Short version: Charm EHR is free under 50 encounters a month, then it’s $0.50 per encounter ($25 monthly minimum) or $350 per provider per month, whichever is cheaper for your volume. The catch is the add-ons: the native AI scribe is a separate $125 per provider per month, and EPCS, telehealth, and messaging stack on top. Add the scribe to the Provider plan and you’re near $475 per provider. If you want the scribe and the EHR in one bill, Patient Square’s Copilot plan is $119 per provider per month annually with the ambient scribe already bundled. You can see the note on a real visit first.
This isn’t a Charm takedown. Its free tier and usage-based pricing are genuinely small-practice-friendly, and it ships a real native scribe. The point is the total, because Charm’s price is honest but modular, and the modules add up.
Key takeaways
- Charm is free up to 50 encounters a month, then $0.50/encounter ($25 minimum) or $350/provider/month.
- The native Charm AI Scribe is a paid add-on: $125/provider/month unlimited, or $2/encounter.
- Add-ons stack: EPCS ($250 one-time plus $10/month), telehealth ($20/month), plus SMS and e-fax overages.
- Scribe plus EHR on Charm’s Provider plan runs near $475/provider/month once you add both.
- Patient Square Copilot is a flat $119/provider/month with the ambient scribe and AI EHR bundled.
Charm free tier, capped at 50 encounters a month
Charm Provider plan ($350) plus native AI Scribe ($125) per provider
Patient Square Copilot: scribe plus AI EHR bundled, annual billing
What does Charm EHR actually cost?
Charm publishes its pricing, which is a real point in its favor, and the model is usage-based. Here’s the base structure from Charm’s own pricing pages.
| Charm plan | Price |
|---|---|
| Free | $0, up to 50 encounters / month |
| Encounter (Flexi) | $0.50 / encounter, $25 / month minimum |
| Encounter, high volume | $1,000 + $0.30 / consult beyond 2,000 |
| Provider (physician) | $350 / provider / month, unlimited encounters |
| Provider (non-physician) | $200 / provider / month |
The logic is simple: low-volume practices ride the free tier or pay per encounter, and busy practices flip to the flat $350 Provider plan once that’s cheaper than metered encounters. That’s a fair model. It means a slow clinic pays little and a full one pays a predictable flat rate.
One data caveat worth flagging: some aggregators list the Provider plan at $200, but Charm’s own FAQ shows $200 is the non-physician rate; the physician Provider plan is $350. Use the first-party number.
The base plan isn’t the whole bill, though. The scribe is where it grows.
Why the Charm scribe changes the price
Charm ships a native ambient AI scribe, Charm AI Scribe, that transcribes the visit and drafts notes with diagnosis-code suggestions. That’s a genuine feature, and it’s real ambient documentation, not a third-party bolt-on. But it’s a paid add-on, priced separately: $125 per provider per month for unlimited use, or $2 per encounter with a $20 monthly minimum.
Do the arithmetic on a typical setup. A physician on the Provider plan at $350 who wants the scribe adds $125, landing at $475 per provider per month. That’s the number to compare, because most practices reading a pricing page want the note automated, not typed by hand.
Patient Square bundles the same category of tool, an ambient scribe, into one price with no separate scribe line. Check the note quality against your own visit before you decide which model fits.
The add-ons that stack on Charm
Charm’s base tier is the floor. The total is what shows up once you turn on the modules a real practice needs. From Charm’s own pricing FAQ:
- Charm AI Scribe. $125 per provider per month unlimited, or $2 per encounter.
- EPCS (controlled-substance prescribing). $250 per provider as a one-year license, plus a $10 monthly Rx subscription fee.
- Telehealth. $20 per provider per month.
- SMS and e-fax overages. $0.08 per message and $0.10 per fax beyond your plan’s allowance.
None of that is unusual for a modular EHR, and Charm is upfront about each line. But it means the free or low sticker isn’t the total. A practice that wants the scribe, controlled-substance prescribing, and telehealth is stacking three add-ons on top of the base plan. Add the modules you’ll actually use before you compare, or you’ll compare the wrong number.
Charm vs a flat bundle: the total-cost view
Let’s compare like for like. Say you run a two-provider practice that wants the ambient scribe on every visit.
| Charm (Provider plan + AI Scribe) | Patient Square Copilot | |
|---|---|---|
| EHR base (per provider / mo) | $350 | $119 (annual billing) |
| Ambient scribe | $125 add-on | Bundled, unlimited |
| Combined (per provider / mo) | ~$475 | $119 |
| Per-encounter metering | Optional (Encounter plan) | No |
| Free tier | Yes (under 50 encounters) | No, but 7-day trial |
| Published price | Yes | Yes |
Read that honestly. Charm’s free tier is a real advantage for a brand-new or very low-volume practice, and its usage-based option genuinely helps a seasonal clinic. What Patient Square gives a busier practice is the scribe-plus-EHR combination in one flat bill, without adding the scribe as a separate module.
Patient Square is an AI clinical platform. Practice Copilot brings the whole practice under one AI copilot: an ambient AI Medical Scribe that hands back a structured SOAP note, ICD-10 suggestions, and a prescription draft minutes after the visit, plus a bundled AI EHR, scheduling, and messaging as you move up the plan. The bundled AI Copilot EHR ships at the Copilot tier, $119 per provider per month on annual billing. Put it in front of your visit type and judge the note.
What you give up leaving Charm
Be fair about the trade. Charm is a capable, low-cost EHR with a genuinely useful free tier.
- The free and usage-based options. If your volume is tiny or seasonal, Charm’s model can be cheaper than any flat plan, including ours. That’s a real reason to stay.
- A mature module catalog. Charm has years of depth in billing, patient portal, labs, and practice management. Patient Square offers ICD-10 suggestions and a bundled AI EHR, not a full practice-management suite.
- Controlled-substance prescribing. Charm’s EPCS add-on transmits controlled-substance prescriptions. Patient Square’s eRx is a draft for you to review and sign, not a transmission engine.
Patient Square’s export claim is precise: EHR-ready export (PDF, HL7, FHIR). That’s a clean export, not a certified interoperability engine. For a broader look at bundled options, our best EHR with AI scribe built in roundup and the Elation EHR pricing breakdown cover the other end of the market.
When Charm is the better choice
Stay with Charm, or pick it, if you run a very low-volume or startup practice that can live on the free tier, or if you want granular usage-based pricing and a deep module catalog you’ll configure yourself. Charm’s free plan and per-encounter option are real cost advantages that a flat bundle can’t match at the low end. If controlled-substance prescribing is central to your day, Charm’s EPCS transmission is a genuine feature we don’t match.
Choose a flat bundle if you’re a busier practice that wants the scribe on every visit, you’d rather not stack add-ons to get there, and you want the note and the record in one predictable bill. Once you add Charm AI Scribe to the Provider plan, a flat $119 with the scribe included is the cheaper path. The full ladder is on the pricing page.
How to price your real Charm cost in an afternoon
Skip the marketing math and build your own number:
- Count your monthly encounters. Under 50, Charm is free. Above it, compare $0.50 per encounter against the $350 flat Provider plan and pick the cheaper one.
- Add the scribe: $125 per provider per month, or $2 per encounter, since it’s not in the base plan.
- Add EPCS, telehealth, and any messaging overages you’ll actually use.
- Compare that total against a flat $119 per provider annually with the scribe and EHR bundled.
- Trial the alternative on a real clinic week before you decide. A demo flatters everyone.
The receipts behind our claims, encryption, access, and audit status, are on the security page, and the price ladder with no asterisks is on the pricing page. Book a short demo to check the note against your own visits, then run the 7-day trial on a real week. For a busy practice that wants the scribe on every visit, the bundle usually beats the add-on stack.