This research study is primarily focused on the analysis of the determinants that affect behavioral intentions related to the actual implementation of electronic payment (e-payment) systems within the realm of primary healthcare services. The objective of this research is to assess the impact of behavioral intentions on the practical execution of e-payment mechanisms in primary healthcare environments. This investigation rigorously examines the influence of behavioral intentions on the actual adoption of electronic payment systems within primary healthcare institutions in Malaysia, with a specific emphasis on the regions of Penang and Selangor. It employs a cross-sectional research design, involving 431 carefully selected respondents from ten primary healthcare facilities located within these two states. This document analyzes how perceived ease of use, perceived usefulness, perceived value-added, patients' behavioral intention, and the actual usage of e-payment in primary healthcare facilities. This study holds substantial relevance for scholars, consumers, and providers engaged in electronic payment systems, as it elucidates that perceived ease of use, perceived usefulness, and perceived value addition constitute three of the three pivotal factors influencing patients' behavioral intentions regarding the actual utilization of electronic payment methods in primary healthcare services. A restricted array of academic inquiries has attempted to clarify which elements influence the adoption of electronic payment systems about their actual application, particularly from the standpoint of the Technology Acceptance Model (TAM), the Theory of Planned Behavior (TPB), and the Innovation Diffusion Theory (IDT). Conversely, a plethora of researchers have focused on exploring the correlation between security and consumer trust concerning adoption intentions. Accordingly, this exploration seeks to augment the existing literature by clarifying the three aspects that govern both the intention to accept and the real application of e-payment systems in Penang and Selangor.