Kareo vs Practice Fusion vs Praxamed: An Honest Comparison for Independent Physicians
We compare three practice management platforms side-by-side — features, pricing, AI capabilities, and who each is actually built for. Note: we make Praxamed, so read accordingly, but we've tried to represent the competitors fairly.
Who This Comparison Is For
This guide is for independent physicians, small clinic owners, and practice managers evaluating practice management software in 2026. We're comparing:
- Kareo (now Tebra) — one of the most widely used PM platforms for small practices
- Practice Fusion — a cloud-based EHR/PM with a large user base, though controversial history
- Praxamed — a newer, AI-powered platform built for independent practices (our own product)
Quick Summary: Who Each Platform Is Best For
- Kareo/Tebra: Practices that need robust, mature billing capabilities and can tolerate a complex interface and annual contracts
- Practice Fusion: Practices prioritizing EHR documentation that are comfortable with the platform's history
- Praxamed: Independent practices that want modern UX, AI front desk automation, and month-to-month flexibility
| Category | Kareo | Practice Fusion | Praxamed |
|---|---|---|---|
| Target Market | Small-mid practices, enterprise pivot | Small practices, behavioral health | Small practices, independent physicians |
| AI Receptionist | Not available | Not available | Voxline AI, 24/7 |
| UX Modernity | Legacy interface | Dated, functional | Modern, clean |
| Medical Billing | Integrated (robust) | Limited / add-on | Integrated |
| CMS-1500 Claims | Yes | Limited | Yes |
| EHR / Charting | Full EHR | Full EHR | Clinical charting |
| Patient Portal | Yes | Yes | Yes |
| Online Scheduling | Yes | Yes | Yes |
| Lab Orders | Yes | Yes | Yes |
| Prescriptions | Yes (e-Rx) | Yes (e-Rx) | Tracking |
| Free Trial | No (demo only) | No | Yes |
| Contract Required | Annual | Annual | Month-to-month |
| Setup Fee | Yes | No | No |
| Pricing Model | Per-provider | Per-provider | Practice-level |
| Data Privacy History | Clean | Past controversy | Clean |
| Onboarding Time | Weeks | Days | < 1 day |
Deep Dive: Kareo (Tebra)
Kareo merged with PatientPop to become Tebra in 2022. It remains one of the most feature-rich practice management platforms for small practices, with particular strength in medical billing and revenue cycle management.
Strengths: Mature, robust billing; extensive payer network integrations; large user community; e-prescribing.
Weaknesses: Legacy interface; annual contracts with meaningful penalties for early exit; enterprise-focused pivot means small practice feature development has slowed; no AI receptionist or front desk automation; complex onboarding.
Best for: Practices with dedicated billing staff who need a proven billing engine and can tolerate interface complexity.
Deep Dive: Practice Fusion
Practice Fusion was acquired by Allscripts in 2018 and has had a turbulent history since, including a 2020 DOJ settlement over opioid prescription promotion. It maintains a large user base largely due to its historically low pricing.
Strengths: Solid EHR documentation; large template library; affordable pricing; cloud-based.
Weaknesses: Past data privacy and legal controversies; limited integrated billing (often requires third-party billing services); no AI features; interface has aged; limited billing module for medical practices.
Best for: Practices prioritizing EHR documentation over billing integration who are comfortable with the platform's history.
Deep Dive: Praxamed
Praxamed is a newer platform purpose-built for independent practices, with AI front desk automation (Voxline) as a core differentiator. It targets the gap between legacy platforms and modern practice needs.
Strengths: AI receptionist (24/7 call handling and scheduling); modern UI built from scratch; integrated billing; month-to-month pricing; fast onboarding; free trial.
Weaknesses: Newer platform (less track record); e-prescribing integration still maturing; smaller user community than legacy competitors.
Best for: Independent practices that want modern UX, AI automation, and flexibility without long-term contracts.
Our Honest Verdict
If you're running a small independent practice in 2026 and evaluating these three options:
- Choose Kareo/Tebra if billing complexity is your top priority and you're comfortable with annual contracts.
- Consider Practice Fusion only if your primary need is EHR documentation and billing is handled separately.
- Choose Praxamed if you want AI automation, a modern interface, flexibility, and don't want to commit long-term before seeing results.
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