EMR Pricing Explained: Your Guide to Upfront, Recurring & Hidden Costs

on June 19, 2018

How much should you pay for an electronic medical records (EMR) system?

There’s no easy answer. Sometimes, even free or open source EMRs involve hidden fees that can send your original budget into a tailspin.

It can take days of online research and meetings with vendors to understand how much a new or replacement system will actually cost your business. And after all that, you might end up paying more than expected for features you need, but assumed were being offered by the vendor for no extra charge.

According to a study, 30 percent of clinicians are planning to replace their EMR due to customization issues. It also found that small practices with six or fewer clinicians don’t take full advantage of more advanced EHR functionalities, such as secure messaging, patient engagement and decision support.

Don’t pay for extra features if your practice won’t use them. They may sound great on paper, but they won’t give you the ROI you expected. Save the money now and opt for more advanced features when you really need them.

With this in mind, we’ve compiled this comprehensive guide. Use this guide to compare the pricing of top-rated EMR solutions, learn how much others are spending and find the ideal product that fits your price point.

EMR Pricing Factors Explained: Considerations and Product Comparisons

Medical software vendors often do not disclose pricing information on their websites. Instead, they encourage potential buyers to contact their sales team for an estimate.

It’s difficult to find EMR price listings because of the many factors that can impact the total cost of ownership (TCO). Here are some factors that affect pricing:


    • What types of users will access the system (e.g., doctors, nurse practitioners, physician assistants, therapists, office managers), and how many users need unique logins?


    • How many patients do you see each day?


    • Will you need extra help with training and setup, or does your office have dedicated IT staff to assist with this?


  • Do you need to migrate patient data from your current system, or are you a new EMR software buyer?

Based on how you answer the above questions, a vendor could quote you hundreds of dollars less or thousands more for the same system.

Even with these considerations in mind, it’s just not efficient to call each individual software vendor just to find out whether you can afford their platform.

Luckily for you, there’s an easier way to get pricing information for many popular EMRs. Just click here to download our report that features detailed price ranges for the vendors listed below, among many others.

Software Advice EMR pricing report vendor logo list

Pricing Models Demystified: Upfront, Recurring and Hidden Costs

When you evaluate EMR price quotes, you’ll notice two main categories of EMR pricing models: perpetual license and subscription license. You may already have a basic understanding of these options, but let’s consider the full upfront, recurring and hidden costs of each:

Perpetual License

Perpetual License


What it is: You pay an upfront fee for the license to own the EMR software and use it forever.

Commonly used for: On-premise deployments where the system is hosted and maintained in-house, on your practice’s own servers.

Upfront costs:

    • A one-time license fee (this can range from $1,200 to $500,000 and up)


  • Hardware (e.g., servers)

Recurring costs:

    • Monthly, annual or ad hoc maintenance (e.g., updates, patches and upgrades)


  • Premium support offerings (e.g., expanded phone support hours)

Hidden costs:

    • Customization (e.g., note templates with custom fields, reporting and analytics capabilities)



  • IT staff overtime (or hiring more IT staff) to maintain servers
Subscription License

Subscription License


What it is: You pay a monthly fee to use the EMR software for a specific amount of time.

Commonly used for: Cloud-based deployments, where the system is hosted remotely and can be accessed on compatible devices over the internet.

Upfront costs: Installation/setup

Recurring costs:

    • A monthly subscription fee per provider/user (this can range from $200 to $35,000 or more)


  • Premium support offerings (e.g., expanded phone support hours)

Hidden costs:

    • Customization (e.g., note templates with custom fields and reporting/analytics capabilities)



  • Storage (e.g., extra GBs for patient data)

Need help deciding whether a perpetual or subscription license is better for your organization? Email me at rahul.kumar@softwareadvice.com, and I’ll guide you in the right direction.

Once you’re familiar with the different pricing models, there are additional fees to implement a new EMR that are equally important to understand.

We interviewed Bruce Edmunds, director of programmatic activity and development at the West Texas HIT Regional Extension Center, to find out which EMR expenses are universal, regardless of the vendor’s pricing model.

    • Data migration. This is when your current software vendor extracts patient data and exports it as files that can then be imported into the new EMR. Edmunds says this is the “biggest surprise cost” for buyers, as vendors can charge $30,000 to $50,000 for the service.


    • Training. Depending on how extensive or basic the staff training for the new system is, it can cost nothing at all or several thousand dollars. These days, vendors have a wealth of free online training materials, such as webinars and how-to videos, that can help cut down on costs. However, you might find it worthwhile to bring in an implementation specialist to get your staff up to speed as soon as possible in order to reduce costly downtime.


  • (Initial) productivity losses. You’ll likely lose some speed as you get used to charting and entering data into a new system. This could result in seeing fewer patients per day and a temporary dip in profits. Edmunds recommends setting aside three months of capital to ensure your finances stay healthy during the transition.

It’s important to take these oft-overlooked costs into account before you begin evaluating vendors. This way, you can add them to your budget at the start.

Doctors’ EMR Budgets Revealed: How Much Real MDs Are Spending

Now that you know what to expect when it comes to EMR pricing and costs, you may be curious to know what your competitors paid for their systems. Software Advice gives you a peek into doctors’ EMR budgets to help you validate or adjust your financial planning.

Every year, our expert software advisors speak with thousands of medical practices looking for the right software. We analyzed a sample of our most recent interactions to bring you this data.

Practitioners told our advisors how much they’re willing to spend on a best-of-breed EMR system, excluding setup costs. Here are their responses, broken up by practice size.

(Note: The practices surveyed are budgeting for monthly subscription-based EMRs, unless otherwise noted.)

Most small and midsize practices expect to pay less than $500 for a monthly EMR subscription. Only a tiny percentage of small practices (4 percent) expect to pay less than $100, showing that buyers are willing to invest in health IT.

It’s noteworthy that only 22 percent of large practices we spoke to were willing to consider perpetual license systems. In fact, several large practices tell us they are prepared to pay “hundreds of thousands” of dollars for the right perpetual license EMR.

Conclusion: 3 Key EMR Pricing Takeaways

We hope all the research, tips and insights we just shared will help you avoid sticker shock when you begin evaluating EMRs. Here’s a summary of the most important takeaways:

    • Your needs will dictate your costs. Don’t assume that a vendor’s EMR price quote includes all the features you want or supports all the staff in your office. Be clear about your expectations and requirements so that you get to know the true cost of a product.


    • Seek out free resources for EMR cost comparisons. Download this Software Advice report for instant access to the pricing information of some of the top-rated EMR vendors in the market.


  • Beware of hidden and overlooked costs. The cost of an EMR is more than just the license fee. Be sure to factor in data migration, training and staff productivity costs when planning your budget.

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