How much does it cost to launch a telehealth business?

The useful question is what you already operate. A clinic with licensed clinicians and patient relationships may be buying a better digital workflow. A new cash-pay prescription brand must arrange clinical coverage, fulfillment, merchant approval, and a way to reach patients. Its platform subscription is only one of those purchases.

The prices above come from the vendors' own pages; Bask, OpenLoop, and Beluga require a quote for a numeric comparison.^[4][6][7] Bask's July 2026 article mentions Mini and Growth prices, but its current plans page names Start-up, Enterprise, and Custom. We would not use the older figures as a current offer.^[4][5]

Care and fulfillment are where the quote becomes an operating model

A prescription program has more billing events than a completed order. A patient may submit an intake, require a synchronous visit, need follow-up, be declined, receive a prescription, or return for a refill. Ask whether a clinical fee is triggered by the submitted intake, the clinician review, the visit, the approval, or the filled order. The answer determines what you owe when revenue never arrives.

Beluga publishes a structure with a monthly access fee, different prices for asynchronous and synchronous visits, pharmacy and lab pass-through, and a fulfillment coordination fee. Bask's terms list visit, pharmacy, shipping, dispensing, and transaction fees outside its subscription. Neither page gives you the price for your particular medication, clinical protocol, volume, or service-level agreement.^[7][8]

Build one unit-cost sheet for each patient path. A first consultation with lab work and shipping is a different unit from a refill that requires another review. Record the fee trigger, the party billing you, and the timing of that invoice. If your brand sells several programs, do this separately for each one.

Your states and advertising channel change the launch budget

Start with the states where patients will be located, not just where the company is incorporated. HHS explains that a clinician treating patients across state lines may need a full license, a compact privilege, or a state registration, depending on the jurisdiction. The clinical partner's coverage and your launch geography therefore affect both operating scope and cost. There is no defensible national license line item to copy into every budget.^[9]

Paid search introduces another conditional expense. For U.S. telemedicine advertisers facilitating prescribing, Google's healthcare policy calls for LegitScript Healthcare Merchant Certification and Google certification. LegitScript publishes a $975 application fee per root domain and a $2,150 annual fee due upon approval. For one approved domain, those two published fees total $3,125 in the first year. That figure belongs in a budget only if the program and channel require the certification; it does not include preparation, legal review, or ad spend.^[10][11]

Certification for advertising and approval to accept payments are separate decisions. Stripe says LegitScript is not automatically required for telemedicine payment processing and that restricted businesses are reviewed case by case. Do not assume a Google Ads requirement applies to every processor, or that processor approval permits every ad campaign.^[13][14]

Use your merchant terms for payment costs

Stripe's published standard U.S. price for a successful domestic card payment is 2.9% plus 30 cents. On a hypothetical $150 charge, that is $4.65. At 100 such charges each month, the same arithmetic produces $5,580 over 12 months. It excludes refunds, disputes, other payment methods, and any account-specific terms. Stripe identifies telehealth and prescription activity for additional review, so this is an illustration, not a rate promised to a telehealth merchant.^[12][13][14]

Payment timing matters as much as the rate. A program that collects before clinical review needs a clear path for declined patients, releases, captures, refunds, and disputes. Our analysis of authorization and capture after clinical review covers that workflow in more detail.

A first-year budget with the unknowns left visible

Published prices can populate a few cells. ScalerMD Starter is $12,000 for 12 months with no standard onboarding fee. TelegraMD Plus is $40,988 for its listed subscription and onboarding. Healthie Group is $1,799.88 for 12 months of practice software. None of these is a total launch budget, and they should not be compared until the missing services are priced to the same scope.^[1][2][3]

Leave unknown cells blank until you have partner terms. Also reserve cash for the period between paying vendors and receiving patient revenue. A business can have acceptable order economics and still run short of cash while approvals, campaigns, or payouts are pending.

Price acquisition against paying patients, not leads

The cost of acquiring a customer depends on the offer, channel, claims you can support, and the number of people who make it through clinical review. Divide media, creative, and campaign management spend by completed paying patients. A cost per form submission hides people who are ineligible, decline care, or abandon checkout.

For each cohort, compare collected revenue with the clinical, fulfillment, processing, support, and acquisition costs it generated. Then test whether the remaining contribution covers fixed monthly commitments. Do not assume a repeat purchase or refill until your program and patient data support it. The FTC expects objective health-related advertising claims to have appropriate substantiation, so budget review time before launching creative.^[15]

What to request before treating any quote as a budget

Send each vendor the same program brief: care type, asynchronous or synchronous visits, medications or labs, target states, expected monthly intakes and completed orders, existing systems, and launch date. Ask for written answers to these questions:

1. Which website, checkout, portal, clinical, pharmacy, and support services are included? Which require another contract?
2. What fee is triggered by an intake, review, visit, decline, approval, prescription, shipment, refill, refund, or dispute?
3. Which states and clinicians are covered now, and what changes when we add a state or a new clinical program?
4. Who obtains merchant, advertising, and pharmacy approvals, and when do fees begin if approval or launch is delayed?
5. Who owns the domain, content, patient data, merchant account, and advertising accounts? What does it cost to move them?

Our ScalerMD, OpenLoop, and TelegraMD comparison goes deeper on where platform, clinical, and growth responsibilities sit. For a real budget, the next step is a dated proposal from each partner and a unit-cost sheet for the exact patient journey you intend to sell.