How to Build a Telehealth Private Practice from Scratch in 2026

Starting a telehealth private practice has never been more accessible. The barriers to entry are lower than traditional brick-and-mortar practices, startup costs are minimal, and the potential patient base is nationwide. But success requires more than just hanging a virtual shingle.

Quick Answer

You can launch a telehealth private practice in 4-6 weeks for private pay, or 4-6 months if accepting insurance (due to credentialing). Essential steps: (1) Choose your niche (anxiety, ADHD, perinatal mental health, etc.), (2) Set up business entity (LLC recommended, $200-500), (3) Get licenses and NPI ($500-2,000), (4) Choose tech stack—ClinikEHR provides everything you need: EHR, telehealth, scheduling, billing, patient portal for $0-79/month, (5) Build website and online presence ($100-500), (6) Start with private pay while credentialing processes (90-180 days), (7) Launch with 5-10 patients to test systems. Total startup cost: $1,000-3,000 one-time plus $71-345/month ongoing. Break even at 10 patients/week charging $150/session. ClinikEHR's free plan ($0/month for 20 clients) is perfect for launch phase.

Why ClinikEHR is Perfect for New Telehealth Practices

When starting from scratch, choosing the right technology foundation is critical. ClinikEHR is specifically designed for telehealth-first practices:

Pros of Starting with ClinikEHR:

• All-in-one platform - EHR, scheduling, telehealth, billing in one system
• Free plan to start - $0/month for up to 20 clients (perfect for launch phase)
• Integrated telehealth - no need for separate video platform
• HIPAA-compliant out of the box
• Online booking - patients self-schedule 24/7
• Insurance billing ready - credentialing support included
• Patient portal - secure messaging and documents
• Mobile-friendly - work from anywhere
• No setup fees - start immediately
• Scales with you - upgrade as you grow

Let's build your telehealth practice step by step.

Phase 1: Foundation (Weeks 1-4)

Step 1: Choose Your Niche

Why Niche Matters:

• Easier marketing to specific audience
• Command higher rates as specialist
• Better patient outcomes with focused expertise
• Clearer brand identity
• Less competition

Popular Telehealth Niches:

Mental Health:

• Anxiety and depression
• ADHD assessment and management
• Trauma and PTSD
• Perinatal mental health
• LGBTQ+ affirming therapy

Substance Use Disorders:

• Medication-assisted treatment
• Recovery support
• Harm reduction counseling

Chronic Disease Management:

• Diabetes management
• Hypertension monitoring
• Weight management

Specialty Consultations:

• Dermatology
• Nutrition counseling
• Sleep medicine

How to Choose:

1. What are you passionate about?
2. What's your training and experience?
3. What's the market demand?
4. What can you deliver effectively via telehealth?
5. What's the reimbursement landscape?

Step 2: Business Structure and Legal Setup

Choose Business Entity:

• Sole Proprietorship - Simplest, but no liability protection
• LLC - Liability protection, pass-through taxation (recommended for most)
• Professional Corporation (PC) - Required in some states for healthcare

Register Your Business:

1. Choose business name
2. Register with state
3. Get EIN from IRS
4. Open business bank account

Get Required Licenses:

• State medical/professional license
• DEA registration (if prescribing controlled substances)
• NPI number (National Provider Identifier)
• State business license
• Professional liability insurance

Cost: $500-2,000 for setup

Step 3: Set Up Your Tech Stack

Essential Technology:

1. EHR with Integrated Telehealth (ClinikEHR)

• Cost: $0-79/month
• Why: All-in-one solution saves money and complexity
• Features needed:
  • HIPAA-compliant video
  • Clinical documentation
  • E-prescribing
  • Online scheduling
  • Patient portal
  • Billing

2. Business Phone Number

• Google Voice: Free
• RingCentral: $20-30/month
• Why: Separate from personal phone

3. Business Email

• Google Workspace: $6/month
• Why: Professional appearance, HIPAA-compliant with BAA

4. Website

• Squarespace/Wix: $16-30/month
• WordPress: $5-15/month
• Why: Online presence for marketing

5. Payment Processing

• Stripe: 2.9% + $0.30 per transaction
• Square: 2.6% + $0.10 per transaction
• Why: Accept credit cards easily

Total Monthly Tech Cost: $50-150/month

Phase 2: Credentialing and Insurance (Weeks 5-12)

Step 4: Decide on Payment Model

Three Options:

Option 1: Private Pay Only

• Pros: Simpler, no insurance hassles, higher rates
• Cons: Smaller patient pool, marketing harder
• Best for: Specialized niches, established reputation

Option 2: Insurance Only

• Pros: Larger patient pool, steady referrals
• Cons: Lower rates, administrative burden, credentialing time
• Best for: Building volume quickly

Option 3: Hybrid (Recommended)

• Pros: Flexibility, diversified income
• Cons: More complex billing
• Best for: Most new practices

Step 5: Get Credentialed (If Accepting Insurance)

Timeline: 90-180 days

Process:

1. Choose Payers - Start with 2-3 major insurers in your state
2. Gather Documents:
   • CV
   • Licenses
   • DEA certificate
   • Malpractice insurance
   • W-9
   • CAQH profile
3. Submit Applications - Through CAQH or directly
4. Follow Up Weekly - Credentialing is slow
5. Get Contracted - Negotiate rates if possible

Credentialing Services:

• DIY: Free but time-consuming
• Credentialing Service: $500-2,000 per payer
• ClinikEHR Support: Included guidance

Phase 3: Marketing and Launch (Weeks 8-16)

Step 6: Build Your Online Presence

Essential Marketing Assets:

1. Professional Website

• About you and your approach
• Services offered
• Insurance accepted
• Online booking link
• Contact information
• Blog (optional but helpful)

2. Google Business Profile

• Free listing
• Shows up in local searches
• Collect reviews

3. Psychology Today Profile (for mental health)

• $30/month
• High-quality referrals
• Easy to set up

4. Social Media Presence

• Choose 1-2 platforms
• Post weekly
• Educational content
• Don't overthink it

Step 7: Set Your Rates

Research Market Rates:

• Check competitors in your niche
• Consider your experience level
• Factor in your costs

Typical Telehealth Rates:

• Initial Evaluation: $150-300
• Follow-up Sessions: $100-200
• Medication Management: $100-150
• Brief Check-ins: $75-100

Insurance Reimbursement:

• Typically 50-70% of private pay rates
• Varies by payer and location

Step 8: Launch Strategy

Soft Launch (Weeks 12-14):

• See 5-10 patients
• Test your systems
• Refine workflows
• Get comfortable with telehealth

Official Launch (Week 15+):

• Announce on social media
• Email professional network
• Activate marketing channels
• Start accepting new patients

Phase 4: Growth and Optimization (Months 4-12)

Step 9: Track Your Metrics

Key Performance Indicators:

• New patient inquiries per week
• Conversion rate (inquiries to scheduled)
• Show rate (scheduled to attended)
• Revenue per patient
• Patient retention rate
• Marketing ROI

Use ClinikEHR Analytics:

• Built-in reporting
• Track all metrics automatically
• Identify trends
• Make data-driven decisions

Step 10: Scale Your Practice

Growth Strategies:

Increase Capacity:

• Add evening/weekend hours
• Reduce session length (45 min → 30 min for some)
• Optimize scheduling

Expand Services:

• Add group therapy
• Offer workshops
• Create digital products
• Supervision/consultation

Hire Help:

• Virtual assistant ($15-25/hour)
• Billing specialist ($20-35/hour)
• Marketing consultant ($50-150/hour)

Add Providers:

• Hire associate therapists
• Supervision model
• Group practice

Common Mistakes to Avoid

Mistake #1: Waiting Until Everything is Perfect

The Problem:

• Spend months planning
• Never actually launch
• Miss opportunities

The Solution:

• Launch with "good enough"
• Improve as you go
• Done is better than perfect

Mistake #2: Trying to Serve Everyone

The Problem:

• Generic marketing
• No clear brand
• Harder to stand out

The Solution:

• Pick a niche
• Become known for something specific
• Easier to market

Mistake #3: Underpricing Your Services

The Problem:

• Attract wrong clients
• Burnout from overwork
• Undervalue your expertise

The Solution:

• Charge what you're worth
• Start higher, adjust if needed
• Remember your overhead costs

Mistake #4: Neglecting Marketing

The Problem:

• Build it and they will come (they won't)
• Inconsistent patient flow
• Feast or famine cycle

The Solution:

• Market consistently
• Even when full
• Build referral pipeline

Mistake #5: Poor Boundaries

The Problem:

• Available 24/7
• Burnout quickly
• Unsustainable practice

The Solution:

• Set clear office hours
• Use scheduling software
• Protect personal time

Startup Cost Breakdown

One-Time Costs:

• Business registration: $200-500
• Professional liability insurance: $500-1,500/year
• Website setup: $100-500
• Initial marketing: $200-500
• Total: $1,000-3,000

Monthly Costs:

• ClinikEHR: $0-79
• Phone: $0-30
• Email: $6
• Website hosting: $15-30
• Marketing: $50-200
• Total: $71-345/month

Total First Year: $1,852-7,140

Break-Even Analysis:

• If you charge $150/session
• And see 10 patients/week
• Monthly revenue: $6,000
• Monthly profit after costs: $5,655-5,929
• Break even: Month 1

Timeline Summary

Month 1:

• Choose niche
• Set up business entity
• Get licenses
• Set up ClinikEHR
• Build website

Months 2-3:

• Submit credentialing applications
• Create marketing materials
• Set up social media
• Soft launch with 5-10 patients

Months 4-6:

• Official launch
• Ramp up marketing
• Build to 15-20 patients/week
• Refine systems

Months 7-12:

• Optimize operations
• Scale to full capacity
• Consider expansion
• Evaluate year one

Why ClinikEHR is the Best Choice for New Telehealth Practices

Start Free, Scale as You Grow:

• Free Plan: $0/month for up to 20 clients
• Starter Plan: $29/month for up to 50 clients
• Professional Plan: $79/month for unlimited clients + AI notes

Everything You Need in One Platform:

• Integrated telehealth (no separate video platform needed)
• Online scheduling with patient self-booking
• Clinical documentation with templates
• E-prescribing (Professional plan)
• Insurance billing and claims
• Patient portal
• Automated reminders
• Payment processing
• HIPAA-compliant

Built for Telehealth:

• Mobile-friendly for patients
• Works on any device
• Reliable video quality
• Easy for patients to join
• No downloads required

Support for New Practices:

• Free setup assistance
• Credentialing guidance
• Practice management resources
• Responsive support team
• Growing community

Frequently Asked Questions

Q: How long does it take to start seeing patients? A: If going private pay only, you can see patients within 4-6 weeks. If accepting insurance, add 90-180 days for credentialing.

Q: Do I need a physical office for a telehealth practice? A: No. You can practice from home as long as you have a private, professional space for sessions. Check your state's requirements.

Q: Can I practice telehealth across state lines? A: You must be licensed in the state where the patient is located during the session. Some states have interstate compacts that make this easier.

Q: How much can I realistically make in my first year? A: Depends on your rates and volume. At $150/session, seeing 15 patients/week = $117,000/year gross. Subtract 30-40% for expenses and taxes.

Q: What if I'm not tech-savvy? A: ClinikEHR is designed to be simple. If you can use email and browse the web, you can use ClinikEHR. Plus, we provide setup support.

Q: Should I start part-time or full-time? A: Most clinicians start part-time while maintaining other income. Transition to full-time once you have 15-20 consistent patients/week.

Q: Do I need malpractice insurance for telehealth? A: Yes, absolutely. Make sure your policy covers telehealth. Cost is typically $500-1,500/year.

Q: How do I handle emergencies in telehealth? A: Have a crisis protocol, know local emergency resources in patient's area, and have clear informed consent about limitations of telehealth.

Ready to Start Your Telehealth Practice?

Building a telehealth practice from scratch is achievable with the right plan and tools. ClinikEHR provides everything you need in one affordable platform.

Next Steps:

1. Start Free with ClinikEHR - No credit card required, no time limit
2. Choose your niche - What will you specialize in?
3. Set up your business - LLC, licenses, insurance
4. Build your online presence - Website, Google, directories
5. Launch and iterate - Start seeing patients, improve as you go

Need Help Getting Started?

Contact our team - We've helped hundreds of clinicians launch successful telehealth practices. We can help you too.

Join our community - Connect with other telehealth practitioners, share experiences, and learn from each other.

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About ClinikEHR ClinikEHR is the #1 rated EHR for telehealth and private practices. Our mission is to empower healthcare providers to deliver exceptional care through technology that works for them, not against them. With features like integrated telehealth, AI-powered clinical documentation, and seamless insurance billing, ClinikEHR helps you focus on what matters most: your patients.

Related Reading on ClinikEHR

• Telehealth guides: Telehealth EHR for Solo Practitioners | Cross-State Telehealth Rules | Can You Prescribe Outside the US
• Practice setup: How to Start a PMHNP Private Practice | Best Guide to Starting Telehealth Practice
• Marketing: How to Market Telepsychiatry Practice | Telehealth Marketing Strategies | How to Get Therapy Clients Online
• Business models: Private Pay vs Insurance | Headway, Alma, Grow: Do You Need Your Own EHR?
• EHR selection: Best EHR for Solo Practice | EHR Pricing Explained
• Credentialing: Insurance Credentialing Made Simple | How to Start Billing Insurance

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Last updated: January 2026. Regulations and best practices evolve. Verify current requirements in your state.