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What you will learn from this read?
Starting your own telemedicine practice in the United States can seem like a formidable task, particularly if you’re lacking the necessary information.
However, equipped with the right knowledge and resources, you can successfully embark on this journey without even needing to quit your current job.
Together, we’ve assembled a comprehensive, step-by-step guide that aims to simplify this process for you.
This guide serves as a valuable resource for various medical professionals such as licensed physicians, MDs, DOs, nurse p
But before we delve into the details of starting your business, let’s first explore the rapid expansion of telemedicine or telehealth and understand its impact on existing and new medical businesses. By grasping the “why” behind telemedicine’s growth, we can more effectively navigate the “how” of beginning your very own telemedicine practice.
Why Telemedicine?
The remarkable benefits of telemedicine cannot be overstated. As a physician, it offers you the fantastic opportunity to engage with patients more conveniently and inexpensively.
Just imagine the liberation of not needing to expand your clinic, hire additional staff, or lease a new office – all while successfully advancing your practice.
This innovative medical approach allows you to reach more patients, without the necessity of leaving the comfort of your home or office.
Moreover, the ascendancy of telemedicine doesn’t stop at convenience alone. An exciting new reality is rapidly unfolding – telemedicine is leading the way into the future of medical practice.
A glance at the following statistics will illuminate the sheer impact and potential of this cutting-edge trend.
What Is Telemedicine?
Telemedicine (or telehealth) lets healthcare providers diagnose and treat patients remotely using secure video, phone calls, or messaging. It’s ideal for:
Routine check-ups
Chronic condition management (e.g., diabetes)
Mental health therapy
Follow-up visits
Key Features:
HIPAA-compliant platforms (like Doxy.me or Zoom for Healthcare) protect patient privacy.
Patients avoid travel and wait times.
Providers can reach underserved areas.
Why Is Telemedicine Important?
Since COVID-19, telehealth has become a standard part of healthcare.
Insurance coverage expanded: Medicare, Medicaid, and private insurers (see CMS guidelines) now pay for telehealth visits at the same rate as in-person care.
Safety: Reduces exposure to illnesses.
Access: Helps seniors, busy parents, and rural patients get care faster.
Cost-effective: Clinics save on overhead; patients save time/money.
Did You Know?
Before 2020, telehealth was mostly limited to rural areas. Today, 82% of U.S. patients have used it (Rock Health Report).
Types of Telemedicine Services
Live Video Visits (Interactive Medicine)
Store-and-Forward
Providers share patient records (e.g., lab results, X-rays) with specialists for review.
Example: A dermatologist assesses a skin photo sent by a primary care doctor.
Remote Patient Monitoring (RPM)
Wearables (like blood pressure cuffs or glucose monitors) send data to providers.
Ideal for chronic conditions (CDC tips on RPM).
Key Benefits
For Patients:
No commute or waiting rooms.
Easier access to specialists (e.g., mental health NPs).
For Providers:
Lower overhead costs.
Fewer no-shows (studies show 50% less).
Example:
A nurse practitioner can manage a full telemedicine practice from home, seeing 20+ patients daily without renting office space.
Key steps to set up a telemedicine practice successfully.
- Medical Board Certification (Optional).
- Medical Licensing
- NPI.
- EIN.
- Office Space & Address.
- Bank Account.
- Medical Malpractice.
- DEA Registration (Optional).
- Provider Enrollment and Credentialing.
- HIPAA-Compliant Audio Video Software.
- Medical Billing.
- Collaborative & Supervising Physician (Optional).
- Practice Marketing & Re-Targeting.
- The Good News.
Board Certification for Nurse Practitioners in Telehealth
Medicare and most commercial health insurers in the U.S. require nurse practitioners (NPs) to hold board certification from an accredited agency (e.g., AANP or ANCC) to enroll as providers—whether practicing in-person or via telehealth.
Key Notes:
Physicians often don’t need board certification, but rules vary by state and payer.
NPs in all specialties must be certified, unlike some other healthcare roles.
Why It Matters?
Without certification, you cannot bill Medicare/Medicaid or most private insurers—a critical step for reimbursement.
State Licensing for Telemedicine Practice
To start your own telehealth practice, you must be licensed in the state where your patients are located. Here’s what to know:
How to Get Licensed:
Apply through your state’s medical board (find yours here).
Licensing typically takes 2–6 months, but some states offer
Temporary licenses (processed in 7–14 days).
Waivers (common during public health emergencies like COVID-19).
Pro Tip:
If serving patients in multiple states, check the Nurse Licensure Compact (NLC)—it allows NPs to practice across participating states with one license.
Next Steps:
Contact your state board for updates on temporary licensing.
For multistate practice, research interstate telehealth laws (FSMB guidelines).
If you are not familiar with the licensing process, you can get FREE advice here from our experienced team.
Get Your National Provider Identifier (NPI) Number
Every nurse practitioner needs an NPI number—a unique ID required for billing insurance, prescribing medications, and credentialing.
How to Apply for Your NPI
Apply Online for Free:
Use the CMS NPI Enrollment portal (takes ~20 minutes).
No fee is required—it’s free directly through the government.
Need Help? We Assist at No Cost:
Our team guides you through the process for free—we never charge for NPI setup.
Just fill out our contact form (at the bottom of this page), and we’ll help you get your NPI quickly.
Why This Matters:
Without an NPI, you can’t bill insurers or legally practice.
Avoid third-party services that charge fees—the official process is simple and free.
If you’re starting a telemedicine practice as a nurse practitioner, you may need an Employer Identification Number (EIN)—a unique tax ID for your business. Here’s what you should know:
When an EIN Is Required
Operating as a Business: If you’re forming an LLC, S-Corp, or partnership, you’ll need an EIN for tax filings, hiring employees, and opening a business bank account.
Billing Insurance Companies: Many insurers require an EIN for credentialing and reimbursement.
When You Might Not Need an EIN
Sole Proprietors Using Personal SSN—If you’re running your practice under your own name (not a business entity) and don’t plan to hire employees, you can use your Social Security Number (SSN) instead.
However, getting an EIN adds professionalism and separates personal/business finances.
How to Get or Retrieve Your EIN
🔹 Apply for Free: Get an EIN instantly from the IRS website.
🔹 Lost Your EIN? If you misplaced your confirmation letter, call the IRS Business & Specialty Tax Line at 800-829-4933 to recover it.
Why This Matters for NPs
An EIN helps:
Protect your SSN from fraud when dealing with vendors/insurers.
Simplify tax reporting and business banking.
Prepare for future growth (e.g., hiring staff).
Next Step:
If forming an LLC, check your state’s business registration site to complete legal requirements.
Office Space & Address
Many NPs assume they need a physical office to start a telemedicine practice—but that’s not true. While an office can help if you plan to scale, you can launch your practice from home to save costs.
Key Points:
Use your home address for administrative tasks (e.g., business registration, insurance credentialing).
Patients don’t visit in person, so a professional home setup suffices.
Upgrade to a dedicated office later if needed.
Tip: Ensure your workspace is quiet, private, and HIPAA-compliant for patient calls.
Business Bank Account
Separate your personal and business finances by opening a business bank account. Here’s how:
Get a Tax ID (EIN) from the IRS (free via IRS.gov).
Use your EIN (or SSN for sole proprietors) to open an account.
Set up direct deposit for insurance payers (e.g., Medicare).
Why It Matters:
Most insurers (including Medicare) require direct deposit for faster payments.
Avoid managing paper checks—automate revenue flow.
Resource: Medicare Direct Deposit Setup Guide.
Malpractice Insurance
Telemedicine practices require professional liability insurance (typically 1,000–2,000/year for NPs).
Coverage Types:
Claims-made: Covers incidents only during the policy period.
Occurrence-based: Covers incidents even after the policy ends (recommended).
Top Pick for NPs: CM&F Group offers affordable, NP-tailored policies with quick approval.
Pro Tip: Some insurers require malpractice coverage before credentialing—check payer rules.
DEA Registration
If prescribing controlled substances (e.g., ADHD meds, opioids), you’ll need a DEA license ($888 for 3 years). Apply at DEA.gov.
Note: Some states restrict NP prescribing—verify your state’s regulations.
Insurance Credentialing
Credentialing with insurers (e.g., Medicare, Blue Cross) is critical for reimbursement.
Steps:
Start with Medicare (takes 2–4 months; no malpractice insurance required).
Expand to private payers (e.g., Aetna, UnitedHealthcare).
Why It Pays Off:
In-network status lists you on insurer directories, attracting referrals.
PCPs may assign you 400+ patients if you’re a primary care NP.
Need Help? Our team specializes in fast-track credentialing for NPs.
Cost for telemedicine credentialing services:
Telemedicine Credentialing & Insurance Enrollment
To maximize patient volume, getting credentialed with insurance payers is key. Here’s what you need to know:
Costs: Credentialing companies typically charge 200 per payer per provider. Some offer bulk discounts (e.g., $1,000 for 10 payers or $2,000 for 18–20 payers).
Why It’s Worth It: Enrolling with multiple payers (like Medicare, Aetna, or Blue Cross) expands your patient base and revenue potential.
Outsourcing Saves Time: Let experts handle paperwork, payer analysis, and direct deposit (EFT) setup so you can focus on patient care. (Learn more about credentialing for NPs.)
Pro Tip: If you plan to hire other providers later, streamline credentialing early to avoid delays.
Choosing a Telehealth Platform
During the COVID-19 public health emergency, CMS relaxed rules, allowing providers to use everyday tools like Skype, FaceTime, or WhatsApp for telehealth. However, for long-term practice:
HIPAA-Compliant Tools: Use secure platforms like Doxy.me or Zoom for Healthcare to protect patient privacy.
Audio-Only Visits: Permitted in some cases, ideal for patients with limited internet access.
Note: Post-pandemic, some states reinstated stricter platform requirements—check your state’s telehealth laws.
Why Start Your Own Telemedicine Practice?
Higher Growth Potential: Building your own brand can outpace a traditional salary over time.
Flexibility: Set your schedule and services (e.g., chronic care, mental health).
Next Steps:
Get credentialed with insurers.
Pick a HIPAA-compliant platform.
Market your practice to attract patients.
For a detailed guide, explore how nurse practitioners can start telehealth.
Medical Billing for Your Telemedicine Practice
Once you begin seeing patients, you’ll need a system to handle insurance claims and reimbursements. Here’s how to manage billing efficiently:
Option 1: Outsource Medical Billing
Saves time: Focus on patient care while experts handle claims.
Faster payments: Billing companies streamline cash flow and reduce claim denials.
Cost: Typically 3–5% of monthly collections (e.g., 500 10,000 in revenue). Some offer flat-rate plans.
Recommended Services:
Kareo (for small practices)
AdvancedMD (automated claims tracking)
- RxCredentialing offer best billing services
Option 2: In-House Billing
Use telehealth-friendly EHRs with built-in billing (e.g., AthenaHealth).
Learn telehealth billing codes (e.g., CPT 99441–99443 for virtual visits).
Pro Tip: If billing in-house, train staff on payer-specific rules to avoid denials. Medicare reimburses NPs at 85% of physician rates.
Collaborative Physician Rules for NPs in Telemedicine
Starting a telemedicine practice as a nurse practitioner? State laws vary widely on whether you need a collaborative or supervising physician. Here’s what you need to know:
Full-Practice States (22 states): You can practice independently with no physician oversight. Check if your state is on the list.
Reduced-Practice States (13 states): You’ll need a written agreement with a supervising physician, but they don’t need to be onsite.
Restricted-Practice States: Requires a physician to be onsite or nearby (e.g., within 30 miles).
Pro Tip: If your state requires collaboration, consider partnering with a physician who shares your goals. Need help finding one?
Email us at support@rxcredentialing.com—we offer free advice on physician agreements.
Marketing Your Telemedicine Practice
As a startup, focus on low-cost, high-impact strategies:
Social Media: Create profiles on Facebook, Instagram, and LinkedIn to share health tips and promote your services.
Word of Mouth: Encourage satisfied patients to refer others.
SEO: Optimize your website for terms like “telemedicine NP in [Your State]” to attract local patients.
Example: Post short videos about common health concerns (e.g., “How to Manage Diabetes at Home”) to build trust.
Already Working as an NP? Launch Faster!
If you’re currently employed, you likely already have
A medical license and malpractice insurance
NPI and EIN (tax ID)
A home office (perfect for telehealth!)
Use these resources to start small, test demand, and scale gradually.
FAQs: Starting a Telemedicine Practice
1. Do I need a medical license for telemedicine?
Yes—you must be licensed in the state where your patients are located. Learn more about licensing.
2. What HIPAA-compliant software should I use?
Platforms like Doxy.me or Zoom for Healthcare meet privacy standards.
3. How do I bill for telemedicine visits?
Use telehealth-specific CPT codes (e.g., 99441–99443). Medicare reimburses NPs at 85% of physician rates.
4. Do I need malpractice insurance?
Yes! Ensure your policy covers telehealth (e.g., CM&F Group).
5. Can I prescribe medications via telemedicine?
It depends on your state and DEA registration. Check DEA rules here.
