How to Start a Functional Medicine Practice: Checklist

To start a functional medicine practice, settle five things in order: your payment model (cash, membership or hybrid insurance), what your license lets you order and prescribe in your state, your services menu, your lab and supplement workflow, and one software platform to run it. Ona covers the last part, from intake to billing, on one chart.

Quick answer:

Decide the money model first. Cash-pay, membership and hybrid insurance practices need different billing setups, different intake and different software features, and changing later is expensive.
Your clinical license, not a functional medicine certificate, decides what you can order and prescribe, and scope rules differ by state. Confirm with your state board before you build the services menu.
Pick software that holds labs, supplements, memberships and billing on the same patient record. On Ona, a solo practitioner seat is $130 per month with every feature included, and there is a 14-day free trial with no card.

Step 1: Choose the Payment Model

Every later decision depends on this one, so make it on paper before you sign a lease or a software contract.

Cash-pay. Patients pay you directly for visits, programs and often labs. Simplest to run: no payer enrollment, no claims, no clearinghouse. The trade-off is that patients carry the whole cost, so the value has to be obvious before they book. Self-pay patients are also covered by the No Surprises Act good faith estimate rules: per CMS, providers usually must give uninsured or self-pay patients an estimate of expected charges when they schedule at least 3 business days ahead or ask for one.

Membership. Patients pay a recurring fee, monthly or yearly, that covers a defined set of visits and services. It smooths cash flow and makes the relationship ongoing rather than transactional. It also needs recurring card billing and a way to count what each member has used. Ona Memberships bills plans monthly or yearly to the card on file and counts included visits as they are booked.

Hybrid insurance. You bill insurance for what is billable (often the visit itself and many conventional labs) and charge cash for what is not (extended visits, programs, specialty tests). This widens your patient pool but brings credentialing, payer enrollment, claims and denials, which take months to set up.

A useful test: if you cannot describe in one sentence what a new patient pays for their first 90 days, the model is not ready.

Step 2: Confirm Scope and Entity Rules

Functional medicine is an approach, not a separate license. The clinicians who practice it hold their own licenses (MD, DO, NP, PA, ND, DC and others), and that license sets what they can order, prescribe and bill. What an NP or ND can do independently differs from state to state, and some states restrict who can own a medical practice. These are questions for your state licensing board and a healthcare attorney, not for a blog post, but ask them before you build the menu, because they decide:

Whether you can order labs and prescribe independently, or need a collaborating or supervising physician.
Whether you need DEA registration for controlled substances, and whether your prescribing needs EPCS.
Who can own the entity and employ the clinicians.
Whether you can see patients by telehealth in other states (generally, the clinician must be licensed where the patient is located).

Get an NPI for each clinician and one for the organization if you plan to bill insurance. Every practice handling patient data needs a signed BAA with each software vendor that touches PHI; Ona signs one with every workspace.

Keep the first menu short. Most functional practices launch with some version of:

A new-patient consult. Long, history-heavy, often with labs ordered at the end.
A results review. Where the plan gets built.
Follow-ups. Shorter, on a schedule.
A program or membership. A bundle that packages the above over three to twelve months.
Optional add-ons. Health coaching sessions, specialty tests, supplement protocols.

Write each service down with its length, its price (or the CPT code if you bill it), whether it can be booked online, and whether it needs payment at booking. That list becomes your software configuration on day one. In Ona, services carry their price, CPT code, place of service and default copay, and a package groups several services at one price.

Price from your own costs and local market, not from a number someone posted online. Your cost floor is clinician time plus overhead plus software, and your ceiling is what your target patient will pay for the outcome they expect.

Step 4: Design the Lab and Supplement Workflow

This is where functional practices differ most from other outpatient practices, and where a poor setup costs the most clinician time. Decide:

How you will order. Electronic ordering for routine blood work, a catalog such as Fullscript for specialty kits, and a requisition for patients who use their own lab.
Who pays for which tests. Insurance for conventional panels where coverage applies, patient-paid for specialty tests, with prices told up front.
How results become trends. A specialty result read once as a PDF is wasted. You need values you can compare at the next visit.
How you dispense supplements. In-office stock, an online dispensary, or a printed list the patient fills elsewhere.

In Ona, Labs orders through Junction, Fullscript or a PDF requisition from the chart, parses every result (from Junction, a fax or an upload) into values against reference ranges, and trends markers across labs by LOINC code. Supplements charts products coded from the NIH Dietary Supplement Label Database, saves protocols as templates you chart in one step, and ships 15 starter templates that each list their references. Fullscript is optional for dispensing, and Ona can track items sold from your own stock on invoices.

Step 5: Choose the Software Stack

The question we see in search data is literally "what company should I use to start a functional medicine practice". The honest answer is that there are two shapes of stack:

Stitched. A scheduling tool, an EHR, a payments tool, a lab portal, a dispensary, a video tool and a texting service, connected by staff copying data between them. Cheap per tool, expensive in hours and errors.

One platform. Intake, scheduling, charting, telehealth, labs, supplements, memberships and billing on one patient record. Fewer logins, one source of truth, and a single BAA to manage.

Most new practices are better off with one platform, and the choice then comes down to which one fits the model from Step 1. Here are the published prices of platforms commonly considered by functional practices, taken from each vendor's own pricing page in October 2026. This is not a ranking; check each vendor for current terms.

Platform	Published starting price	How it is priced	Notes from the vendor's page
Ona	$130 per practitioner per month; staff $45 per month	Per seat, every feature on every plan, 10% off annual	E-prescribing +$45, EPCS +$25 per prescribing practitioner; 14-day trial, no card
Healthie	Core $19.99 per month billed monthly	Tiered plans by client count and features	Plus $129.99 per month; Group $149.99+ with team members at $50 per clinician
Practice Better	Starter $35 per month billed monthly	Tiered plans by client count and features	Plus $99, Team $155 per month billed monthly; free Sprout plan for students
OptiMantra	$99 per month for the first practitioner	Per practitioner, add-ons extra	$49 per additional practitioner; eRx license with EPCS $38 per month
Cerbo	$281 per month per full-time prescribing provider	Per user type, plus one-time setup	$1,195 one-time setup fee; eRx and EPCS included for prescribing providers

Prices are not the whole picture. Ask each vendor three questions from your own model: how memberships bill and count visits, how lab results get into the chart, and what happens to price when you add a second clinician.

Step 6: Map the Patient Journey

Walk a new patient through the practice on paper before launch:

Inquiry. A call, web form, text or chat. Someone has to answer within hours, not days. Ona collects these into a leads pipeline with an owner, source and follow-up date.
Booking. Online, against real availability, with payment at booking if the service requires it.
Intake. Functional histories are long. A conversational interview, which Ona offers with a ready-made Functional Medicine Intake, gathers timeline, body systems and lifestyle and returns a summary and suggested chart records.
First visit. In person or by telehealth. Ona's video runs in the browser, and the call's audio can feed the ambient scribe so the note drafts from the conversation against your template.
Labs ordered. From the chart, through the routes in Step 4.
Results review and plan. Results trended, protocol charted from a template, plan shared.
Follow-up and retention. Membership renewals, reminders, and the next lab round.

Every handoff between two tools on this list is a place a patient can drop out. Count them.

Step 7: Make Your First Hires

A solo clinician can launch alone with good software, but the first hire usually comes sooner than planned. The typical order:

A front desk or care coordinator. Answers inquiries, books, chases intake, runs payments. On Ona this is a staff seat at $45 per month.
A health coach or second clinician. Extends capacity for follow-ups and programs. Check what your state allows each role to do.
A biller, only if you take insurance. Many hybrid practices outsource this at first; on Ona a billing partner can be given a staff seat to work the same claims queue.

Ona prices practitioner and staff seats separately, so the software bill grows with the team rather than in tier jumps, and practices with five or more practitioners or several locations get custom pricing. The same platform runs a solo launch and a multi-location group.

Step 8: Plan Telehealth From Day One

Many functional consults, results reviews and follow-ups work well by video, and at-home lab kits make a virtual or hybrid practice realistic. The constraint is licensure: a clinician generally needs a license in the state where the patient is during the visit. Decide which states you will serve before you market.

A Sample First-Year Software Budget

Using Ona's published prices, a solo practitioner with one front-desk staff member pays $130 + $45 = $175 per month, or $157.50 per month on annual billing. Add e-prescribing at $45 per month if the practitioner prescribes, and EPCS at a further $25 if they prescribe controlled substances. Omnichannel messaging (SMS, email and chat) is included for practices with two practitioners or fewer. A cash-pay practice needs no clearing house plan; a hybrid practice adds one from $69 per month. Payments run on your own Stripe account, and Ona takes no cut.

A Functional Medicine Business Plan, Condensed

If you need a one-page business plan for a lender or partner, these headings cover it:

Model: cash, membership or hybrid, and why.
Patient: who you serve and how they find you.
Services and prices: the menu from Step 3.
Capacity: clinician hours per week, visit lengths, patients per clinician.
Costs: space, clinician pay, staff, software, insurance, marketing.
Break-even: how many members or visits per month cover the fixed costs.
Compliance: licenses, entity, BAAs, good faith estimates for self-pay patients.

See how Ona fits a lab-heavy practice on the functional medicine page.

Frequently asked questions

What do I need to start a functional medicine practice?

A clinical license that covers what you plan to order and prescribe in your state, a legal entity that meets your state's ownership rules, an NPI, malpractice cover, a payment model, a short services menu, a lab and supplement workflow, and software to run intake, scheduling, charting, labs, billing and payments. Confirm scope and entity rules with your state board and a healthcare attorney first.

What company should I use to start a functional medicine practice?

Choose a platform that fits your payment model and holds labs, supplements, memberships and billing on one patient record. Ona is an AI-native, all-in-one practice management platform that does this at $130 per practitioner seat per month with every feature included. Healthie, Practice Better, OptiMantra and Cerbo are also commonly considered; compare their published pricing and how each handles labs and memberships.

Should a functional medicine practice take insurance?

It depends on your patients and your appetite for admin. Cash-pay is simplest to run and needs no payer enrollment or claims. A hybrid model bills insurance for the visit and many conventional labs and charges cash for programs and specialty tests, which widens access but adds credentialing, enrollment and denials. Ona supports both on the same visit record.

How much does software cost for a new functional medicine practice?

On Ona, a solo practitioner seat is $130 per month and a staff seat is $45 per month, with every feature included and 10% off on annual billing. E-prescribing adds $45 and EPCS a further $25 per prescribing practitioner. Cash-pay practices need no clearing house plan. Other vendors publish their own prices, so compare totals for your actual team.

Can I run a functional medicine practice through telehealth?

Many consults, results reviews and follow-ups work well by video, and at-home lab kits support a virtual model. The main constraint is licensure: a clinician generally must be licensed in the state where the patient is located during the visit. Ona includes browser-based telehealth with no patient app, and video visits are charted and billed like in-person ones.

What should a functional medicine business plan include?

The payment model, target patient, services and prices, clinician capacity, fixed and variable costs, break-even volume, and compliance items such as licensure, entity structure, BAAs with vendors, and good faith estimates for self-pay patients. Keep it to the decisions that change how you operate, and revisit it after the first 90 days of real bookings.

Next step

Bring your services menu and payment model to a 15-minute demo and we will set them up live, or start the 14-day free trial from the pricing page, no card required.

How to Start a Functional Medicine Practice: The Operator's Checklist