ModMed Alternatives for Specialty Practices: 8 Options

Before a single number, the rule this page runs on, stated once so you can hold us to it. A figure is labelled VERIFIED only when it was read off the vendor's own page, or verified by absence at a vendor URL that loaded and contains no price. A figure published by a third party aggregator, a review platform, a research firm or a competing vendor is REPORTED, however good that source's data is. A fetch that failed, a 403 or a 404, proves nothing at all and is excluded from the evidence rather than treated as absence. And any number that is neither observed nor sourced, such as a future escalation rate, is labelled ASSUMPTION and disclosed. Those four labels appear on every figure below.

What ModMed publishes about its own price

Nothing, and the way it publishes nothing is itself informative. Under the ONC certification programme, a certified health IT developer maintains a Costs and Limitations disclosure describing the costs and fees associated with each certified capability. ModMed's version of that document is live on its own site and we read all five pages of it directly on August 30, 2026. It contains no dollar figure for any capability. Here is exactly what it says about EMA itself, verbatim: Modernizing Medicine charges certain one-time and ongoing fees in connection with EMA. Users may also be required to reimburse the cost of certain third party fees and pay the cost of certain of Modernizing Medicine's out-of-pocket and travel related costs for services such as training and implementation.

We then checked two more ModMed pages that loaded normally and confirmed the same absence. This matters more than it might appear, because a claim that a vendor publishes no price is the exact kind of claim that is usually an artefact of a broken instrument rather than a fact about the world. So it was checked three ways, on three separate documents, each of which returned a live page rather than an error. A fourth URL, the dermatology pricing path, returned an error to us and is therefore excluded entirely rather than counted as evidence of anything.

What ModMed does publish, which is the contract shape

This is the part worth photocopying. ModMed publishes remarkably specific structural terms in two documents on its own site, and those terms tell you more about your five year cost than any rate card would, because they describe every direction the bill can move without renegotiation. Every row below was read from a ModMed document on August 30, 2026 and is quoted or closely paraphrased from it.

Two caveats on that table, because they matter and nobody else will tell you. First, the revenue cycle management terms document we read is dated June 2015. Treat it as strong evidence of deal structure and weak evidence of current dollar amounts, which live in an unpublished Schedule B that only you and ModMed can see. Second, it is a revenue cycle management agreement, so several of its clauses govern the billing services relationship specifically rather than the bare EMA licence. We have flagged the source of every row so you can check that yourself rather than take our word for the scope.

The dollar figures, and who is actually behind each one

Since ModMed publishes none, every figure below is REPORTED by someone else, and the useful information is not the number but the provenance. Read the source column before the price column.

Look at what those four rows have in common. The two widest ranges come from parties with a commercial interest in the answer. The narrower one traces to a research firm through a comparison site rather than to the firm's own publication. The single most concrete figure, the one that names a contract length and a practice size, comes from one reviewer describing one invoice. That is the entire public evidence base for what ModMed costs. It is thin, and pages that present a confident single number are not being straight with you about how thin it is.

Where they converge is around $800 per provider per month, which is why that is the default in the model below. It is the midpoint of the medicalrecords.com range, it sits inside the Edvak range, and it matches the reviewer's stated figure. It is still REPORTED, it is still not ModMed's number, and the calculator exists precisely so you can replace it with your invoice in about four seconds.

The escalation rate, and why we are using a lower one than we could

This deserves its own heading because it is the number most likely to be quietly abused on a page like this. No source anywhere publishes a documented ModMed renewal escalation percentage. We checked that two separate ways: a direct search for a documented renewal increase percentage, which surfaced only qualitative language, and a search through the company's ownership history, which turned up real corporate events but nothing that translates into a per client cost figure. The claim that no such percentage is published is a null finding, and null findings are the claims most likely to be wrong, so we checked it against our own cited sources before printing it.

The one escalation figure in circulation is Edvak's ten or twenty percent, and it carries no citation. Our model uses eight percent, labelled ASSUMPTION, which is deliberately below the only number anyone has published. That direction is not an accident. An escalation rate on the incumbent's side is the single easiest lever for making a build look inevitable, and the honest discipline is to choose the conservative end when the number is unsourced, not the flattering end. If your renewal notices actually show ten or twenty percent, the calculator will let you enter it and the conclusion gets stronger without us having reached for it.

The same discipline applies to our own side of the model. Build maintenance at eighteen percent of the build price per year is also an ASSUMPTION, and it is not a ColabContent contract term. It is a stated planning figure covering hosting, updates, monitoring and a change budget. Replace it with a real quote before you decide anything. If eighteen percent is too low, the model is wrong in our favour and you should know that too.

Cumulative spend for a five provider specialty group, five years out. ModMed at $800 per provider per month, REPORTED, the figure the three independent third party sources above converge on and the one ModMed itself does not publish, escalating eight percent a year as a labelled ASSUMPTION chosen deliberately below the only escalation figure anyone has published. Against it, a commissioned build at $90,000, the midpoint of our $45,000 to $180,000 fixed fee range rather than a quote for anyone, paid once at the start, with maintenance at eighteen percent of the build price per year as a stated ASSUMPTION. The build line starts at $90,000 in year zero because that is when the fee is paid; the ModMed line starts at zero because you have not yet been invoiced for the year being compared. Every figure in the chart comes from the table above, and every label comes with it.

Read the first two years before anything else, because that is the part most vendor charts hide by starting the vertical axis somewhere flattering. The build line starts $90,000 above the subscription and stays above it for two and a half years. At the end of year one the subscription has cost $48,000 and the build has cost $106,200, so ModMed is genuinely and substantially the cheaper decision through the whole first year and most of the second. At the end of year two it is still $99,840 against $122,400. That is not a concession we are making reluctantly. It is the actual shape of the trade, and any practice that needs the money to work inside twenty four months should stop reading here and go renegotiate instead.

The lines cross about seven months into year three, at roughly $131,600 of cumulative spend on each path. From that point the gap widens every single year, because one curve compounds and the other is a flat line. By the end of year three the difference is $17,227 in your favour. By the end of year five it is $110,597, and nothing in the model bends the subscription line back down, because nothing in the contract does either. That is the whole argument in two sentences, and it only holds at scale.

Now the part that moves it the other way, stated with the same prominence. Change the provider count and the crossover moves hard, because the subscription is per provider and the build is not. At five providers it lands in year three as drawn. At four providers it lands in year four. At three providers it does not land until year six, and the five year totals are $168,958 on ModMed against $171,000 for the build, which means at three providers the build is still marginally behind at the end of year five. At one provider it never lands at all: five years of ModMed at $800 a month comes to $56,319, and a $90,000 build with maintenance does not cross that inside ten years. Even at our $45,000 floor, a single provider practice does not cross until year nine. There is no version of this argument that works for a solo practitioner, and the calculator below will say so in plain language if you type in a one.

The rate moves it too. At the low end of the reported range, $500 per provider per month, a five provider group's three year ModMed cost is $97,392 against $138,600 for the build, and the crossover slips to year five. At the high end, $1,300, three year ModMed cost is $253,219 and the crossover arrives in year two. The spread in the public reporting is not a rounding difference. It is the difference between a decision that is obvious and one that is genuinely close, which is why your own invoice is the only input that matters.

Every default below is a figure from the tables above, and every one of them is editable, because the defaults are third party estimates and your invoice is a fact. Nothing is submitted anywhere. There is no email gate, the tool makes no external request, and it stores no value. The arithmetic runs in your browser and stops there. If your inputs make the build lose, the tool says so in the same size type rather than quietly hiding the result.

A word on the roster first. Most of the alternatives lists a practice administrator will find for this product are either software directory pages that earn a fee when you request a demo, or content published by a vendor that appears in its own comparison. In both cases the shortlist you are handed was assembled for a purpose other than yours. That does not make them useless. It does mean you should read them the way you would read a pharmaceutical rep's slide deck: the facts are usually accurate and the selection is not neutral. The list below covers the systems EMA actually competes against for a specialty practice, ordered roughly the way a multi provider group would sensibly evaluate them, and each one carries the price the vendor publishes on its own site or an honest statement that it publishes nothing.

One structural note that applies to the whole list, and that no comparison table we found makes explicit. These eight are not interchangeable. Three of them are specialty native systems that could genuinely serve as the certified record for a dermatology or ophthalmology group. Two are generalist ambulatory platforms that would need configuring toward your specialty. One is a practice management tool at a completely different scale and price point. One openly states it is not US certified at all. And one of them we could not get a price for because its own page refused our request, which we are reporting as a failed fetch rather than dressing up as a finding. Sorting by star rating, which is what the directory pages do, obliterates every one of those distinctions.

1. Nextech

What it is. A specialty practice platform built for ophthalmology, dermatology, plastic surgery and orthopedics, covering electronic health records, practice management, revenue cycle and patient engagement. It is the closest like for like competitor to EMA in the specialties where ModMed is strongest, and it is the name that appears most often on a multi provider group's shortlist when the complaint is about the vendor rather than the category.

Price. None published. We requested nextech.com/pricing on August 30, 2026 and it returned a 404, which under the rule at the top of this page proves nothing and is excluded from evidence. We then loaded the nextech.com homepage successfully and scanned its visible text: no dollar figure of any kind. VERIFIED by absence on the page that loaded. We are deliberately not printing the third party per user estimate that circulates for Nextech, because when we traced it, it resolved to aggregator commentary and competing vendor blogs rather than to any named primary source, and a number we cannot stand behind is worse than no number.

Best for. Multi provider ophthalmology, dermatology, plastics and orthopedic groups that want a genuine specialty alternative rather than a generalist platform they will spend a year configuring. If your objection to ModMed is the relationship rather than the shape of the product, this is the switch that changes least about how your clinicians work.

Where it falls short. It reproduces the exact problem that brought you to this page. No published price, quote by sales cycle, contract terms visible only after you are deep into an evaluation. Switching from one opaque negotiated licence to another opaque negotiated licence buys you one round of competitive tension and then puts you back where you started, one renewal cycle later, with a fresh migration behind you.

Verdict. The most credible specialty for specialty swap on the list, and the one least likely to fix the underlying cost transparency problem.

2. Pabau

What it is. A practice management and patient engagement platform built primarily for aesthetic clinics, medical spas and private pay practices, covering scheduling, client records, marketing, online booking and payments. It sits closer to the operational layer than to the clinical record, which is exactly why it belongs on this list and exactly why it cannot do the whole job.

Price. This one requires two sentences rather than one, and collapsing them into a single figure would be dishonest. Pabau's own marketing blog states that its plans start from $65 per month per practitioner. Pabau's own current pricing page, which we loaded on August 30, 2026, publishes no dollar figure at all: it shows tiers named by team size, user counts and patient limits, notes that pricing depends on your location and user count, mentions a saving of up to twenty percent on annual billing, and directs you to book a demo. Both statements are VERIFIED and both come from pabau.com, the vendor's own domain. They conflict, and the conflict is the useful information: treat the $65 as an indicative starting figure from the vendor's marketing rather than as a rate you can hold them to.

Best for. Aesthetic, cosmetic and private pay clinics where the workload is booking, client communication, packages and retail rather than insurance billing and certified clinical documentation. Also worth a look as a comparison point if you are trying to work out what the operational layer alone is worth.

Where it falls short. Pabau states plainly on its own site that it does not carry US ONC certification, which it describes as making it unsuitable for practices that require a certified EHR for MIPS and MACRA reporting. VERIFIED, read from pabau.com on August 30, 2026. We want to be clear that we regard publishing that voluntarily as creditable and unusual; most vendors let the buyer discover it in month four. But it settles the question. Pabau cannot be your system of record for the clinical documentation and e-prescribing that ModMed currently carries.

Verdict. A genuinely good tool for a different job, honest about its own limits, and not a replacement for a certified specialty EHR.

3. Carepatron

What it is. A general practice management and telehealth tool aimed at solo practitioners, therapists and small allied health practices, covering scheduling, notes, client portal, billing and payments. It is on this list because it publishes an actual rate card, and because seeing that rate card next to the reported ModMed figure tells you something important about what you are buying.

Price. A free plan at $0, Plus at $15.50 per month, Advanced at $19.50 per month, with an e-prescribe add-on at $39 per month per user, electronic claim filing starting from $0.25 per claim, and automatic insurance status checks at $0.15 per check. VERIFIED, read from carepatron.com/pricing on August 30, 2026. Note that the pricing page was running a fifty percent off for six months promotion when we read it, and displays higher figures alongside the tier names, so confirm the standard rate before you plan around the promotional one.

Best for. Solo practitioners, small allied health practices, and cash pay clinics where the clinical documentation requirement is light and the insurance billing load is small. Also genuinely useful as a sanity check: if your practice could actually run on this, you are almost certainly overpaying for a specialty platform.

Where it falls short. It is a general practice management tool, not a dermatology or ophthalmology electronic health record. There is no specialty body mapping, no visual documentation designed around skin lesions, no built in specialty coding depth, and nothing resembling the in house dermatopathology workflow ModMed sells. Notice also that its e-prescribing is an add-on priced per user, which is the same structural pattern as ModMed's separate EPCS fee, just with the number published.

Verdict. The most transparent vendor on the list and the least likely to fit a multi provider specialty group. Useful as a benchmark, not as a destination.

4. EZDERM

What it is. A dermatology specific electronic health record best known for visual, body map driven documentation, where a clinician marks lesions on an anatomical diagram rather than working through a form. For a high volume dermatology practice that is a genuinely different documentation model, not a cosmetic difference.

Price. None published that we could observe. We requested ezderm.com/pricing on August 30, 2026 and it returned a 404, which is excluded from evidence. We then loaded the ezderm.com homepage successfully and found no dollar figure in its visible text. VERIFIED by absence on the page that loaded. Third party estimates for EZDERM circulate in the $250 to $500 per provider per month band, but every one we traced led back to aggregator pages whose own citation was another aggregator, so we are naming the band's existence and declining to present it as a sourced figure. Ask for a written quote and treat any number you find online as a conversation starter only.

Best for. Dermatology practices whose primary complaint about their current system is documentation speed and visual lesion tracking rather than billing depth or reporting.

Where it falls short. Aggregator commentary consistently describes narrower billing and cosmetic tooling than ModMed, which matters a great deal for a practice with a significant cosmetic or in house pathology line. And it is opaque on price in exactly the way the incumbent is.

Verdict. A real specialty contender on documentation, unproven to us on total cost, and worth a quote if visual documentation is the specific thing you are chasing.

5. Edvak

What it is. A dermatology electronic health record positioned at solo dermatologists and groups under roughly ten providers, sold with an unusual amount of published pricing detail for this category.

Price. Essential at $299 per month per provider, Plus at $549 per month per provider, Premium at $599 per month per provider, and an Enterprise tier quoted rather than published. Essential covers a single location, Plus supports up to five locations, and Premium and Enterprise cover unlimited locations. VERIFIED, read from edvak.com/pricing on August 30, 2026.

Best for. Single location and small multi location dermatology practices that want a published number they can plan around, and that are prepared to do their own diligence on clinical maturity.

Where it falls short. Two things, and the second is about how you should read its content rather than about the product. First, Edvak's own tiers still bill per provider per month, so a growing group carries the same structural per seat tax as it does on EMA; at ten providers, Premium is $71,880 a year at list. Second, and we are stating this as an observation with a citation rather than an accusation: the widely circulated article about ModMed price increases and alternatives is published by Edvak on its own domain, is written in the register of neutral buyer guidance and recommends the product Edvak sells. Edvak's own name is on the domain and throughout the piece, so the commercial interest is visible; what the article does not do is attach that interest to the ModMed price range it publishes. Its ModMed price range of $500 to $1,300 is attributed only to independent reviews on Capterra and Software Advice. That is not fraud and it is very common. It does mean the most confident sounding public statement about what ModMed costs was written by a company that benefits from that number being high, and you should weight it accordingly. We benefit from it too, which is why our version of that figure is labelled and traced.

Verdict. A published rate card in a category that hides them, which is worth something real. Verify the clinical depth independently, and read its comparison content knowing who wrote it.

6. athenahealth

What it is. A large ambulatory platform covering electronic health records, practice management and revenue cycle, with a strong interoperability story and a network model that pools payer rules across its client base. It is the name that comes up when a group's frustration is about claims and payer performance rather than clinical documentation.

Price. We do not know, and we are not going to imply that we do. We requested athenahealth.com/pricing on August 30, 2026 and received a 403 error. Under the rule at the top of this page, a failed fetch is a failure to observe and not an observation of absence, so it is excluded from evidence entirely. We can neither report a price nor claim that athenahealth publishes none. Every aggregator comparison table we saw shows Custom Quote for it, but aggregator tables are REPORTED and copying an empty cell across is not evidence of anything.

Best for. Multi specialty groups, and specialty groups large enough that payer performance and claims throughput dominate the conversation. Its revenue cycle proposition is the strongest thing about it for a practice whose real problem is denials rather than charting.

Where it falls short. It is not specialty native. A dermatology or ophthalmology group will spend real configuration effort getting to where EMA starts, particularly around cosmetic and aesthetic billing, in house pathology and specialty specific coding. Historically its commercial model has also been percentage of collections in places, which is a fundamentally different cost curve from per seat and one you should model separately rather than assume.

Verdict. A serious platform we cannot price for you, worth including in a formal request for proposal and impossible to shortlist responsibly from public information alone.

7. eClinicalWorks

What it is. One of the largest ambulatory electronic health record vendors in the United States, generalist by design, covering clinical documentation, practice management, patient engagement and revenue cycle services across essentially every outpatient specialty.

Price. No figure on its own site. We requested eclinicalworks.com/pricing/ on August 30, 2026; it redirected to a page that loaded successfully and contains no dollar figure, though it does market revenue cycle service at a lower price than your current provider without saying what that price is. VERIFIED by absence. Separately, Pabau's blog reports eClinicalWorks at roughly $449 per month per provider. That is REPORTED, it comes from a competing vendor's comparison article, and it is the only figure with any traceable publisher behind it that we found.

Best for. Budget conscious multi specialty groups, and practices whose priority is breadth and market ubiquity over specialty fit. There is a large pool of billers and administrators who already know it, which is a real switching cost saver.

Where it falls short. Generalist, which is the whole point and the whole problem. Nothing about it is purpose built for dermatology lesion documentation, ophthalmic imaging workflow or orthopedic templating, and the configuration burden to close that gap lands on your staff. And at roughly $449 REPORTED against $800 REPORTED, the saving is real but it is still a per provider per month subscription with the same growth tax and the same renewal mechanics.

Verdict. A credible way to spend meaningfully less on the same category of thing, and not a way to stop renting.

8. NextGen Healthcare

What it is. A long established ambulatory platform selling into both small independent practices and larger multi specialty groups, with electronic health record, practice management and revenue cycle offerings and a substantial installed base.

Price. No figure on its own site. We requested nextgen.com/pricing on August 30, 2026; it redirected to a contact page that loaded successfully, offering a demo request form, a sales phone number and support routing, with no dollar figure anywhere on it. VERIFIED by absence. Its own frequently asked questions on that page distinguish its enterprise product for larger organisations from its cloud product for smaller independent practices, which tells you the pricing conversation forks before it begins.

Best for. Larger multi specialty organisations, particularly ones already inside the NextGen ecosystem through an affiliated group or an acquisition, where consolidation onto one platform has value beyond the licence cost.

Where it falls short. Generalist positioning again, with the same specialty configuration burden as the other broad platforms, and the same complete opacity on price. Nothing here solves the structural problem this page is about.

Verdict. Reasonable if you are already in that ecosystem, and no more checkable on money than what you are leaving.

Is Nextech better than ModMed?

Answered here as a section rather than spun into a separate page, because it is a question inside this decision and not a decision of its own. On specialty fit the two are genuinely comparable, and which one wins depends on your specialty mix rather than on any general ranking; Nextech's ophthalmology and plastics depth is its strongest suit, ModMed's dermatology documentation and in house pathology workflow is its. On price nobody can answer, because neither vendor publishes anything and both quote through a sales cycle. On the thing that actually decides most switches, which is whether the new relationship will be structurally different from the old one, the honest answer is no. You would be trading one negotiated per provider licence with unpublished renewal terms for another negotiated per provider licence with unpublished renewal terms, and paying a migration to do it. That can still be the right call if the quote is materially better or the relationship has broken down. It is not a fix for the category.

Is Edvak or EZDERM a real alternative for a dermatology group?

For a practice under about ten providers, yes, both belong on a real shortlist, and Edvak's published rate card makes it the easiest one to evaluate without a sales cycle. For a larger group the answer gets harder and neither of us can settle it from public information: the questions that decide it are in house pathology depth, cosmetic and aesthetic billing, multi location scheduling and the maturity of the reporting, and none of those are answerable from a pricing page. What we would push back on is the framing that appears in a lot of comparison content, where the choice is presented as ModMed versus a cheaper clone. At ten providers, Edvak Premium at list is $71,880 a year, which is real money on the same per seat curve, escalating from a lower base. The structural question, whether you want to keep renting the operational layer at all, does not go away by picking a cheaper landlord.

9. A commissioned build you own, sitting alongside the certified record

What it is. A fixed fee engagement in which we build the scheduling, intake, eligibility and prior authorization tracking, billing operations, denial follow up, practice reporting and patient communication layer your group actually runs on, calibrated to your workflow rather than to a category average, and hand it to you owning it outright. No per provider licence, no seat count, no renewal escalator, no module gate. The certified electronic health record stays, with fewer seats on it.

Price. $45,000 to $180,000, one time, fixed before any work starts, set after a free forty five minute diagnosis. Published on our own pricing page. Maintenance is quoted separately and the eighteen percent figure used throughout this page is a planning assumption rather than a contract term.

Best for. Multi provider specialty groups, realistically four providers and up on the numbers in this page's model, where the operational layer is where the labour and the leaked revenue actually live, and where the licence bill grows every time the practice hires.

Where it falls short, stated as bluntly as we can. It is not an ONC certified electronic health record and it never will be. It does not carry e-prescribing of controlled substances, which has its own federal identity proofing requirements before a prescriber may transmit at all. It does not hold the legal medical record. It does not do your MIPS attestation. It takes months rather than weeks. It costs more than the subscription for the first two years at almost any realistic scale. It requires you to have an opinion about your own workflow, which is harder work than accepting a vendor's. And if your practice is small, it loses on the math outright, which the next section covers in detail.

Verdict. The only option on this list that ends the per provider curve, available only to practices large enough for the arithmetic to work, and useless as a substitute for the certified core.

This section exists because the rest of the page would be dishonest without it, and because not one of the guides a practice administrator is likely to read makes this distinction at all. They treat ONC certification as a feature checkbox in a comparison table, tick or cross, next to appointment reminders and mobile app. It is not a feature. It is the legal and regulatory foundation the rest of your clinical operation stands on, and the reason a custom build is a complement to it rather than a substitute for it.

What stays on the certified system, non negotiably

The certified capabilities themselves. ModMed's own disclosure lists specific 2015 Edition Cures Update criteria by Code of Federal Regulations citation, and those citations are not decoration. 170.315(a)(2) is computerized provider order entry for laboratory. 170.315(b)(1) is transitions of care. 170.315(b)(2) is clinical information reconciliation and incorporation. 170.315(b)(3) is electronic prescribing. 170.315(b)(6) is data export. 170.315(e)(1) is view, download and transmit to a third party. 170.315(g)(7), (g)(9) and (g)(10) are the application access and standardised API criteria. VERIFIED, read from ModMed's own document on August 30, 2026. A system that has not been through certification testing does not hold those, cannot claim them, and cannot be used where a certified system is required.

Electronic prescribing of controlled substances. ModMed's own disclosure spells out why this one is a hard stop rather than a technical hurdle: prescribers of controlled substances are required to take part in an identification proofing process before being permitted to e-prescribe, that process involves providing personal information to a third party to confirm the prescriber's identity, and the workflow requires additional identity authentication and registration with third party service providers. VERIFIED. That is federal identity assurance architecture, not a feature somebody codes over a weekend. It lives where it lives.

The legal medical record. The chart is a legal document. It is what gets subpoenaed, audited, produced on a records request and relied on in a malpractice defence. Splitting the authoritative clinical record across two systems, one certified and one not, is a bad idea for reasons that have nothing to do with software and everything to do with the fact that a records custodian has to be able to answer, under oath, where the record lives.

Anything your quality reporting depends on. If your MIPS or quality programme attestation rests on capabilities in the certified system, moving those capabilities is not a software decision, it is a compliance decision, and it needs your compliance advisers rather than a vendor comparison page.

What a build honestly replaces

The operational layer, and here is the useful part: ModMed itself will tell you where that layer is, because it is where the company is putting its own newest products. Its own marketing describes AI assistants aimed at patient scheduling and communication, eligibility processing, prior authorization, and claim denial appeals. VERIFIED, quoted from ModMed's own site on August 30, 2026. Its own dermatology page markets automating manual workflows, eliminating phone tag, streamlining check in to checkout, automating insurance eligibility verification and finding lost revenue opportunities. VERIFIED, same source.

We agree with the vendor completely about where the labour sits. The disagreement is narrow and it is about ownership: whether the software that runs your scheduling, your intake, your eligibility checks, your prior authorization queue, your denial follow up, your practice reporting and your patient messaging should be rented per provider forever from the same company that holds your clinical record, or built once around your actual workflow and owned by the practice. That is a real question with a real answer that depends on your size, and it is not the same question as whether you need a certified EHR. You do.

The compliance posture, stated rather than implied

Any system that touches protected health information needs its own compliance posture, stated explicitly, in writing, before a single record moves. Not inherited by proximity to a certified vendor, not assumed because the software is custom, not waved at. ModMed's own agreement makes the shape of this clear: the parties acknowledge that the medical practice is a Covered Entity and ModMed's billing entity is a Business Associate under HIPAA, with a Business Associate Addendum incorporated into the agreement. VERIFIED, read from ModMed's own revenue cycle terms on August 30, 2026. Anyone building software that handles your protected health information stands in that same Business Associate position and needs the same executed addendum, the same defined safeguards, the same breach notification obligations, and the same auditable answer to where the data sits and who can reach it. If a prospective build partner does not raise this before you raise it, that is your answer about the partner.

We will say the uncomfortable half too. A build that deliberately stays out of protected health information entirely is a smaller, safer, cheaper project than one that handles it, and for a meaningful number of practices the right first project is the one that touches no clinical data at all: scheduling logistics, reporting on data the practice already exports, internal workflow, staff facing tools. If your risk appetite says start there, start there. The arithmetic on this page still works, and the project gets easier.

One thing the contract says about building anything

Worth knowing before you scope anything, because it is in ModMed's own terms and almost nobody reads it. The practice and its users may not access the software or services in order to build a competitive product or service, nor copy any features, functions or graphics of it. VERIFIED, ModMed's own revenue cycle terms, section 8.2. Read plainly, that restricts using your access to EMA as a design reference for a rival electronic health record. It is a standard clause and it is not the same thing as restricting your own data. But it is a real reason to scope a build around your workflow and your data rather than around reproducing what a screen in EMA looks like, and it is a question worth putting to your own counsel with your own contract in front of them rather than taking a website's word for it, including ours.

Every argument below applies to the operational layer only, on the boundary set out above. None of them is an argument for replacing a certified electronic health record, and any of them that gets quoted back to us as one has been misquoted.

1. The math, restated with the number attached

A subscription never ends. That is not a complaint, it is the product definition, and it is the only line item in a practice's overhead that has no terminal value. Five providers at the reported $800 per provider per month, escalating at our stated eight percent assumption, costs $155,827 across three years and $281,597 across five. A $90,000 commissioned build with eighteen percent annual maintenance costs $138,600 across three and $171,000 across five. The lines cross about seven months into year three, and by year five the difference is $110,597. Then year six happens, and year seven, and the subscription curve keeps compounding while the maintenance line stays flat. Every number in that paragraph is on the chart above with its label attached, and the calculator will redo all of it on your provider count and your invoice.

2. Per seat pricing taxes exactly the thing you are trying to do

Growth is the goal. Per named user licensing makes growth a cost event. ModMed's own terms are explicit about this: the number of users shall not exceed the number specified in the agreement, increases run through a signed Add-On Addendum, and ModMed may make any increase contingent on payment of fees including without limitation activation fees. VERIFIED. So hiring an associate is a licence negotiation. Adding a part time injector for two days a week is a licence negotiation. Bringing on a scribe, a care coordinator, a billing hire, a new location's front desk: each one moves the bill, and each one is a small conversation with a vendor about whether you may. A system you own has no seat count, so the marginal cost of the eleventh person using it is zero, and nobody has to approve them.

3. An asset on the balance sheet instead of a line in overhead

Five years of subscription leaves you with nothing you can point at. A commissioned build is property: it is owned, it is transferable, it survives a partner buy in, and it is a real component of enterprise value in a practice sale or a private equity conversation, which is a conversation a great many specialty groups are now having whether they went looking for it or not. Nobody has ever increased the sale multiple on a dermatology group by having a longer software subscription. Owning the systems the operation runs on is a different conversation with an acquirer than renting them.

4. Built around your workflow instead of the other way around

An off the shelf platform is the average of thousands of practices, and your practice is not the average of thousands of practices. Every specialty group we have looked at has some version of a process the software cannot express, so the process gets carried in a spreadsheet, a shared inbox, a whiteboard or one person's head. That is the tax nobody puts in the total cost model, and it is usually larger than the licence. A build starts from what you actually do. You also stop paying for the large fraction of a suite that your practice never opens, which is the honest version of a claim other pages make with an invented percentage attached; we are not going to pretend we know what fraction of EMA your group uses, because we do not.

5. Change speed

A change request to your own system is a scoping conversation and a sprint. A feature request to a platform vendor is a ticket that joins a queue prioritised by what is good for thousands of other practices, and the honest answer is that most of them are never built, because they should not be. That is the correct behaviour for a platform serving eleven specialties. It is simply a different relationship from owning the thing. We are deliberately not attaching a timeline comparison here, because we found no sourced material comparing anyone's feature request turnaround to anything measurable, and an invented number would undermine the point.

6. The module gate disappears

This one is specific to ModMed and it is in its own disclosure: clients must subscribe to EMA in order to subscribe to additional products, modules, and services. VERIFIED. Whatever the operational module is worth to you, you cannot buy it without holding the base licence, and you cannot unbundle it. Software you own has no gate, because there is nothing to gate. You decide what gets built next and in what order, and the answer is not constrained by what else you have subscribed to.

7. Data ownership and an exit that is not a negotiation

Your own data is yours in both worlds, and we are not going to imply otherwise. What differs is the exit path. Leaving a platform means an export in the format the vendor supports, on the vendor's timeline, under the termination assistance language you signed years ago. Leaving nothing is the alternative, because with a system you own there is no leaving: the code, the schema and the data are already in your possession, and switching hosting or development partners is a procurement decision rather than a migration project. Read your own agreement's data access and termination assistance clauses now, while nothing is happening, rather than during a switch. That is good advice regardless of what you decide about us.

8. Vendor risk you simply do not carry

ModMed published two press releases on its own site about a majority investment from Clearlake Capital, one announcing it and one confirming its completion, both live on modmed.com when we checked on August 30, 2026. VERIFIED that ModMed published them; we could not read the article bodies through our tooling and are reporting the titles only, and we are printing no valuation figure because we could not read one off ModMed's own release. We are also not asserting that the change of control caused any price change, because no source we found documents that, and asserting it would be exactly the kind of unsupported causal claim this page is built to avoid. The point is narrower and it does not need embellishment. The ownership of the company that holds your clinical record changed hands, you had no say in it, and the same is true of every roadmap decision, every product sunset, every acquisition and every repricing for as long as you rent. Software you own has none of that above it.

9. One fixed fee, and the AI argument stated honestly

Our fee is $45,000 to $180,000, one time, scoped and fixed before work starts, published on our own pricing page rather than quoted through a sales cycle. That is the entire commercial structure and there is no per provider component to it.

On AI specifically, here is where we depart from what most pages in this category will tell you, because the evidence does not support the usual line. The standard argument is that incumbents sell AI as a premium per seat add-on while a custom build has AI at the core with no seat tax. The second half of that is true of what we build. The first half we cannot substantiate for ModMed, and we are not going to pretend we can. ModMed's own dermatology page says of ModMed Scribe 2.0 that it is AI built directly into our EMA EHR, no additional software or integrations required. VERIFIED. No price for Scribe is published anywhere we could find, on ModMed's site or off it. So if somebody shows you a ModMed AI surcharge figure, ask them where it came from. What we can document as genuinely separate and per provider is the EPCS fee, which is a certification capability rather than an AI module. The honest version of the AI argument here is not about a surcharge. It is that AI built into a platform serves the platform's model of your workflow, while AI built into a system you own serves yours, and only one of those two is something you can change your mind about.

The proof, and its limits

We would rather understate this than dress it up, and the limit is important enough to lead with. None of our reference work is in healthcare. These engagements demonstrate that we deliver production systems that carry real operational load; they do not demonstrate healthcare domain experience, and we are not going to imply that they do. If healthcare specific delivery history is a requirement for you, that is a legitimate requirement and we do not meet it today. Say so on the call and we will tell you the same thing.

What we can point at: Jim Glaser Law, a named client who takes reference calls, so you can ask someone other than us what working with us is like. The LELF platform, a production system we built and run. More than 6,000 AI handled calls across live deployments, which is operational volume rather than a pilot. More than 40 commissions delivered. Those four are the whole list, they are all real and finished rather than mocked up, and they are the only things we will ever put in front of you as proof.

This section is not a courtesy and it is not a rhetorical device. It is the section that determines whether you should believe the rest of the page, so it is specific, it names numbers, and every one of those numbers comes from the same model that produced the crossover chart.

Solo practitioners and one to three provider practices. Full stop.

The math does not work and nothing in the presentation can make it work. At one provider on the reported $800 per month, five years of ModMed comes to $56,319. A $90,000 build with eighteen percent maintenance costs $171,000 over the same five years and never crosses inside ten. Even at our $45,000 floor, which would buy a genuinely narrow scope, the crossover does not arrive until year nine. At two providers, five year ModMed is $112,639 against $171,000 for the mid range build; the floor build crosses in year four, which is a real but marginal case that depends entirely on the scope being genuinely small. At three providers the five year totals are $168,958 on ModMed against $171,000 for a $90,000 build, which means at three providers a mid range build is still slightly behind at the end of year five. If you are a solo dermatologist reading this because your renewal went up, the answer is to negotiate, to shop Edvak's published rate card as a real comparison, or to reduce your module footprint. It is not to commission software, and we will tell you that on a call rather than take the meeting and hope.

Practices that need it working next month

A build takes months. Scoping, design, development, a parallel run, staff training, cutover. If you have a compliance deadline, a payer requirement, a location opening or a partner arriving on a fixed date, buy something that exists. That is not a compromise, it is the correct decision, and the correct decision for a nine week horizon is almost never a build.

Practices where the value is genuinely in the certified clinical core

If what you love about EMA is the touch based dermatology documentation, the recall of laser settings and biopsy anaesthesia preferences, the built in specialty coding, the in house dermatopathology receipt and billing, and the MIPS support, then most of the value you are buying sits on the side of the line a build cannot cross. Trimming seats might still make sense. Replacing the system does not, and anyone telling you otherwise is describing a different product than the one you are actually using.

Practices mid contract with meaningful term remaining

ModMed's own terms show fee changes taking effect at the beginning of the next renewal term after a thirty day notice period. VERIFIED. If you are eighteen months from renewal with no increase notice in hand, you are modelling a hypothetical. Diarise the date, pull your invoice history, run the calculator with your real numbers a full two quarters before the renewal window, and have the conversation then. Starting a build to escape a bill you are contractually paying anyway means paying twice for a while.

Practices without an internal owner

A commissioned system needs one person inside the practice who can decide what it does, arbitrate between the front desk and the billing team, and say no. Not a committee, not a champion with no authority, and not a physician with four hours a month. If nobody in the group can hold that role, the build will drift, and a drifting build is more expensive than the subscription you were trying to leave. Vendor software is, among other things, a way of buying someone else's decisions, and for a practice with no internal decision maker that is a genuinely rational purchase.

Practices whose real problem is the negotiation, not the software

A meaningful share of the people who arrive at a page like this one do not have a software problem. They have a renewal they were not prepared for. Before anything else: pull three years of invoices, list every module and separately billed service you are paying for, count how many of your licensed seats logged in last month, and find out what happens if you drop the modules you do not use. ModMed's own disclosure confirms several things are billed separately, including EPCS and supplemental analytics. There is often a real number available from that exercise alone, and it costs you a morning rather than $90,000.

Work down it in order. Several branches end with stop reading, and they are meant literally.

1. How many providers hold a licensed seat?
One to three: stop here. Negotiate, trim modules, or compare against Edvak's published rate card. The build arithmetic does not work at your scale and the section above shows the numbers. Four or more: continue.

2. Do you need the certified electronic health record for clinical documentation, e-prescribing or quality reporting?
Almost certainly yes, and if the answer is yes then a full replacement is off the table permanently. Continue on the basis that you are considering an operational layer alongside a reduced seat count, not a rip and replace. If your practice genuinely does not need a certified system, which is rare and usually means fully cash pay with no controlled substance prescribing, then a wider range of the alternatives above becomes viable and you should be shopping them, not us.

3. Where does the labour actually go?
Spend one week counting. If most of the administrative hours are in scheduling, intake, eligibility, prior authorization, denial follow up, reporting and patient messaging, continue. If most of them are in clinical documentation, stop here: that is on the certified side of the line and your answer is a scribe, a template rebuild or a negotiation, not a build.

4. Run your own numbers in the calculator.
Use your actual invoice rate, your actual provider count, and the number of seats you would realistically keep on the certified system. If the crossover lands beyond year five, stop here. A five year payback on operational software is too long to be a good decision, and we will say so on the call.

5. Do you have an internal owner and a renewal window?
If there is no one person who can make decisions about the build, stop here until there is. If your renewal is more than a year out, diarise it and come back two quarters before the window. Neither of those is a no; both are a not yet.

6. Everything above passed.
Then the question worth forty five minutes is which single operational workflow, built and owned, would pay for itself fastest, and whether the resulting seat reduction on the certified system is real or theoretical. That is the whole agenda of the diagnosis call, and about half of them end with us telling the practice to do nothing yet.

This section assumes the harder case, a full move to another certified electronic health record, because that is the project most people mean when they say migration. If you take the narrower path this page recommends, keeping the certified core and building the operational layer alongside it, most of what follows still applies to the integration work but the risk profile is dramatically lower, because the clinical record never moves.

The timeline

Multiple independent migration guides, including one published by a competing vendor and several written by neither party, converge on a four to eight week go live window measured from the point migration work actually starts, with a test migration recommended four to six weeks before cutover. REPORTED, aggregated from migration guidance rather than from any single authority, and treat it as the optimistic end. That window does not include the months before it: selection, contracting, scoping the data map, and the internal decision making that always takes longer than anyone plans for. Budget two to three quarters end to end and be pleasantly surprised.

What actually has to move

Patient demographics and insurance. Clinical notes and encounter history. Problem lists, medication lists and allergies. Images and attached documents, which are usually the largest and least well behaved portion. Open accounts receivable and claim status, which is the part that most often gets underestimated because it is a moving target rather than a static export. Scheduled future appointments. Recall and follow up queues. Portal accounts and patient credentials. Templates, order sets and any macros your clinicians have built up over years, which frequently do not transfer at all and have to be rebuilt.

The test migration is the whole ball game

Run it early, and validate three categories by hand rather than by summary count: demographics, clinical notes and billing records. Pick twenty real patients spanning your oldest records, your most complex charts and your highest value open claims, and check them field by field in the destination system. A row count that matches tells you almost nothing; a chart that lost its attachments while the row count matched is the failure mode. Then repeat the same check on the day of cutover, before you turn the old system off.

The parallel run, and the thing nobody budgets for

Plan to run both systems for a defined overlap period with a written rule about which one is authoritative for what, on which date. The cost that never appears in a migration plan is the productivity dip: for several weeks your fastest biller is slow, your front desk is slow, and your physicians are unhappy, and that cost is real money that lands on the switching side of the ledger. Model it. If a four week dip at your practice costs more than the annual saving you are chasing, the migration does not pay and you should know that before you sign anything.

Read your own contract before anything else

Two things specifically, and pull the actual document rather than trusting anyone's summary of it, ours included. First, the data access and termination assistance language: what format your export comes in, on what timeline, at what cost, and what happens to data ModMed holds after termination. Second, the term and renewal mechanics, since ModMed's own published terms show fee changes taking effect at the beginning of the next renewal term after a thirty day notice period, which means the calendar matters as much as the decision. VERIFIED from ModMed's own document; your executed agreement is the one that governs you and it may differ.

One clause worth putting to your counsel

ModMed's own terms restrict the practice and its users from accessing the software or services in order to build a competitive product or service, or copying its features, functions or graphics. VERIFIED, section 8.2 of its published revenue cycle terms. That is a standard clause and it does not restrict your own patient data. It is a real reason to scope any build around your workflow and your data rather than around reproducing a ModMed screen, and it is a question for your own lawyer with your own signed agreement in hand. We are describing a published document, not giving you legal advice, and we are not in a position to tell you how your specific contract reads.

The honest recommendation

For most qualifying multi provider groups, the lowest risk path is not a migration at all. Keep the certified system, reduce the seats on it to the people who genuinely need certified capabilities, and build the operational layer alongside it with a real integration rather than a rip out. The clinical record never moves, the compliance posture does not change, the failure mode of a bad build is an inconvenience rather than a clinical incident, and you can stop at any point with your practice still fully operational. It is a less dramatic story than switching platforms. It is also the one we would recommend to a friend.

Everything below is open in the page source and folded only for reading comfort. Nothing is fetched, nothing is hidden.

Side by side on the seven dimensions that matter

Comparison tables in this category almost always compare features, which is the least decisive information available. Here are the seven dimensions that actually determine what a specialty group pays and how much freedom it has, with the incumbent, a like for like specialty swap, and a commissioned operational layer set against each other.

Dimension	Stay on ModMed EMA	Switch to another specialty EHR	Keep certified core, own the operational layer
Price transparency	None published anywhere. VERIFIED by absence on three modmed.com pages that loaded	None on nextech.com or nextgen.com; eclinicalworks.com pricing redirects with no figure; athenahealth.com pricing refused our request; published on edvak.com and carepatron.com	Fixed fee published as a range on colabcontent.com before any conversation, exact number fixed before work starts
Cost curve	Per named user per month, escalating, no published cap	Per provider per month, escalating, mostly no published cap	One time, plus a flat maintenance assumption that does not scale with headcount
Cost of hiring your eleventh person	A licence negotiation and possible activation fees. VERIFIED in modmed.com RCM terms, section 4.7	Another seat at list or negotiated rate. On edvak.com's published card, a tenth Premium provider is $7,188 a year	Zero, on the owned layer
Certification and compliance	ONC 2015 Edition Cures Update criteria, listed by CFR citation. VERIFIED in the modmed.com Costs and Limitations document, and checkable at chpl.healthit.gov	Varies. pabau.com states on its own site that it does not carry US ONC certification	Not certified, never will be, and does not attempt to be. The certified system stays.
Time to value	Already live	Four to eight weeks from migration start, REPORTED, plus selection and contracting	Months, with a parallel run and a productivity dip that belongs in the model
Change speed	A request in a queue prioritised across eleven specialties	The same, at a different vendor	A scoping conversation with whoever maintains it
What you own at year five	Nothing. Access ends when payment does.	Nothing.	A transferable asset, plus whatever certified seats you kept

Notice that the incumbent wins two of the seven outright, on certification and on time to value, and those two are not small. A page that gave it zero out of seven would be lying to you and would be easy to dismiss.

When to pick which, in one paragraph each

Stay and renegotiate when you are under four providers, when your renewal is more than a year out, when the value you get is concentrated in the certified clinical core, or when you simply have not yet done the invoice audit. The audit is free and often produces a real number.

Switch specialty EHR vendors when the relationship has genuinely broken down, when your specialty mix has moved toward something another vendor serves better, or when you have a materially better written quote in hand. Go in knowing you are buying one round of competitive tension rather than a structural fix, and price the migration honestly including the productivity dip.

Drop to a cheaper platform when your requirements are genuinely lighter than what you are paying for. Edvak publishes a rate card and Carepatron publishes one at a much lower tier. If your practice could actually run on either, the fastest saving available to you is on this page and it is not us.

Keep the certified core and commission the operational layer when you are at four or more providers, when the administrative labour is concentrated outside clinical documentation, when there is one internal person who can own the decisions, and when the crossover in the calculator lands inside about three years on your own numbers. That combination is narrower than most of this page's readers, which is why the section on who should stay is as long as it is.

Do nothing this quarter when you are mid contract with no notice in hand. Diarise the renewal, run the numbers two quarters out, and spend the intervening time counting where the administrative hours actually go. That data is what makes the eventual decision easy, and you cannot buy it.

How to audit your own ModMed bill before you do anything else

This is the highest return hour available to you and it does not involve talking to any vendor, us included. Work through it in order.

One. Pull three years of invoices, not one. One invoice tells you a number. Three years tells you a slope, and the slope is the input that matters for every projection on this page. If your actual year over year increase is lower than the eight percent this page assumes, every crossover moves later and you should recalculate with your real figure.

Two. Separate the licence from everything else. ModMed's own disclosure confirms that several things are billed separately from the base EMA subscription: EPCS carries its own per provider monthly fee plus a possible setup fee, in house pathology functionality may carry one-time and ongoing fees, supplemental analytics functionality and reports may require additional fees, and revenue cycle management runs under its own agreement. Get each of those onto its own line. Practices are routinely surprised by the ratio.

Three. Count actual logins, not seats. Ask for a usage report or count it yourself over one month. The number of named users on the contract and the number of humans who opened the software last month are frequently different, and every gap between them is money with no corresponding activity. ModMed's terms mean the seat count is contractual, so reducing it is a conversation rather than a toggle, but you cannot have the conversation without the number.

Four. List modules against use. For each separately billed module, name the person who used it last month and what they used it for. Anything that fails that test is a candidate to drop at renewal.

Five. Find your renewal date and your notice window. ModMed's published terms show fee changes taking effect at the beginning of the next renewal term after at least thirty days written notice. Whatever your executed agreement says, the leverage exists only inside a window, and the window is on a calendar you can look up today.

Six. Only now, model alternatives. With those five things in hand, the calculator on this page produces a real answer instead of a plausible one, and so does any competing quote you request.

What a commissioned operational layer actually contains

Concrete, because a vague description is how build projects go wrong. For a multi provider specialty group, the layer that sits around a certified electronic health record typically covers some subset of the following, and a good scope picks two or three rather than all of them.

Scheduling and rescheduling logistics. Provider and room templates, block rules that reflect how your practice actually books, waitlist and gap filling when a cancellation lands, and the recall queue for follow ups that currently lives in someone's head.

Intake. Forms that adapt to visit type, collected before arrival, in a state your staff can act on rather than a PDF someone retypes.

Eligibility and prior authorization tracking. Not the payer transaction itself, which is a clearinghouse function, but the tracking layer: what is outstanding, with whom, for how long, and who is chasing it. This is the single most common place we find a specialty group carrying a spreadsheet.

Billing operations and denial follow up. Work queues, ageing, denial categorisation, and reporting that tells you which denial reasons are actually costing you money rather than which are most numerous.

Practice reporting. The reports the partners actually ask for at the monthly meeting, built once, rather than assembled by hand from exports every month.

Patient communication. Structured messaging that reduces phone volume, which is the workflow ModMed's own marketing highlights first when it describes eliminating phone tag.

What it never contains: the clinical note, the prescription, the certified capabilities, or the legal medical record. If a proposal you receive from anyone includes those, that proposal has a problem and the problem is not the price.

Reading vendor comparison content without getting played

Four habits, learned the hard way and applicable to this page as much as any other.

Find the publisher before you read the content. Two of the most complete ModMed alternatives guides available to a practice administrator are published by companies that appear in their own comparisons. One of them, Pabau, is transparent about its own limitations to a degree that is genuinely unusual. The other, Edvak, sells a competing dermatology EHR and recommends it in the article. Neither fact makes the content wrong. Both change how much weight a specific claim deserves.

Follow a price to its origin, not to its citation. A great deal of this category's pricing information is aggregators citing aggregators. When we traced the widely quoted ModMed range, one route ended at independent reviews on Capterra and Software Advice, meaning review platform commentary rather than any vendor or research publication, and another ended at KLAS Research by way of a comparison site rather than at KLAS itself. Both are worth knowing. Neither is a rate card.

Treat a failed page load as nothing at all. If a guide tells you a vendor publishes no price, ask how they know. A 403 or a 404 is a failure to observe, not an observation of absence, and the difference is the difference between evidence and a guess dressed up as one. We hit both on this page, with athenahealth and with two dermatology vendors' pricing paths, and each is excluded above rather than converted into a finding.

Watch for a number with no source, especially a percentage. Escalation rates, utilisation rates, time savings and efficiency gains are the four places invented numbers accumulate, because they are hard to check and they make a story land. Every percentage on this page is either read from a document with the source named, or labelled as an assumption. If you find one that is neither, we would genuinely like to know.

How much does ModMed cost per provider?

ModMed does not publish a price, and the way it does not publish one is worth knowing. Under the ONC certification programme a certified developer maintains a Costs and Limitations disclosure describing the costs associated with each certified capability. We read ModMed's version of that document in full on August 30, 2026, all five pages, and it contains no dollar figure for any capability anywhere in it. What it says about EMA is that Modernizing Medicine charges certain one-time and ongoing fees in connection with EMA, and that users may also be required to reimburse certain third party fees and out-of-pocket and travel related costs for services such as training and implementation. We also loaded ModMed's homepage and its dermatology product page the same day and found no currency figure in the visible text of either. That is three separate ModMed pages that loaded successfully and published no price. So every ModMed number in circulation, including the ones on this page, comes from somebody other than ModMed, and there are three of them worth knowing. A site called medicalrecords.com reports $500 to $1,000 per provider per month and attributes that to KLAS Research, a third party research firm. Edvak, which sells a competing dermatology electronic health record and recommends it in the same article, reports $500 to $1,300 per provider per month and attributes it to independent reviews on Capterra and Software Advice. And a single physician reviewer on Capterra, in a review dated May 2026, describes entering into a five year agreement at approximately $800 or more per user per month for a two provider setup, later referencing $800 to $1,000 per user per month. All three are REPORTED rather than VERIFIED, because none of them is ModMed. They converge loosely around $800, which is why that is the default in our calculator, and your own invoice is the only figure that is actually true for you.

Is ModMed EMA worth the price for a dermatology practice?

It depends almost entirely on how much of your value sits in the certified clinical core, and that is a question you can answer in a week by counting where the hours go. If your dermatologists genuinely use the touch based documentation, the recall of laser settings and biopsy anaesthesia preferences, the built in dermatology coding, the in house dermatopathology receipt and billing through the Pathology module and the MIPS support, then you are buying something specialty native that a generalist platform would take a year of configuration to approximate, and the price is buying real capability. All of those are described on ModMed's own dermatology page, which we read on August 30, 2026. If, on the other hand, most of the administrative burden in your practice sits in scheduling, intake, eligibility, prior authorization, denial follow up, reporting and patient communication, then a large share of what you are paying per provider per month is for an operational layer, and that layer is the part with a genuine alternative. Notice that ModMed itself points at exactly those workflows when it markets its newest AI assistants, describing them as handling patient scheduling and communication, eligibility processing, prior authorization, and claim denial appeals. We agree with the vendor about where the labour is. The disagreement is only about whether a multi provider group should rent that software per provider forever or own it. At one to three providers the answer is rent, because the arithmetic does not work at that scale. At four or more it becomes a real question.

What is the best EHR alternative to ModMed for a small practice?

For a small practice, meaning roughly one to three providers, the honest answer is one of the published rate card vendors rather than anything custom, and we will name them even though neither is us. Edvak publishes an actual rate card on its own site: Essential at $299 per month per provider, Plus at $549, Premium at $599, with Essential covering a single location and Plus supporting up to five. We read that page on August 30, 2026 and it is VERIFIED. Carepatron sits at a much lower tier and publishes a free plan, Plus at $15.50 per month and Advanced at $19.50 per month, with an e-prescribe add-on at $39 per month per user, also VERIFIED on its own pricing page the same day, though it is a general practice management tool rather than a dermatology specific electronic health record and will not carry specialty visual documentation. EZDERM is worth a quote if visual body mapping is the specific thing you are chasing, though it publishes no price we could observe. What we would steer a small practice away from is commissioning software, including from us. At one provider paying the reported $800 per month, five years of ModMed comes to $56,319, and a $90,000 build with an eighteen percent maintenance assumption never crosses that inside ten years. Even at our $45,000 floor the crossover does not arrive until year nine. That is not a close call and we would rather say it here than take the meeting.

How long does it take to migrate from ModMed to a new EHR?

Migration guidance from several independent sources converges on four to eight weeks from the point migration work actually starts to go live, with a test migration recommended four to six weeks before cutover. That is REPORTED, aggregated from migration guides rather than sourced to any single authority, and it should be read as the optimistic end of the range. It also excludes everything before it: vendor selection, contracting, mapping your data, and the internal decision making, which in a partnership always takes longer than anyone plans. A realistic end to end budget for a full certified system replacement is two to three quarters. Three things reliably take longer than expected. Images and attached documents are usually the largest and least well behaved part of the export. Open accounts receivable and claim status is a moving target rather than a static file, so it has to be reconciled rather than copied. And clinician built templates, order sets and macros frequently do not transfer at all and have to be rebuilt, which is the item most likely to turn your fastest physician into your unhappiest one. Validate the test migration by hand on twenty real patients spanning your oldest records, most complex charts and highest value open claims, checking demographics, clinical notes and billing records field by field. A matching row count proves nothing; a chart that silently lost its attachments while the row count matched is the actual failure mode. If instead you keep the certified system and build an operational layer alongside it, the clinical record never moves and this entire risk profile mostly disappears, which is why that is the path we usually recommend.

Why did my ModMed renewal price go up?

Because the contract allows it, and there is no published schedule to argue against. ModMed's own revenue cycle terms and conditions state that it may change fees by providing at least thirty days prior written notice, with the change taking effect at the beginning of the next renewal term after the notice period expires. Its Costs and Limitations disclosure closes by saying that the fees and costs set forth in it are subject to change. Both statements are VERIFIED, read from ModMed's own documents on August 30, 2026, and both are entirely ordinary contract language. What makes them consequential in this category is the absence of anything else. No published rate, no published escalation cap, no public benchmark, so the only reference point for next year's number is this year's invoice. On the size of increases, we have to be straight with you: nobody publishes a documented ModMed renewal escalation percentage. We checked that two separate ways and found only qualitative language. The one figure in circulation is Edvak's assertion of ten or twenty percent at renewal, which is uncited and which comes from a company selling against ModMed. Our own model uses eight percent, labelled as an assumption, deliberately chosen below the only number anyone has published rather than above it. Practically, the useful response to an increase is not to argue the percentage. It is to audit what you are paying for: separate the base licence from separately billed items such as EPCS, in house pathology functionality, supplemental analytics and revenue cycle services, then count how many licensed seats actually logged in last month. That exercise costs a morning and frequently produces a real number.

Does ModMed charge extra for e-prescribing of controlled substances?

Yes, and this is one of the few ModMed cost facts that is documented in the vendor's own words rather than reported by a third party. ModMed's Costs and Limitations of Certified Health IT document states that Modernizing Medicine charges a per provider subscription fee for EPCS functionality, that the fee is usually structured as a monthly per provider fee, and that an additional set-up fee may also be charged. That is VERIFIED, quoted from modmed.com and read on August 30, 2026. No amount is published, and we are not going to guess at one. The same document explains why EPCS carries its own machinery rather than being a checkbox: prescribers of controlled substances are required to take part in an identification proofing process before being permitted to e-prescribe, that process involves providing personal information to a third party to confirm the prescriber's identity, and the workflow requires additional identity authentication steps and registration with third party service providers. This matters for anyone weighing a custom build, so we will state the consequence plainly. EPCS is federal identity assurance architecture attached to a certified capability. A commissioned build does not carry it, cannot carry it, and any vendor who suggests otherwise has told you something important about themselves. If your providers prescribe controlled substances, the certified system stays, and the only question worth asking is how many seats need to be on it.

Is ModMed ONC certified?

Yes, and it is worth understanding what that actually covers rather than treating it as a checkbox. ModMed's own Costs and Limitations of Certified Health IT document lists specific 2015 Edition Cures Update certified criteria by their Code of Federal Regulations citation, and we read those citations directly from the document on August 30, 2026. They include 170.315(a)(2), computerized provider order entry for laboratory; 170.315(a)(4), drug-drug and drug-allergy interaction checks; 170.315(b)(1), transitions of care; 170.315(b)(2), clinical information reconciliation and incorporation; 170.315(b)(3), electronic prescribing; 170.315(b)(6), data export; 170.315(e)(1), view, download and transmit to a third party; 170.315(h)(1), the Direct Project; and 170.315(g)(7), (g)(9) and (g)(10), the application access and standardised API for patient and population services criteria. That is VERIFIED from the vendor's own document. The document also directs readers to chpl.healthit.gov, the Certified Health IT Product List, for the full and current list of criteria applicable to EMA, and that is the place to check the current state yourself rather than trusting any comparison page including this one. Why it matters here: certification is the foundation your MIPS reporting, your patient access requirement and the defensibility of your clinical record stand on. It is also the single hardest thing on this page to replace, which is why the boundary section states plainly that a commissioned build is not a certified electronic health record and never will be.

Can a custom built system replace ModMed, or does a practice still need a certified EHR?

No, a custom system cannot fully replace it, and yes, a practice that prescribes and documents clinically still needs a certified electronic health record. We would rather lose the enquiry than blur that, so here is the line drawn exactly. What stays on the certified system: the ONC certified capabilities themselves, listed by CFR citation in ModMed's own disclosure; electronic prescribing of controlled substances, which carries federal identity proofing requirements before a prescriber may transmit at all; the legal medical record, which is what gets subpoenaed, audited and produced on a records request; and anything your quality reporting attestation depends on. What a commissioned build honestly replaces is the operational layer that has accumulated around that core: scheduling and rescheduling, intake and forms, eligibility and prior authorization tracking, billing operations and denial follow up, practice reporting, and patient communication. ModMed itself identifies exactly those workflows as where the administrative labour sits, describing its newest AI assistants as handling patient scheduling and communication, eligibility processing, prior authorization, and claim denial appeals. So the realistic outcome for a qualifying multi provider group is not zero ModMed seats. It is fewer seats, kept for the clinicians who genuinely need certified capabilities, plus a layer the practice owns for everything else. That is a smaller claim than you will read elsewhere and it is the only one we will make. Two further conditions apply. Any system touching protected health information needs its own explicitly stated compliance posture and an executed business associate agreement, not a posture inherited by proximity to a certified vendor. And the arithmetic only works at scale: at one to three providers a build does not pay back inside five years on any input we would defend, which is covered in detail in the section on who should stay.

Four folds. The first three are for the meeting with any vendor, us included. The fourth is the one you should read first.

Twelve questions to ask any EHR or platform vendor

Ask them in writing and keep the answers. Every one of these is a question we have watched a specialty group wish it had asked two years earlier.

1. What is the licence unit, exactly, and what counts as a user? Named seat, concurrent seat, provider, or full time equivalent, and does a part time clinician count as one?
2. What does adding a seat cost mid term, and is it contingent on any activation fee? Get the mechanism in writing, not just the rate.
3. What is the renewal escalation, is there a cap, and will you put the cap in the agreement? If the answer is no cap, that is an answer.
4. Which capabilities are billed separately from the base subscription? Name each one and its price. E-prescribing of controlled substances, pathology, analytics beyond a baseline and revenue cycle services are the usual candidates.
5. What are your current certified criteria and where can I verify them independently? The Certified Health IT Product List at chpl.healthit.gov is the answer you should hear.
6. What does implementation, training and travel actually cost, including out-of-pocket reimbursement?
7. What is the data export format, on what timeline, at what cost, and what happens to my data after termination? Ask for the clause, not the reassurance.
8. What is the termination assistance obligation and how long does it run?
9. Do customisations have a published price, or are they separately negotiated? Who decides what counts as a customisation?
10. What is your AI functionality, is it included or priced separately, and what happens to that answer at renewal?
11. Who owns the company today and has that changed in the last three years?
12. Name three practices in my specialty at my size who left in the last two years, and tell me why. A vendor who cannot answer this has not asked.

The one page cost model to build before any meeting

Do this on a single sheet before you talk to anybody. It takes about an hour and it changes every conversation that follows.

Row 1. Base licence, per provider, per month, times your actual seat count, times twelve. From your invoice, not from a website.
Row 2. Every separately billed item, annualised and listed individually. EPCS, pathology, supplemental analytics, revenue cycle services, payment processing, anything else on the invoice.
Row 3. Your real year over year increase, calculated from three years of invoices rather than assumed. This is the single most valuable number on the sheet, and it is the one nobody has.
Row 4. Project rows 1 and 2 forward five years at the rate from row 3. That is your do nothing number, and it is the only figure any alternative should be measured against.
Row 5. For each alternative, the same five year projection using their quoted rate and their stated escalation, plus a migration line covering data work, training and a realistic four to six week productivity dip.
Row 6. For the build path, a one time fee plus a maintenance assumption, plus the seats you would genuinely keep on the certified system, escalating at your row 3 rate.
Row 7. The crossover year for each option, and a written note on whether that year is inside your planning horizon. If it is not, the option is not real for you, however good it looks in isolation.

Six red flags in any proposal, ours included

A price with no source. If a comparison page tells you what a competitor charges without naming where the figure came from, it is a guess with confidence applied. That test applies to this page: every number here carries a label and a source, and if you find one that does not, we want to hear about it.

A percentage nobody can trace. Escalation rates, efficiency gains, hours saved and utilisation percentages are where invented numbers live, because they are hard to check and they make a story land. Ask for the source of any percentage in any proposal.

Absence claimed from a failed page load. A vendor page that returns an error proves nothing. Anyone who converts a 403 into a finding about what a competitor does or does not publish has told you how carefully they work.

A build presented as a certified EHR replacement. This is the specific red flag for this category. If anyone proposes replacing your certified clinical documentation, your e-prescribing or your legal medical record with custom software, the problem is not the price and you should end the conversation.

Silence on protected health information. If a build partner does not raise HIPAA, business associate obligations, data location and access control before you do, that is the answer about the partner.

A proposal with no scenario where you should not buy. Any honest advisor in this category can describe the customer they would turn away. If a proposal has no such section, it was written to close rather than to be true.

When not to buy from us

Left open deliberately. These are the situations where we are the wrong answer, and where we will say so on the call rather than after the invoice.

You have one to three providers. The arithmetic does not work and we have shown it above rather than asserting it. At one provider, five years of ModMed at the reported rate is $56,319 and a mid range build never crosses inside ten years. Go negotiate, or go look at a published rate card.

You need a certified electronic health record. We do not build one, we will not build one, and nobody should. If your real requirement is certified clinical documentation, e-prescribing of controlled substances or the legal medical record, this is not a project, it is a vendor selection, and the eight alternatives above are your list.

You need it in six weeks. Buy something that exists. A build cannot compress to that and pretending otherwise would waste your quarter.

Healthcare specific delivery history is a hard requirement. Ours is not in healthcare. Jim Glaser Law is legal, the LELF platform is not clinical, and the call volume and commission count we cite demonstrate execution rather than domain experience. That is a legitimate thing to require and we do not meet it today. We would rather you knew that from a web page than from a reference check.

There is nobody inside the practice who can own it. A build needs one person with authority to decide what it does and to say no. Without that it drifts, and a drifting build costs more than the subscription you were trying to escape.

Your crossover lands past year five on your own numbers. Run the calculator with your invoice. If ownership does not pay back inside about three years, and certainly if it does not inside five, the answer is no, and it is no regardless of how much we would like the work.

Your real problem is the negotiation. If you have not yet audited three years of invoices, counted actual logins against licensed seats, and listed every separately billed module against the person who used it, do that first. It is free, it takes a morning, and it quite often removes the need for this entire conversation.

For the pricing evidence behind this page and every other category we track, the vertical software pricing index carries the dated ledger. If you want to see this same sourced cost model run on a category with the same no published price problem, CoStar alternatives and CDK Global alternatives are the closest structural analogues, and ServiceTitan alternatives runs it on a per seat field service platform where headcount growth carries the same tax as it does here. For the underlying decision rather than the vendor comparison, renting AI versus owning it lays out what renting really costs against a build over the same horizons, off the shelf versus a custom commission is the five test framework we run on every diagnosis call including the tests that send people back to buying, and generic SaaS AI versus a custom commission covers the AI specific version of the same question. If your alternative is hiring rather than buying, an internal hire versus a commissioned build compares the two on eighteen month cost. And if the workflow you care about most is the phone, AI receptionist versus a custom build covers patient facing call handling specifically. The full comparison library holds the rest, how the fixed fee is set explains where a number inside $45,000 to $180,000 comes from, and the process page walks through what the weeks after a signature look like.