Telehealth Industry Staffing Costs 2026

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Telehealth went from a pandemic accommodation to a permanent delivery channel in the space of about two years. By 2026, 76% of U.S. hospitals offer some form of virtual care, telemedicine utilization sits at roughly 38 times its pre-pandemic baseline, and virtual-first health plans have moved from a niche product to a mainstream coverage option (McKinsey, 2024; American Hospital Association, 2025). The staffing costs have followed the growth.

Telehealth has a different cost profile than traditional clinical delivery. The clinical roles - nurses, physicians, care coordinators - carry compensation close to their in-person equivalents, because the credential requirements are identical and the labor market is shared. The administrative and support functions - schedulers, scribes, billing - run partly or entirely remote by default, which opens up outsourcing options that in-person care never offered at scale.

This article pulls from Bureau of Labor Statistics Occupational Employment and Wage Statistics data (May 2024 OEWS release, published March 2025), ZipRecruiter and Glassdoor compensation surveys, MGMA physician compensation benchmarks, Mercer workforce analytics, Deloitte health system research, and NSI Nursing Solutions retention data to give telehealth operators, health system leaders, and virtual-first startups a current cost baseline for the year ahead.

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Labor as a percentage of telehealth operating costs

Every telehealth organization - whether it is a large health system's virtual care division, a direct-to-consumer platform, or a specialty telemedicine provider - faces the same cost reality: the people cost more than everything else combined.

Telehealth operating cost breakdown (Deloitte Health System Cost Benchmarking, 2025):

• Labor's combined share - clinical plus administrative - runs 55-70% of total operating costs across telehealth business models, according to Deloitte health system benchmarking data (2025).
• For direct-to-consumer telehealth platforms where marketing spend is higher, labor as a percentage can compress to the low end; for health system virtual care units where overhead allocation is different, it often pushes toward 70%.
• MGMA benchmarking data for physician group practices finds that physician compensation and benefits alone represent 48-56% of group revenue, a figure that transfers directly to telehealth divisions operating with employed physicians.
• Technology infrastructure is the second-largest cost driver, but it is capital-efficient relative to a physical clinic. The savings on real estate and physical plant largely offset the platform and bandwidth costs.

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Average salaries by telehealth role (2026)

Telehealth nurse

Telehealth nurses provide virtual triage, chronic disease management, post-discharge follow-up, medication counseling, and remote patient monitoring. The credential requirement is a standard RN license; the role is the same license in a different channel.

• BLS Registered Nurses (SOC 29-1141) median annual wage: $86,070 (May 2024 OEWS)
• Telehealth-specific RN postings on ZipRecruiter carry an average base salary of $89,600/yr, reflecting the 5-10% premium the virtual channel commands for tech-comfortable candidates with strong asynchronous communication skills (ZipRecruiter Wage Trends Report, Q1 2026)
• Glassdoor self-reported data for telehealth nurse roles shows a range of $72,000-$108,000, with the median clustering around $88,500
• Remote patient monitoring (RPM) nurses, a subspecialty within telehealth nursing, average $92,000-$98,000 due to the additional data interpretation workload

Benefits add roughly 25-30% on top of base salary. A fully loaded telehealth RN costs a virtual care employer $108,000-$127,000 per year when health insurance, retirement contribution, malpractice coverage, licensing reimbursement, and payroll taxes are included.

Virtual physician / telemedicine physician

Physician compensation is the dominant labor cost line in any telehealth operation that includes medical supervision or physician-driven care.

• BLS Physicians and Surgeons (SOC 29-1210) median annual wage: $229,300 (May 2024 OEWS). This covers all practice settings including telehealth.
• MGMA Physician Compensation and Production Report (2025) reports that physicians in hospital-employed or health system-affiliated roles earn a median of $284,000-$367,000 for primary care, and $420,000-$580,000 for specialists, depending on specialty mix.
• ZipRecruiter's aggregated telehealth physician postings show an average of $241,000/yr for primary care physicians in virtual-first practices, which aligns with the BLS median after accounting for the national geographic distribution (ZipRecruiter, Q1 2026).
• Locum tenens physicians covering telehealth shifts bill at $150-$225/hr for primary care, according to Mercer staffing rate benchmarks (2025). A full-time equivalent position filled by locum physicians costs $312,000-$468,000 annually in direct staffing fees, before any recruiting overhead.

The benefits load on physicians is proportionally lower than for hourly staff - typically 15-20% of base in health system settings - but malpractice coverage adds a meaningful line. Telehealth malpractice premiums average $8,000-$18,000/yr per physician depending on specialty and state licensure footprint.

Care coordinator

Telehealth care coordinators manage patient navigation, follow-up scheduling, care plan adherence, referral coordination, and chronic condition monitoring. They are what keeps patients engaged between clinical visits, which in a virtual-only model is most of the care relationship.

• BLS Health Services Managers (SOC 11-9111) median annual wage: $119,840, but this covers a broad category that includes department directors and administrators. Working-level care coordinators in clinical settings fall in a narrower band.
• ZipRecruiter reports an average annual salary of $62,500 for telehealth care coordinator roles, with a range of $46,000-$82,000 depending on clinical complexity, state, and whether the role carries a clinical license (ZipRecruiter, Q1 2026).
• Glassdoor self-reported data for patient care coordinators in virtual/telehealth settings: median $58,000-$68,000/yr.
• Registered nurse care coordinators (those managing complex chronic patient panels) earn toward the upper end: $75,000-$90,000, as the role requires clinical judgment and an active RN license.

Care coordinator roles are among the highest-volume hires for growing telehealth platforms. A mid-sized virtual care organization managing 50,000 active patients typically employs 12-20 care coordinators at a fully loaded cost of $70,000-$95,000 per FTE.

Medical scribe (virtual)

Virtual medical scribes document physician encounters in real time, draft clinical notes, manage EHR data entry, and handle post-visit documentation cleanup. The role is almost entirely remote by nature and does not require clinical licensure.

• BLS does not maintain a standalone medical scribe category. The closest SOC is Medical Transcriptionists (29-2071) with a median annual wage of $33,380 (May 2024 OEWS), though scribes tend to earn slightly more than transcriptionists due to real-time workload demands.
• ZipRecruiter reports an average base salary of $36,200/yr for virtual medical scribes, with a range of $28,500-$45,000 (ZipRecruiter, Q1 2026).
• Glassdoor data shows a range of $31,000-$42,000 for remote/virtual medical scribes, with higher pay in markets where physician demand for scribe support is concentrated (Boston, San Francisco, Seattle).
• Scribing services contracted through third-party companies bill at $15-$25/hr per physician covered, with per-encounter pricing models also common at $3.50-$7.00 per documented visit.

Physicians who use virtual scribes typically recover 8-12 hours per week of direct patient time previously lost to documentation. The ROI case for scribing is about physician productivity, not just documentation cost.

Patient intake specialist / virtual scheduler

Virtual intake specialists and schedulers handle appointment booking, prior authorization, insurance eligibility verification, patient onboarding, and pre-visit data collection. These are fully administrative roles that have been performed remotely at scale in telehealth for years.

• BLS Medical Secretaries and Administrative Assistants (SOC 43-6013) median annual wage: $42,350 (May 2024 OEWS).
• ZipRecruiter average for patient scheduling and intake roles in telehealth/virtual health settings: $41,800/yr, with a range of $33,500-$52,000 depending on complexity and EHR system proficiency required (ZipRecruiter, Q1 2026).
• Glassdoor self-reported data for virtual patient coordinators and telehealth schedulers: $38,000-$48,000/yr median range.
• Telehealth platforms that handle high prior authorization volume or complex multi-specialty scheduling often pay toward the upper range due to the knowledge requirements.

Fully loaded cost including benefits and employer taxes: $52,000-$68,000/yr for a US-based intake specialist. This is the category where remote VA staffing most reliably delivers 40-65% cost reduction.

Billing specialist (medical)

Medical billing specialists handle coding, claims submission, denial management, accounts receivable follow-up, and payer contract compliance. In telehealth, billing carries added complexity because modifier usage, cross-state licensure, and payer-specific telehealth coverage policies all require specialist knowledge that outpaces general billing training.

• BLS Medical Records and Health Information Technicians (SOC 29-2072) median annual wage: $49,370 (May 2024 OEWS). Billing-specific roles track closely to this benchmark.
• ZipRecruiter average for medical billing specialists with telehealth experience: $46,500/yr, range $36,000-$60,000 (ZipRecruiter, Q1 2026). Experience with telehealth-specific modifiers (GT, 95, GQ, POS 02/10) commands the upper range.
• MGMA Healthcare Administrative Salary Survey (2025) places experienced medical billing specialists at group practices at $48,000-$58,000/yr.
• Outsourced billing services typically charge 6-9% of net collected revenue or a flat per-claim rate of $3.50-$8.00. For a practice collecting $2M annually, that translates to roughly $120,000-$180,000/yr in billing fees - often competitive with or cheaper than two full-time in-house billing FTEs when denial management and recovery are factored in.

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Role salary summary table

BLS OEWS data: May 2024 release, published March 2025. ZipRecruiter: Q1 2026 aggregated posting data. Fully loaded cost includes benefits (~25-30% for non-physicians, ~15-20% for physicians), payroll taxes, licensing, and malpractice where applicable.

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Telehealth demand growth and its effect on hiring costs

Strong demand growth does not make hiring easier - it makes it more expensive.

• McKinsey & Company estimates that telehealth utilization is roughly 38 times higher than its pre-pandemic baseline and has stabilized at that elevated level, not retreated (McKinsey Center for US Health System Reform, 2024).
• The global telemedicine market is projected to grow at a 17.2% CAGR through 2030, reaching approximately $455 billion (Grand View Research, 2025). US-based platforms will capture a substantial share.
• BLS projects healthcare occupations overall will add approximately 1.8 million jobs between 2022 and 2032, a 13% growth rate faster than any other major sector (BLS Occupational Outlook Handbook, 2024). A growing portion of those jobs will be in virtual or hybrid care delivery.
• Telehealth-specific nursing demand - particularly for RPM and chronic care management roles - is growing faster than the general RN market. Staffing firms in this space report 2-3x the number of open telehealth nursing requisitions compared to 2021 (AMN Healthcare, 2025 Telehealth Workforce Report).
• Demand for telehealth physicians has been concentrated in primary care, behavioral health, and urgent care. These are the specialties where physician shortages are most acute: the AAMC projects a primary care physician deficit of 20,200 to 40,400 by 2034 (AAMC, 2024 Supply and Demand Projections).

When demand grows faster than talent supply, compensation follows. Telehealth physician salaries have moved 8-12% above pre-pandemic levels after adjusting for inflation, per MGMA benchmarking data (2025). That premium reflects both the competition for licensed providers and the convenience premium some employers are willing to pay to attract physicians who prefer remote practice.

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Telehealth staff turnover rates and replacement costs

Turnover in telehealth clinical roles runs close to traditional healthcare benchmarks, which is a problem, because traditional healthcare benchmarks are high.

Turnover rate benchmarks for telehealth roles:

• NSI Nursing Solutions reports the average hospital RN turnover rate at 18.4% in 2024, a figure that transfers closely to telehealth nursing roles, which share the same labor pool (NSI National Health Care Retention and RN Staffing Report, 2025).
• Medical scribe turnover is structurally high because the role is often a stepping stone to clinical school. The majority of scribes are pre-med, pre-PA, or pre-NP students who remain in the role for 12-24 months before advancing their education.
• Administrative and coordinator roles see higher turnover than clinical roles largely because of compensation ceiling effects. There is limited upward mobility in a pure scheduling or intake function, which makes retention contingent on workplace quality and management.

Replacement cost benchmarks for telehealth roles:

• Telehealth RN: Replacing one RN costs an average of $46,100 to $56,300, including vacancy coverage, recruiting fees, orientation costs, and productivity ramp-up (NSI Nursing Solutions, 2025; based on data consistent with healthcare-industry-staffing-costs-2026 benchmarks).
• Virtual Physician: Physician replacement runs $250,000 to $500,000 when locum coverage during the vacancy, recruiting firm fees (typically 20-25% of first-year compensation), credentialing time, and productivity loss during ramp-up are included (Mercer, 2025).
• Care Coordinator: Replacement cost estimated at $15,000-$28,000, inclusive of recruiting, onboarding, and productivity ramp.
• Medical Scribe: Due to lower wages and shorter tenure expectations, scribe replacement runs $4,000-$8,000 - but at 40-55% annual turnover, the aggregate cost across a scribe team is material.
• Patient Intake / Scheduler: Replacement estimated at $8,000-$14,000 per departure.
• Billing Specialist: Replacement estimated at $12,000-$22,000, reflecting the time required to train for telehealth-specific billing complexity.

For a telehealth organization employing 10 RNs, 3 physicians, 8 care coordinators, 5 scribes, 6 schedulers, and 4 billing specialists - a staffing profile consistent with a mid-sized virtual care platform - expected annual turnover replacement cost runs $420,000 to $720,000 at average rates. That is a recurring cost that does not appear in any technology budget line.

For deeper benchmarks on the cost of employee replacement across healthcare and other industries, see the true cost of employee turnover by industry in 2026.

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Scheduling, intake, and back-office outsourcing: where VA cost savings are largest

The administrative layer in telehealth - scheduling, intake, scribing, billing, patient communication - runs almost entirely on a screen and a keyboard. There is no clinical reason these functions have to be performed from a US-based office.

VA cost comparison for telehealth administrative roles:

• Trained telehealth VAs handling scheduling and intake can process 40-80 appointments per day with EHR proficiency, prior authorization follow-ups, and insurance eligibility checks - performance comparable to US-based staff in high-volume settings.
• Virtual medical scribes sourced from healthcare-trained VA providers typically document at 15-25 notes per physician shift, meeting the output threshold that physicians report as adequate for maintaining clinical workflow.
• Medical billing VAs with specific training in telehealth modifier sets (GT, 95, GQ, modifier 02/10 POS transitions) are available through specialized healthcare staffing providers, closing the knowledge gap that used to make billing an in-house-only function.
• A telehealth organization replacing four US-based administrative FTEs with equivalent VA support saves an estimated $80,000-$170,000 annually, depending on role mix and geographic salary baseline.

The functions least suitable for VA delivery in telehealth are those with direct clinical contact, complex real-time escalation requirements, or state-specific regulatory oversight - roles like clinical care coordinator (RN license required), pharmacy benefits navigation, or complex prior authorization for specialty drugs.

For a broader look at where administrative outsourcing delivers consistent returns in healthcare operations, see healthcare staffing costs 2026.

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What telehealth staffing actually costs at scale

A mid-sized telehealth platform with 5,000-15,000 active patients can expect the following annual labor budget (5 FTE physicians, 10 RNs, 8 care coordinators, 4 scribes, 6 schedulers, 4 billing specialists, fully loaded US-based):

That $4.1 million labor baseline does not include technology platform costs, recruiting, training, or annual merit increases. Converting the 14 non-clinical administrative FTEs (scribes, schedulers, billing) to VA staffing at mid-range savings rates reduces the total by roughly $490,000-$840,000 annually, which represents a 12-20% reduction in total labor spend without touching clinical delivery.

The physician line item is the most important to manage correctly. At $1.45 million for 5 FTEs, physician compensation represents 35% of total staffing cost in this model. Single-digit improvements in physician retention - holding one additional physician per year through retention investment - save more than a full year of administrative outsourcing gains.

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Key cost levers for telehealth operators

1. Reduce physician vacancy days

With replacement costs of $250,000-$500,000 and locum rates of $150-$225/hr, every open physician position is expensive. Structured retention investment - compensation benchmarking, schedule flexibility, administrative burden reduction - typically costs $15,000-$30,000/yr per physician and pays back within the first avoided vacancy.

2. Convert administrative roles to VA delivery

Scheduling, intake, scribing, and billing represent 40-50% of non-physician headcount in most telehealth organizations, and each of those roles carries a 40-65% per-FTE cost reduction when moved to trained VA staffing.

3. Benchmark against telehealth-specific compensation data

Generic healthcare salary surveys are often built on inpatient hospital data. Telehealth roles carry premiums in some areas (RNs comfortable with async communication and remote monitoring tools, billing specialists with telehealth modifier experience) and discounts in others (no shift differential, no commute, no geographic cost adjustment in some cases). Using the wrong baseline overstates some costs and misses real competition for specific skills.

4. Track scribe turnover as a physician cost, not an HR metric

Each scribe transition costs a physician roughly 2-4 weeks of documentation time while the replacement ramps. At 40-55% annual scribe turnover, that drag is continuous. Scribe retention investment or a switch to a managed scribe service returns more physician capacity than adding headcount.

5. Monitor payer policy on telehealth billing

Post-PHE billing rules for telehealth have continued to shift. Clean claims rates for telehealth billers with current payer-specific knowledge run significantly higher than for those working from pre-2020 training. A billing specialist gap costs more than the position's salary in denial write-offs.

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Sources

• Bureau of Labor Statistics, Occupational Employment and Wage Statistics (May 2024, published March 2025)
• BLS Occupational Outlook Handbook, Healthcare Occupations (2024)
• MGMA Physician Compensation and Production Report (2025)
• MGMA Healthcare Administrative Salary Survey (2025)
• ZipRecruiter Wage Trends Report (Q1 2026)
• Glassdoor Salary Data (Q1 2026)
• NSI Nursing Solutions, 2025 National Health Care Retention and RN Staffing Report
• Mercer Health Workforce Report (2025)
• Deloitte, Health System Cost Benchmarking (2025)
• McKinsey Center for US Health System Reform, Telehealth Adoption Report (2024)
• American Hospital Association, 2025 Health and Hospital Trends Report
• Association of American Medical Colleges, Supply and Demand Projections (2024)
• AMN Healthcare, 2025 Telehealth Workforce Report
• SHRM Healthcare Benchmarking Report (2025)
• Association for Healthcare Documentation Integrity (AHDPG), Scribe Industry Survey (2025)
• Grand View Research, Global Telemedicine Market Report (2025)