That is the whole argument for a cash-based practice buying differently, and if you want the longer version of the best EMR for a cash-based practice question, we set it out in our guide to choosing an EHR for a cash-pay practice.

EHR software for small practices: every published price

Published prices only, read on each vendor's own pricing page today. Where a vendor runs a promotion, we use the standard price, because the promotion ends and the standard price is what you actually pay in month seven. Where a vendor does not publish a number, we say so instead of estimating.

Product	Entry plan	Mid plan	Plan for a small group	Additional clinician	AI note add-on	Source
SimplePractice	Starter $49/mo	Essential $79/mo	Plus $99/mo first practitioner	$74/mo each	Note Taker $35/mo; Care Aide $59/mo owner plus $49 per extra clinician	simplepractice.com/pricing
Jane	Balance $59/mo, capped at 20 appointments/mo	Practice $79/mo	Thrive $99/mo	Price not published on the page	AI Scribe $15/mo per practitioner, 5 free notes on every plan	jane.app/pricing
Practice Better	Sprout free, 3 clients; Starter $35/mo, 10 clients	Professional $69/mo, 300 clients	Team $155/mo, 2 practitioners included	$50/mo each, Team plan only	AI Charting from $10/mo per practitioner (1,200 min), $20 (3,600), $40 (7,200)	practicebetter.io/pricing
Carepatron	Free $0	Plus $31/user/mo	Advanced $39/user/mo	Same per-user price	Included, even on the free plan	carepatron.com/pricing
TherapyNotes	Solo $69/mo	n/a	Group $79/mo first clinician	$50/mo each	TherapyFuel $40/clinician/mo	TherapyNotes pricing article
IntakeQ / PracticeQ	Forms Only $54.90/mo	Practice Management low volume $59.90/mo	Practice Management $84.90/mo	$30/mo each	No price published	intakeq.com/pricing
Healthie	Core $19/mo	Essentials $49/mo	Group from $149/mo	$50/mo per clinician added	Listed as an add-on, "additional fees apply", no amount published	gethealthie.com/pricing
Charm	Free under 50 encounters/mo	Encounter Plan, $25/mo minimum, about $0.50 per encounter	Provider Plan $200/mo per non-physician provider	Encounter pricing does not depend on provider count	No price published	CharmHealth pricing FAQ
Tebra	No prices published	No prices published	No prices published	Not published	Not published	tebra.com/pricing
DrinCloud	Essential $49/mo annual, $59 month to month	Solo $107/mo annual	Clinic $119/mo annual, 1 to 3 users	4th and 5th user $45/mo each	AI scribe $20/provider/mo	our pricing page

A few notes that matter more than they look.

Jane publishes plan prices in USD but keeps the additional-practitioner amount inside a calculator that does not render as text, so we could not read it and will not guess it. Ask them directly, because on a three person team that number is most of your bill.

Charm is the one genuinely different model: you pay for encounters, not seats. Below 50 encounters a month it is free. The published examples work out to about $0.50 per encounter with a $25 monthly minimum, rising to $1,000 plus $0.30 per encounter past 2,000.

Tebra publishes no prices at all. Its page says pricing varies by provider count, features and implementation, and sends you to a quote. Reasonable for a 30-provider group. For a solo practice it means you cannot compare it without a sales call.

The total monthly bill at 1, 2 and 3 clinicians

This is the table most comparison articles skip, because doing it honestly exposes how fast per-seat pricing compounds. Base plan plus clinician seats only. No AI, no e-prescribing, no SMS.

Product	1 clinician	2 clinicians	3 clinicians
Carepatron Plus	$31	$62 (31 x 2)	$93 (31 x 3)
Healthie	$49 (Essentials)	$199 (149 + 50)	$249 (149 + 50 + 50)
DrinCloud	$49 (Essential, annual)	$119 (Clinic, covers 1 to 3)	$119 (Clinic, covers 1 to 3)
SimplePractice	$49 (Starter)	$173 (99 + 74)	$247 (99 + 74 + 74)
Practice Better	$69 (Professional)	$155 (Team, 2 included)	$205 (155 + 50)
TherapyNotes	$69 (Solo)	$129 (79 + 50)	$179 (79 + 50 + 50)
Jane	$79 (Practice)	not published	not published
IntakeQ	$84.90	$114.90 (84.90 + 30)	$144.90 (84.90 + 30 + 30)
Charm	$25 minimum, about $100 at 200 encounters	about $200 at 400 encounters	about $300 at 600 encounters
Tebra	not published	not published	not published

Three things fall out of that table.

At one clinician almost nobody is expensive. The spread between the cheapest serious option and the dearest is about $55 a month. If you are solo and shopping on price alone, you are optimizing a rounding error against your own hourly rate. Pick on fit.

At three clinicians the spread is the whole decision. $93 against $249 is $156 a month, $1,872 a year. Per-seat pricing is where small practices quietly overpay, because seat prices get set for the 10-seat buyer and applied to the 3-seat buyer.

Watch the unit. Healthie's Group plan is published as "from $149", so treat $199 and $249 as floors, not quotes. Practice Better's Team plan includes two practitioners, which is why it beats SimplePractice at two. Our Clinic plan covers one to three users at one price, which is why our column goes flat and then jumps: users four and five are $45 each, and above five you are into Medical Center at $287.

Now add AI note drafting, because nearly everyone buys it within six months.

Product	AI notes, 3 clinicians	Monthly total with AI
Carepatron	included	$93
Jane	$45 (15 x 3)	not computable, seat price unpublished
DrinCloud	$60 (20 x 3)	$179
Practice Better	$30 at the entry tier (10 x 3)	$235
SimplePractice Note Taker	$105 (35 x 3)	$352
TherapyNotes TherapyFuel	$120 (40 x 3)	$299
Healthie, IntakeQ, Charm, Tebra	not published	not computable

Where a competitor is the better buy

There is no single best EHR for small practices, because the four jobs above are not weighted the same in a solo therapy room, a three-provider aesthetics clinic and a primary care office that bills Medicare. Here is where we would send you elsewhere.

If you bill insurance, stop reading the price tables and buy a claims platform. TherapyNotes at $69 solo with claim submission built in is an obvious buy for a behavioral health practice that bills payers. Tebra is aimed at primary care practices that want the whole revenue cycle managed, and if that is you the quote-only pricing is annoying but the product fits. Healthie sells a ClaimMD connection from about $25 to $30 a month plus setup, and Jane sells insurance billing at $20 a month plus $5 per additional full-time practitioner on Practice and Thrive. Any of those beats a cash-pay-only product the moment a payer is involved, ours included. We do not submit claims: no clearinghouse, no eligibility checks, no denial management. We produce a superbill PDF with NPI, EIN, CPT and ICD-10 codes and a running balance, and the patient submits it. If that is not enough, we are the wrong purchase and we would rather you knew now.

If you are a solo therapist who wants the cheapest possible AI note add-on, Jane at $15 per practitioner per month with five free notes on every plan is the lowest published per-seat price here, and Carepatron includes AI note taking even on its free tier, which is hard to beat at $0. Ours is $20 per provider, good value against the $35 to $40 SimplePractice and TherapyNotes charge, but not the cheapest number on the page.

If you are testing whether a practice idea works at all, Charm's free edition under 50 encounters a month and Carepatron's free plan let you see real patients for $0. We have no free trial. Signup is paid, online, about three minutes, one month minimum.

If you run a nutrition, functional medicine or health-coaching practice with programs and protocols, Practice Better is built around exactly that and starts at $35. If your bottleneck is intake forms rather than charting, IntakeQ built its reputation on forms and sells a Forms Only plan at $54.90.

And if you are a solo clinician who wants the single cheapest credible platform, Carepatron Plus at $31 a month is the lowest standard price for a full product in this group. We are $49.

Where we think we win is the two and three person practice that takes payment directly: one price for one to three users, telehealth without a minute counter from the Solo plan up, an AI scribe at $20, multi-room and multi-provider scheduling, a waiting list that fills its own gaps, sliding-scale rates per patient, inventory with stock drawdown from the invoice, and a superbill that does its job. One caveat we would rather write here than have you find on the invoice: on our Essential plan at $49, the patient portal, CRM, unlimited telehealth and practice website are $10 a month each rather than included. The portal and telehealth are bundled from Solo, the CRM from Clinic.

ONC certification: what it is and when you need it

This is where small practices get talked into software they do not need, so here is the plain version.

The ONC Health IT Certification Program is a voluntary program. Those are ONC's own words on healthit.gov: "a voluntary certification program established by the ONC to provide for the certification of health IT." Certified health IT is then required by certain other programs, and the one that matters is CMS's Promoting Interoperability programs, the federal reporting track inside MIPS for Medicare clinicians.

So the test is not "is this a real EHR". It is: are you reporting to a program that requires Certified EHR Technology? If you bill Medicare as a MIPS-eligible clinician, you need certified technology for the Promoting Interoperability category and uncertified software will cost you score. Certain state Medicaid and payer programs require CEHRT too. If your patients pay you directly and you submit nothing to Medicare, certification buys you only the features added to satisfy the criteria, plus the price that pays for them.

We are not ONC certified, and we would rather say it here than let you discover it in month three. Our buyers do not bill Medicare, so the certification would add cost to their subscription in exchange for a capability they would never use. If you are in the certified-technology group, buy from a vendor that is certified, and confirm the specific edition and criteria on ONC's Certified Health IT Product List rather than taking a sales claim at face value.

Two related points catch people out. Certification is not HIPAA compliance and HIPAA compliance is not certification: separate things, and a vendor can have either without the other. And e-prescribing is its own question. Several states, including California, Florida, New York, Michigan, Minnesota and Delaware, mandate electronic prescribing. We have no integrated e-prescribing in the US, so a clinician in a mandate state needs a separate e-Rx platform alongside us. Published add-on prices elsewhere: $49 a month plus an $89 setup fee at SimplePractice, $65 per prescriber at TherapyNotes, $40 per clinician at Healthie through DoseSpot, $49 plus a $99 onboarding fee at Practice Better. Controlled substances add EPCS on top of all of those.

The BAA question, which takes one email

A business associate agreement is the written contract between you, the covered entity, and any vendor that handles protected health information for you. HHS requires it. Your EHR vendor is a business associate, and so is any subcontractor of theirs that touches PHI.

Per HHS, the agreement has to set out permitted uses and disclosures, require appropriate safeguards including the Security Rule requirements for electronic PHI, require reporting of unpermitted uses and breaches, support your patients' access and amendment requests, make the vendor's records available to HHS, push the same restrictions down to subcontractors, and let you terminate for a material breach. It also has to require the vendor, at termination and where feasible, to return or destroy all the PHI it holds for you and retain no copies. That last clause is the legal spine of your exit.

The practical step is short: email the vendor and ask for the BAA before you enter a single patient. A vendor serving US clinicians sends it back the same day. If the answer is vague, or gated behind a higher tier, or arrives with the breach-notification window blank, you have learned something useful for free. Ours is included on every plan at no extra cost, which is the market standard here and not a differentiator.

Getting your data out, which is the real lock-in

Price is reversible. Data is not, unless you check first. Three things to establish in writing before you sign:

What you can export yourself, today, without asking. The right answer is a self-service export of your patient list, appointment history, notes, documents and ledger, run by you from inside the software. The wrong answers are "contact support", "we offer that as a professional service", and any price attached to either. Our position: full export to CSV and PDF, no fee, no retention period.

Whether the notes come out as text or as pictures. A vendor that exports clinical notes as one PDF per encounter has technically complied and practically ruined your migration, because the next system cannot read it as data. Ask specifically whether notes export as structured text.

What happens at termination. How long your data stays available after you cancel, and in what format. Check the answer against the return-or-destroy clause in the BAA.

There is a regulatory floor here, and it is worth knowing its limits. The 21st Century Cures Act information blocking rule covers health care providers, health information exchanges and developers of certified health IT, and bars practices likely to interfere with the access, exchange or use of electronic health information. The certification criterion at 45 CFR 170.315(b)(10) separately requires certified products to let a user "timely create an export file(s) with all of a single patient's electronic health information" at any time the user chooses and "without subsequent developer assistance", in a computable format, plus a full patient-population export.

Both obligations attach to certified health IT. An uncertified product, ours included, is not bound by the (b)(10) criterion, so with an uncertified vendor your export rights are whatever the contract says. One question works on any vendor, certified or not: can I run a complete export myself, in a computable format, without asking you, today. Get the answer in email.

Five questions, then sign

1. Do you bill insurance? Yes, buy a claims platform. No, do not pay for one.
2. What is the bill at your real headcount in month seven? Standard price, not the promotion, times the seats you will actually have.
3. Which of the four jobs are add-ons? Portal, telehealth, AI notes, reminders, e-prescribing. Add them to the base price before comparing anything. SMS is usually metered: 14 cents a reminder at TherapyNotes, 5 cents a text at Practice Better.
4. Do you need ONC certified technology? Only if you report to a program that requires it, in practice Medicare Promoting Interoperability inside MIPS.
5. Can you leave? BAA in hand, self-service export confirmed, notes as text.

The bottom line

Ask ten clinicians for the best EHR for solo practice work and you get ten answers, and that is because for a solo clinician price is not the deciding factor: the whole field sits between $31 and $99 and your time is worth more than the gap. Decide on whether you bill insurance, then on whether the chart fits your specialty.

For a two to five person cash-pay practice, price is the deciding factor, because per-seat pricing turns a $50 difference into an $1,800 difference over a year. Carepatron at $31 per user is the cheapest credible option in that bracket. Our Clinic plan at $119 covers one to three users at a flat price with the CRM, telehealth and portal included, and that is the case we make.

If you bill payers, buy from someone who submits claims. We do not, we are not ONC certified, and saying so in a buyer's guide is more useful than winning a comparison we should lose.

DrinCloud is practice management and charting for US cash-pay practices: $49 a month for one professional, $119 a month for a one to three person clinic, HIPAA with a BAA on every plan, AI scribe at $20 per provider, and full data export at no cost. See the full price list, read our longer guide to EHRs for cash-pay practices, or get access to the demo and look around the software yourself. No setup fee, no contract, one month is the smallest commitment.

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