Clinic Software Seat Fees & Add-Ons: 12-Month TCO (2026)

Clinic Software Seat Fees & Add-Ons: The 12-Month TCO Model (2026)

TL;DR: The advertised price of clinic software is rarely the invoice price. Per-seat fees, add-on modules, SMS bundles, and payment processing routinely double the entry number over 12 months. This article gives you the five-line TCO model to run on any vendor - and a worked example for a 5-person clinic.

Clinic software pricing pages are designed to be compared on the entry number. Your actual cost is the 12-month total cost of ownership (TCO): every seat, module, message, and transaction you will really use. This guide shows you how to build that number in fifteen minutes, for any vendor, before you sign.

The five-line TCO model

For each vendor on your shortlist, fill in one row:

Line	What to capture	Where vendors hide it
1. Base plan	Monthly price x 12 (or annual price)	The advertised number
2. Seats	(Staff count - included seats) x per-seat price x 12	"Starting at" prices assume 1 user
3. Add-on modules	Every feature you need that is not in base: online payments, telehealth, marketing, forms, memberships	Feature matrices with footnotes
4. Usage fees	SMS credits, reminder overages, storage, premium support	"Fair use" policies
5. Payment processing	Card rate x your monthly card volume x 12, plus payout fees	Buried in the payments FAQ

12-month TCO = line 1 + 2 + 3 + 4 + 5. Run it for your current team size and for +2 hires, because pricing that punishes growth is a cost you have already agreed to.

A worked example: 5-person clinic, 12 months

The numbers below are an illustrative model, not a quote for any specific vendor - plug in the real figures from each pricing page (and verify current pricing at the vendor's site, because these change).

Per-seat platform (illustrative):

• Base: EUR 0-49/month entry tier - but the entry tier excludes reminders and the portal
• Realistic tier: EUR 45/user/month x 5 users x 12 = EUR 2,700
• Add-ons (telehealth + marketing): EUR 20/month x 12 = EUR 240
• SMS bundle overage: ~EUR 15/month x 12 = EUR 180
• Payment processing at ~1.9% + EUR 0.25 on EUR 25,000 monthly card volume: ~EUR 6,450
• 12-month TCO: roughly EUR 9,570 - of which processing is unavoidable with any vendor, but EUR 3,120 is seat-and-module pricing that flat-rate models don't charge.

Flat-rate platform (Tregovia, actual pricing):

• Base: EUR 47/month x 12 = EUR 564 (includes 2 staff seats, booking, reminders, records, invoicing, portal)
• Extra seats: 1 five-seat pack at EUR 10/month x 12 = EUR 120
• Add-ons as needed - e.g. Online Payments EUR 15 and Telehealth EUR 15: EUR 30 x 12 = EUR 360
• SMS: included in plan bundles; overage only at high volume
• Payment processing at standard card rates on the same volume (unavoidable with any provider)
• 12-month platform TCO: EUR 1,044 plus processing - a difference of roughly EUR 2,000/year in software fees versus the per-seat model above, scaling worse for the per-seat vendor with every hire.

The point is not that per-seat platforms are bad products - several are excellent. The point is that "EUR 45/month" and "EUR 9,570/year" are the same product described two ways, and only one of those descriptions belongs in your budget.

The questions that surface hidden costs

1. What does the invoice look like at my headcount, with the modules I listed? Get it in writing.
2. Which features on your pricing page are add-ons, and what does each cost monthly?
3. Are SMS and email reminders included, capped, or metered?
4. Is there an onboarding, setup, or data-migration fee?
5. What is the contract term, and what is the notice period?
6. What happens to my price when I add two staff next year?

Our clinic CRM hidden fees checklist expands this into a printable vendor-evaluation sheet, and flat pricing vs per-user clinic software models the scaling math in more detail.

One flat price, every feature listed. EUR 47/month for your clinic - seats, modules, and prices on one public page. Start free for 14 days, no credit card or see the pricing page.

Frequently asked questions

What is TCO in clinic software? Total cost of ownership: the complete 12-month spend on a platform - subscription, seats, add-on modules, usage fees like SMS, payment processing, and any setup or migration charges. It is the only number that makes two vendors comparable.

Are per-seat pricing models always more expensive? Not always at very small headcount - a solo practitioner can pay less per month on an entry per-seat tier than on a flat plan. The crossover arrives fast, usually at 2-3 staff or the first add-on module. Model your real team size, not the entry tier.

Should payment processing count in software TCO? Yes, but compare it separately: processing rates are similar across vendors and unavoidable, so they rarely decide between platforms. Seats and modules are where pricing models genuinely diverge.

How often should I re-run the TCO model? Annually, and whenever you plan to hire. Vendor pricing changes frequently - verify current figures at each vendor's site before any renewal decision.