Best Guide to Starting a Telehealth Practice: Complete Guide for US, Canada, UK & Australia 2026

Starting a Telehealth Practice: Your Complete International Guide for 2026

Starting a telehealth practice is one of the most flexible and scalable opportunities in modern healthcare. The global telemedicine market, accelerated by the COVID-19 pandemic, is projected to reach $460 billion by 2026, with strong growth across the United States, Canada, United Kingdom, and Australia.

This comprehensive guide covers everything you need to establish a successful telehealth practice—from country-specific regulatory requirements and licensing to technology setup, reimbursement, patient acquisition, and modern telehealth practice management software.

Why Start a Telehealth Practice?

The telehealth industry offers exceptional opportunities across all four markets:

United States:

• Market size: $80+ billion annually
• 76% of hospitals now use telehealth
• Medicare and private insurance coverage expanded
• Interstate licensure compacts growing
• Permanent telehealth policy changes post-pandemic

Canada:

• Market size: $3+ billion annually
• Provincial health plans covering virtual care
• Growing acceptance among patients and providers
• Rural and remote healthcare access
• Physician shortage driving adoption

United Kingdom:

• Market size: £2+ billion annually
• NHS embracing digital-first primary care
• Private telehealth market growing
• GP shortage accelerating virtual consultations
• Government investment in digital health

Australia:

• Market size: $2+ billion annually
• Medicare telehealth items permanent
• Strong rural and remote healthcare needs
• High digital literacy and adoption
• Government support for virtual care

Common Success Factors:

• Low overhead costs compared to traditional practice
• Geographic flexibility and work-life balance
• Ability to serve patients across wide areas
• Scalable business model
• Growing patient acceptance and preference
• Technology enabling quality virtual care
• Multiple revenue streams possible
• Pandemic-proven viability and sustainability

Understanding Telehealth Practice Models

Before starting, decide which telehealth model suits your goals:

Solo Virtual Practice

• Independent telehealth practice
• Direct-to-patient consultations
• Full control over schedule and pricing
• Startup cost: $5,000-20,000 USD / £4,000-16,000 / $7,000-28,000 CAD / $8,000-32,000 AUD

Hybrid Practice

• Combine in-person clinic with telehealth
• Offer both virtual and physical consultations
• Expand reach while maintaining local presence
• Startup cost: $10,000-40,000 (telehealth component)

Specialist Telehealth Consultation

• Provide specialist opinions virtually
• Second opinions, complex case reviews
• Premium pricing for expertise
• Startup cost: $8,000-30,000

Corporate Telehealth

• Contract with employers for employee health
• B2B model with steady volume
• Occupational health focus
• Startup cost: $15,000-50,000

Platform-Based Practice

• Join existing telehealth platforms (Teladoc, Amwell, Babylon, etc.)
• Lower startup costs, platform handles technology
• Revenue sharing model
• Startup cost: $2,000-10,000

Multi-Provider Telehealth Group

• Multiple providers offering virtual care
• Broader coverage and extended hours
• Shared infrastructure costs
• Startup cost: $30,000-100,000

This guide focuses on solo and hybrid telehealth practices.

Step 1: Country-Specific Legal and Regulatory Requirements

United States

Medical Licensing:

• Must be licensed in state where patient is located during consultation
• Interstate Medical Licensure Compact (IMLC) allows expedited multi-state licensing
• 40+ states participate in IMLC
• Cost: $700-1,500 per state license

Federal Regulations:

• HIPAA compliance for patient privacy
• Ryan Haight Act for prescribing controlled substances
• DEA registration required for prescribing
• Stark Law and Anti-Kickback considerations

State-Specific Requirements:

• Establish doctor-patient relationship (varies by state)
• Informed consent for telehealth
• Standard of care same as in-person
• Prescribing regulations vary by state
• Some states require initial in-person visit

Reimbursement:

• Medicare covers telehealth (expanded post-pandemic)
• Medicaid coverage varies by state
• Private insurance generally covers telehealth
• Use appropriate CPT codes and modifiers

Business Structure:

• LLC or Professional Corporation recommended
• Business license in operating state
• Professional liability insurance: $3,000-10,000/year
• Cyber liability insurance recommended

Total Setup Cost: $5,000-25,000

Canada

Provincial Medical Licensing:

• Must be licensed in province where providing care
• Each province has separate licensing
• College of Physicians and Surgeons approval
• Cost: $1,500-3,000 CAD per province

Federal Requirements:

• Privacy legislation compliance (PIPEDA)
• Controlled substances regulations
• CMA guidelines for virtual care

Provincial Regulations:

• Establish appropriate doctor-patient relationship
• Informed consent requirements
• Medical records standards
• Prescribing regulations

Reimbursement:

• Provincial health plans cover virtual care
• Fee codes for telephone and video consultations
• Private insurance coverage growing
• Direct billing to patients allowed

Business Structure:

• Professional corporation if applicable
• Provincial business registration
• GST/HST registration
• Professional liability insurance through CMPA

Total Setup Cost: $4,000-20,000 CAD

United Kingdom

GMC Registration:

• General Medical Council registration required
• Good standing with GMC
• Indemnity insurance
• Revalidation requirements

CQC Registration:

• May require CQC registration depending on services
• Registered manager if applicable
• Regular compliance monitoring

Professional Standards:

• Follow GMC guidance on remote consultations
• Appropriate clinical assessment
• Clear communication and documentation
• Patient safety paramount

Reimbursement:

• NHS contracts for virtual consultations
• Private pay model common
• Insurance coverage limited
• Direct patient billing

Business Structure:

• Limited company or sole trader
• VAT registration if applicable
• Professional indemnity insurance
• Cyber insurance recommended

Total Setup Cost: £3,000-15,000

Australia

AHPRA Registration:

• Australian Health Practitioner Regulation Agency registration
• Medical Board of Australia approval
• Current practicing certificate
• Professional indemnity insurance

Federal Requirements:

• Privacy Act compliance
• Therapeutic Goods Administration regulations
• Medicare provider number
• Prescribing regulations

State Requirements:

• Notification to state health department
• Comply with state health regulations
• Medical records standards

Reimbursement:

• Medicare telehealth items (permanent)
• Bulk billing or private billing
• Private health insurance coverage
• Direct patient payments

Business Structure:

• ABN and business name registration
• GST registration
• Professional corporation structure
• Professional indemnity insurance

Total Setup Cost: $5,000-25,000 AUD

Step 2: Technology Setup and Infrastructure

Essential Technology Requirements

Hardware ($2,000-8,000):

• Computer/Laptop: High-quality webcam and microphone
  • Cost: $1,000-3,000
• Tablet or Smartphone: For mobile consultations
  • Cost: $500-1,500
• Professional Headset: Noise-canceling with microphone
  • Cost: $100-400
• Lighting: Ring light or professional lighting
  • Cost: $50-200
• Backup Power: UPS system
  • Cost: $200-800
• Second Monitor: For viewing records during consultations
  • Cost: $200-600

Internet Connectivity ($100-300/month):

• Primary Internet: Minimum 25 Mbps upload/download
  • Fiber optic preferred
  • Cost: $60-150/month
• Backup Internet: Mobile hotspot or secondary ISP
  • Cost: $40-150/month

Software and Platforms ($200-800/month):

• Telehealth Platform: HIPAA/GDPR-compliant video software
  • ClinikEHR with integrated telehealth: $200-500/month
  • Alternatives: Doxy.me, Zoom Healthcare, VSee
• Electronic Health Records (EHR): Patient record management
  • Integrated with telehealth platform preferred
• E-Prescribing: Electronic prescription software
  • Often included in EHR
• Payment Processing: Accept online payments
  • Stripe, Square, integrated billing
• Scheduling: Online appointment booking
  • Integrated with EHR preferred

Professional Setup ($500-3,000):

• Consultation Space: Quiet, professional background
  • Neutral wall, good lighting, minimal distractions
• Professional Backdrop: Branded or medical-themed
  • Cost: $100-500
• Soundproofing (Optional): For privacy
  • Cost: $300-2,000

Security and Compliance ($500-2,000/year):

• VPN Service: Secure internet connection
• Antivirus/Security Software: Protect patient data
• Encrypted Storage: HIPAA/GDPR-compliant cloud storage
• Backup System: Automated data backup

Total Technology Investment: $5,000-20,000 (initial) + $300-1,100/month (ongoing)

Step 3: Telehealth Practice Management Software

ClinikEHR offers comprehensive telehealth practice management designed for international practices.

Key Features:

• Integrated Video Consultations: HIPAA/GDPR/PIPEDA-compliant video within platform
• Online Appointment Booking: Patients book and pay online
• Electronic Health Records: Complete EHR with telehealth templates
• E-Prescribing: Digital prescriptions to patient or pharmacy
• Payment Integration: Accept payments via card, bank transfer
• Automated Reminders: SMS/email reminders for appointments
• Patient Portal: Patients access records and consultation history
• Consent Management: Digital consent forms for telehealth
• Secure Messaging: HIPAA-compliant patient communication
• Multi-Currency Support: Bill in USD, CAD, GBP, AUD
• Financial Reports: Track revenue, expenses, profitability
• Insurance Billing: Submit claims with appropriate codes

Telehealth-Specific Features:

• Virtual Waiting Room: Patients wait online
• Screen Sharing: Share information during consultations
• Recording (Optional): Record consultations for documentation
• Multi-Device Support: Laptop, tablet, or phone
• Offline Mode: Access records without internet

Pricing: $200-500 USD/month (£160-400 / $280-700 CAD / $320-800 AUD)

Why ClinikEHR for Telehealth:

• All-in-one platform (no multiple tools needed)
• Multi-currency and country-specific compliance
• Works on various internet speeds
• Integrated payment processing
• Comprehensive reporting
• Free 30-day trial

Step 4: Services and Pricing Strategy

Suitable Telehealth Services

Ideal for Telehealth:

• Primary care consultations
• Follow-up appointments
• Chronic disease management (diabetes, hypertension)
• Mental health and counseling
• Prescription refills and medication management
• Medical advice and second opinions
• Dermatology consultations
• Minor illness consultations
• Lab result interpretation
• Health screening and risk assessment

Not Suitable for Telehealth:

• Emergency conditions
• Conditions requiring physical examination
• First-time diagnosis of serious conditions
• Procedures requiring hands-on intervention
• Situations requiring immediate diagnostic tests

United States Pricing

Consultation Fees:

• New Patient Consultation: $75-200 (30-45 minutes)
• Established Patient: $50-150 (15-30 minutes)
• Follow-up Consultation: $40-100 (10-20 minutes)
• Specialist Consultation: $150-400 (30-60 minutes)

Subscription Models:

• Monthly Membership: $50-150/month (unlimited consultations)
• Family Plan: $100-300/month (up to 4 members)
• Corporate Package: Custom pricing for employee health

Canada Pricing (CAD)

Consultation Fees:

• New Patient: $80-180
• Established Patient: $50-120
• Follow-up: $40-80
• Specialist: $150-350

Provincial Billing:

• Bill provincial health plans directly
• Fee codes for virtual care
• Private billing for non-covered services

UK Pricing (GBP)

Consultation Fees:

• GP Consultation: £40-100
• Specialist Consultation: £100-250
• Follow-up: £30-70
• Prescription Service: £20-50

Subscription Models:

• Monthly Membership: £30-80/month
• Family Plan: £60-150/month

Australia Pricing (AUD)

Consultation Fees:

• Standard Consultation: $60-150
• Long Consultation: $100-250
• Follow-up: $40-100
• Specialist: $150-400

Medicare Billing:

• Bulk bill or private bill
• Medicare telehealth item numbers
• Gap payments for private billing

Step 5: Marketing and Patient Acquisition

Digital Marketing Strategy

Website and SEO ($5,000-20,000 initial + $500-2,000/month):

• Professional website with online booking
• Local and national SEO optimization
• Patient education content
• Telehealth service descriptions
• Doctor profiles and credentials
• Patient testimonials

Google Ads ($1,000-5,000/month):

• Local search campaigns
• Telehealth-specific keywords
• Retargeting campaigns
• Conversion tracking

Social Media Marketing ($500-2,000/month):

• Facebook and Instagram presence
• Educational health content
• Patient success stories
• Live Q&A sessions
• Targeted advertising

Content Marketing:

• Health blog articles
• Video content (YouTube)
• Podcasts
• Email newsletters
• E-books and guides

Online Reviews:

• Google My Business optimization
• Healthgrades, Zocdoc, Vitals profiles
• Encourage patient reviews
• Respond to all reviews

Professional Networking

Physician Referrals:

• Build relationships with local physicians
• Offer specialist consultations
• Provide timely reports
• Easy referral process

Corporate Partnerships:

• Approach employers for employee health programs
• Offer corporate wellness packages
• Provide occupational health services

Insurance Networks:

• Join insurance provider networks
• Become preferred provider
• Credentialing process

Patient Retention Strategies

Excellent Service:

• Minimal wait times
• Professional, caring approach
• Clear communication
• Follow-up care

Convenience:

• Easy online booking
• Flexible scheduling
• Quick prescription refills
• Accessible patient portal

Engagement:

• Automated appointment reminders
• Health tips and education
• Birthday greetings
• Wellness check-in messages

Step 6: Financial Planning

Startup Costs Summary

Item	Solo Practice	Hybrid Practice	Group Practice
Licensing & Legal	$5K-25K	$8K-35K	$15K-60K
Technology Setup	$5K-20K	$10K-35K	$25K-75K
Software (First Year)	$2.4K-6K	$4K-10K	$10K-25K
Professional Setup	$500-3K	$2K-8K	$5K-20K
Insurance	$3K-10K	$5K-15K	$10K-30K
Marketing Launch	$3K-15K	$8K-30K	$20K-60K
Working Capital	$5K-15K	$10K-30K	$25K-75K
TOTAL (USD)	$24K-94K	$47K-163K	$110K-345K

Multiply by 1.4 for CAD, 0.8 for GBP, 1.6 for AUD

Monthly Operating Expenses

Expense	Solo Practice	Hybrid Practice	Group Practice
Internet & Phone	$100-300	$200-500	$500-1.5K
Software Subscriptions	$200-800	$400-1.5K	$1.5K-4K
Marketing	$500-3K	$1.5K-6K	$5K-15K
Insurance	$300-1K	$500-1.5K	$1.5K-4K
Professional Fees	$200-600	$400-1K	$1K-3K
Salaries (if applicable)	$0-3K	$3K-10K	$15K-50K
Miscellaneous	$200-500	$500-1.5K	$1.5K-4K
TOTAL (USD)	$1.5K-9.2K	$6.5K-22K	$26K-81.5K

Revenue Projections

Solo Practice:

• Consultations per day: 8-20 (part-time to full-time)
• Average fee: $75-150
• Working days per month: 20-26
• Monthly revenue: $12K-78K

Hybrid Practice:

• Virtual consultations: 10-25 daily
• In-person visits: 5-15 daily
• Monthly revenue: $25K-150K

Group Practice:

• Providers: 3-8
• Total consultations daily: 40-120
• Monthly revenue: $80K-450K

Profit Margins: 50-70% for virtual-only, 40-60% for hybrid Break-Even: 3-12 months depending on model

Step 7: Best Practices for Telehealth Success

Clinical Best Practices

Patient Selection:

• Screen for telehealth appropriateness
• Clear inclusion/exclusion criteria
• Refer complex cases for in-person care
• Document clinical decision-making

Consultation Quality:

• Ensure good audio/video quality
• Professional environment
• Adequate consultation time
• Thorough documentation
• Clear follow-up plans

Patient Safety:

• Verify patient identity and location
• Emergency protocols in place
• Know when to escalate
• Provide clear instructions
• Ensure patient understanding

Communication:

• Use clear, simple language
• Confirm patient comprehension
• Provide written summaries
• Be available for questions
• Maintain professional boundaries

Technical Best Practices

Reliable Technology:

• Test equipment before sessions
• Backup internet connection
• Keep software updated
• Use secure, compliant platforms
• Have technical support available

Data Security:

• Use encrypted communication
• Secure patient data storage
• Follow privacy regulations
• Have data breach protocols
• Regular security audits

Professional Presentation:

• Good lighting and background
• Professional attire
• Quiet, private space
• Minimize technical issues
• Start on time

Step 8: Common Challenges and Solutions

Challenge 1: Licensing Complexity Solution:

• Use Interstate Medical Licensure Compact (US)
• Start with home state/province
• Expand gradually to high-demand areas
• Consider platform-based practice initially
• Hire licensing consultant if needed

Challenge 2: Technology Issues Solution:

• Invest in quality equipment and internet
• Have backup systems in place
• Provide technical support to patients
• Use user-friendly platforms
• Test technology regularly

Challenge 3: Patient Trust Solution:

• Educate patients on telehealth benefits
• Provide excellent first consultation
• Collect and showcase testimonials
• Build strong online reputation
• Offer trial consultations

Challenge 4: Reimbursement Solution:

• Understand insurance coverage
• Use appropriate billing codes
• Document thoroughly
• Follow up on claims
• Offer direct pay options

Challenge 5: Work-Life Balance Solution:

• Set clear working hours
• Use scheduling software
• Take breaks between consultations
• Don't overbook
• Maintain boundaries

Frequently Asked Questions (FAQs)

How much can I earn from a telehealth practice? Earnings vary by specialty, hours, and model. Part-time telehealth can generate $5,000-15,000/month, while full-time practice can earn $15,000-50,000+/month depending on specialty, volume, and pricing.

Do I need separate licenses for each state/province? In the US, yes—you must be licensed where the patient is located. The Interstate Medical Licensure Compact expedites multi-state licensing. Canada requires provincial licenses. UK and Australia have national registration.

What equipment do I need to start a telehealth practice? Essential equipment includes: quality computer with webcam, reliable internet (25+ Mbps), professional headset, good lighting, quiet consultation space, and HIPAA/GDPR-compliant telehealth software. Total investment: $5,000-20,000.

Can I prescribe medications via telehealth? Yes, in most jurisdictions, following standard prescribing guidelines. US Ryan Haight Act restricts controlled substances without in-person visit. Each country/state has specific regulations. Use e-prescribing systems.

Which telehealth platform is best? ClinikEHR is designed for international telehealth with integrated video, EHR, billing, multi-currency support, and country-specific compliance starting at $200/month. It provides all-in-one solution.

How do I handle emergencies during telehealth consultations? Have clear emergency protocols: verify patient location, guide them to call emergency services (911, 999, 000), stay on line if possible, document thoroughly, and follow up.

Do insurance companies cover telehealth? Coverage has expanded significantly. Medicare (US), provincial plans (Canada), NHS (UK), and Medicare (Australia) cover telehealth. Private insurance generally covers virtual care. Verify specific coverage.

How long does it take to become profitable? Most telehealth practices reach profitability within 3-12 months. Virtual-only practices have lower overhead and faster break-even. Success depends on marketing, patient volume, and operational efficiency.

Related Reading on ClinikEHR

• Telehealth marketing: Telehealth Marketing Strategies
• CPT codes: CPT Codes for Telehealth 2025
• Private practice: Private Practice Software
• EHR selection: Top 5 Free EHR for Private Practice

Conclusion: Building a Successful International Telehealth Practice

Starting a telehealth practice in the United States, Canada, United Kingdom, or Australia is an innovative opportunity that combines clinical expertise with digital technology. With proper planning, regulatory compliance, quality technology, and modern practice management software, you can build a thriving virtual practice with flexibility and scalability.

Key Success Factors:

• Country-specific regulatory compliance and licensing
• Reliable technology and internet infrastructure
• Professional consultation setup and presentation
• Excellent patient communication and care
• Efficient practice management with ClinikEHR
• Effective digital marketing and online presence
• Clear pricing and payment systems
• Strong patient trust and satisfaction
• Appropriate patient selection for virtual care
• Continuous quality improvement

ClinikEHR provides the complete telehealth practice management solution you need, with integrated video consultations, EHR, online booking, payment processing, multi-currency support, and analytics—all in one platform designed for international telehealth practices.

Start Your Telehealth Practice Journey Today

Ready to launch your telehealth practice or add virtual consultations to your existing practice? ClinikEHR offers everything you need to deliver professional telehealth services across the US, Canada, UK, and Australia.

Start Your Free 30-Day Trial - No credit card required. Full access to all telehealth features including video consultations, EHR, and multi-currency billing.

Need help setting up your telehealth practice? Contact our team for a free consultation on how ClinikEHR can help you launch and grow your virtual practice.

Try Our Free Clinical Notes AI Generator: Experience AI-powered documentation with our Free Clinical Notes AI Generator—generate professional telehealth consultation notes instantly.

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For more information on telehealth regulations, consult regulatory bodies: State Medical Boards (US), Provincial Colleges (Canada), GMC (UK), AHPRA (Australia), and healthcare attorneys in your jurisdiction.