Cost of Hiring Virtual Medical Assistants in the USA [2026]

The United States is expected to face a massive shortage of healthcare workers by 2026. Lower-wage healthcare occupations, such as medical and nursing assistants, will face a shortage of about 3.2 million workers nationwide. This has led to an increase in the use of virtual medical assistants (VMAs) in the U.S, which is a cost-effective option for practices.

Staffing is the largest controllable overhead for most outpatient practices, and VMAs are changing how that cost looks in 2026. US-based VMAs are expected to charge roughly $22–$30 per hour in 2026, with blended annual equivalents for part-time-to-full-time coverage ranging from $30,000–$72,000, depending on hours, expertise, and responsibilities.

The post will explore the costs of hiring VMAs in the U.S. in 2026, including pricing models, cost-determining factors, comparisons with in-house medical assistants, and budgeting strategies by practice size.

2026 VMA Cost Snapshot

Hourly contracting remains the simplest model for hiring VMAs and predicting cash flow. Clinics using hourly contracts pay only for hours worked and avoid payroll taxes and benefits, but they must track hours and manage quality internally. For budgeting, multiply expected weekly hours by the target hourly rate and add an onboarding buffer equal to 10–20 percent of monthly spend for the first two months. This provides a realistic short-term projection without hidden surprises.

Retainer and dedicated-team models give predictable monthly spend and typically include some training, a named VMA, and an escalation path. These models will appear more expensive per hour because they include client support, reporting, and quality assurance. For 2026 budget planning, treat retainer fees as an operating expense that consolidates recruiting, HR, and training overhead into one predictable line item.

Outcome- or performance-linked pricing is still emerging, but it is useful for billing-specific engagements. Some VMA providers offer revenue-cycle work priced as a percentage of additional collections recovered from denials or untimely claims. In these cases, the upfront cost is lower, but practices must model ROI carefully because the VMA agencies’ incentive structure affects prioritization and timelines.

The costs for U.S.-based VMAs in 2026 depend primarily on task complexity, practice size, and the medical assistant’s level of expertise, as depicted below:

Entry-level administrative VMAs commonly cost $18–$21 per hour, while experienced assistants who handle billing, coding, or clinical documentation typically cost $26-$35 per hour. These figures reflect the marketplace’s movement toward parity with in-office medical assistant wages, while accounting for the contractor model that eliminates employer-paid benefits.

Monthly retainer and subscription packages are common for clinics that want reliable coverage without hiring a full-time employee. Typical monthly plans for part-time (20–40 hours/week) dedicated U.S.-based VMAs usually range from $2,500 to $6,000, depending on whether the service includes specialty billing or prior-authorization work.

Annualized, a full-time equivalent paid through retainer arrangements typically sits in a $50,000–$72,000 range when continuity, quality assurance, and platform fees are included. These annualized figures incorporate the market premium for U.S.-based labor and ongoing platform/service costs.

Smaller clinics often hire VMAs on an as-needed hourly basis, while larger groups favor retainer or dedicated-partner models to lock in SLAs and training. The midpoint rule many practice managers use for 2026 budgeting is $25/hr for routine admin work and $30/hr for specialized revenue-cycle tasks, with a contingency for onboarding and EHR integration costs in the first one to three months.

Cost Variation by Task Type and Skill Level

A clearer way to budget is to break cost expectations down by the work a VMA performs. Routine front-desk tasks such as appointment confirmation and basic data entry typically command lower hourly rates within the national range.

Moreover, revenue-cycle tasks such as coding, denial management, and claims follow-up are priced higher because they require experience and may directly affect collections. Practices should expect a 10–25 percent premium for VMAs who are certified or have demonstrated experience with a specific EHR or payer mix.

Administrative supervision and QA also influence costs. When a clinic requires the VMA to follow detailed clinical workflows, the VMA provider will include an onboarding and auditing regime in its pricing.

Expect to pay for initial setup hours and periodic quality reviews as part of a monthly package, or at a higher hourly rate, in the first 60–90 days. These early costs tend to pay off through fewer billing errors and faster collections.

Cost Comparisons: In-House Vs. VMAs

Practices must compare the full cost of an in-house employee to the price of a VMA to estimate total annual costs for hiring healthcare assistants. The Bureau of Labor Statistics reports median wages for medical assistants, providing a baseline for wage expectations for 2024–2026.

Employers should then add benefits, payroll taxes, equipment, and real estate costs to arrive at a true in-house figure. For VMAs, the staffing agencies typically exclude benefits and office overhead but include any platform or service fees.

The table below provides a compact, conservative one-year comparison for budgeting purposes using rounded 2026 estimates and a U.S.-only scope. Figures are illustrative and should be customized to the specific practice.

Cost Element	In-house FTE*(annual estimate)	VMA(annual equivalent)
Base wage/pay	$44,000–$52,000	$40,000–$62,000 (depends on hours & role)
Benefits & taxes	$11,000–$15,000	$0
Office overhead & equipment	$6,000–$10,000	$0–$2,000 (integration & software)
Training & onboarding	$2,000–$6,000	$1,000–$4,000 (VMA provider onboarding)
Total annual cost	$63,000–$83,000	$42,000–$68,000

*FTE means Full-Time Equivalent; 1.0 FTE = one person working a standard full-time schedule (typically 40 hours/week)

The table clearly shows that hiring VMAs incurs a lower total annual cost than hiring FTEs, especially when the practice requires flexible hours or specialized billing support. The trade-off typically involves management time spent integrating remote workflows and ensuring compliance.

Hidden and Recurring Cost Drivers To Budget For

Practices that treat VMAs as a simple hourly line often forget recurring costs that affect total spend. Integration fees for EHR connections and secure access can be charged as setup fees or embedded in monthly rates.

Periodic training tied to payer changes, coding updates, or EHR upgrades can create additional recurring expenses. A sound 2026 budget includes a technology and training contingency equal to roughly 5–8 percent of annual VMA spend.

Another recurring cost is quality assurance and supervision. Even experienced VMAs require oversight to align with clinic-specific processes. Many VMA agencies bundle periodic audits and performance reporting into their retainer fees, reducing management overhead but increasing monthly costs.

If you manage VMAs directly as contractors, account for the time you will spend reviewing work, running weekly audits, and updating process documents. This internal time is a real cost that should be allocated to the VMA program budget.

HIPAA, Compliance & Safe Operations Costs

Ensuring HIPAA-compliant operations is non-negotiable and adds measurable cost. Practices must enter Business Associate Agreements (BAAs) with any VMA company that accesses PHI, and they must ensure technical safeguards such as encryption and access logs. The U.S Department of Health and Human Services (HHS) provides model BAA language and guidance that practices can use to reduce legal costs and expedite contracting.

Hiring a HIPAA-trained assistant and enforcing encrypted EHR access often increases hourly costs slightly, as healthcare staffing outsourcing companies factor security controls into their pricing. Expect to pay a small premium for a truly secure and auditable setup, and weigh that premium against the far higher costs of a data breach.

Practices seeking a HIPAA-compliant virtual medical assistant should include proof of security controls and signed BAAs as part of their VMA agency selection criteria.

Monthly Impact of Hidden, Recurring & Compliance Costs

Now that we have made the annual comparisons and discussed the factors that account for hidden, recurring, and compliance costs, here’s a waterfall chart visual showing the anticipated impact on monthly costs practices can expect to pay for hiring U.S.-based VMAs in 2026:

Here are the details used to prepare the above visualization:

• Hourly rate: $30 per hour for a U.S.-based VMA.
• Workload: 20 hours per week (part-time), which equals 86.67 hours per month on average (20 × 4.333).
• Base monthly pay: $30 × 86.67 ≈ $2,600.
• Onboarding: $1,500 one-time cost amortized over 6 months → $250/month.
• Tech & integration: $200/month for secure EHR access, VPN, and initial configurations.
• QA & supervision: 8% of base monthly pay → $208/month.
• HIPAA & legal setup: $1,000 one-time amortized over 12 months → $83/month.
• Software licenses: $150/month for any specialized tools or secure comms.

In the above chart, the first bar shows the base monthly pay derived from the hourly rate and the expected hours. Each subsequent bar shows additional recurring or amortized monthly cost items that practices often overlook.

The final bar labeled “True monthly cost” is the sum of all prior bars and represents the realistic monthly budget line item you should plan for once onboarding, tech, QA, HIPAA, and software are folded into the base monthly cost of hiring VMAs for your U.S.-based practice in 2026.

Procurement & Negotiation: How Cost Structures Are Shaped

Effective procurement reduces the total lifetime cost of a VMA program. Structured RFPs that specify tasks, SLAs, and performance metrics shift the pricing toward predictable outcomes. Ask potential providers to break out time spent on onboarding, recurring QA, and software licensing so you can model a clear monthly cost.

Moreover, volume commitments and longer contract terms usually reduce per-hour rates. However, commitments should be made only after pilot results validate performance. Negotiation levers that matter in 2026 include guaranteed response times, delegated escalation paths, and defined KPIs for revenue-cycle tasks.

Practices comfortable with some internal oversight can negotiate lower retainer fees in exchange for a defined share of the training burden. Use a short-term trial with an exit clause to limit long-term exposure while confirming value.

Regulatory & Market Trends Affecting VMA Costs in 2026

The U.S. market for intelligent virtual health assistants was valued at approximately USD 150.32 million in 2024 and is anticipated to reach around USD 1,395.70 million by 2034. This represents a compound annual growth rate (CAGR) of 24.96% from 2025 to 2034.

In terms of regional growth, North America is expected to continue its dominance in the VMA market share in 2026, with a CAGR of over 35.1% through 2027, driven by its advanced healthcare infrastructure and the rapid adoption of speech recognition technologies.

Telehealth and remote care models continue to reduce the need for some on-site staffing, thereby sustaining demand for VMAs and placing upward pressure on experienced U.S.-based rates. HHS telehealth resources show continued adoption among health centers, which creates stable demand for remote administrative support.

Moreover, telehealth reports also underscore that telehealth is now a routine access channel, reinforcing the need for remote operational staff. As demand stabilizes, practices should expect skilled VMAs to command higher hourly rates in specific markets and specialties.

Professional policies and guidance from medical associations affect the cost of compliant staffing. Organizations that require explicit training, certification, or audit trails for VMAs will encounter higher VMA provider fees but lower legal and compliance risk. The American Medical Association (AMA) has issued guidance on the proper use and oversight of virtual assistants, which clinics should factor into their budgeting and contracting.

Cost-Friendly VMA Selection Process

Selecting a suitable, cost-effective VMA for your practice can be a tiring process for healthcare providers in the U.S. in 2026. When choosing a VMA, ensure the contract:

• Clearly separates setup fees from ongoing monthly costs,
• Requires BAAs,
• Defines KPIs that tie to revenue outcomes,
• Allows a short pilot period with financial remedies if performance is inadequate.

A solo practitioner with modest administrative needs may budget for a part-time VMA at 10–20 hours per week and expect an annualized cost between $12,000 and $30,000 in 2026, including a small onboarding contingency.

A small group practice with mixed administrative and billing support needs should plan for a retainer model in the $36,000–$72,000 annual range for a dedicated U.S.-based VMA or small VMA team.

Larger practices that need continuous revenue-cycle support should model multi-VMA arrangements with consolidated management and platform fees and expect the combined spend to scale accordingly. Use your payer mix and current denial rates to refine these estimates.

Use the following simple decision flowchart to identify the most cost-effective VMA option for your practice in 2026:

As per the above flowchart, practices should start by defining a clear, measurable objective (for example: cut billing denials by 25%, reduce front-desk hours by 10 per week, or shorten days in A/R by 15%). Tally the repeatable tasks that feed that objective, estimate weekly hours, and convert those hours into a monthly budget using your target hourly or retainer rates. Build a 10–20% onboarding contingency into months 1–3 for training and EHR integrations.

When selecting a pricing model, weigh how much internal oversight you can provide: hourly contracts minimize commitment but increase admin work, retainers buy predictability and vendor QA, and dedicated-team arrangements favor continuity for revenue-cycle needs. Document baseline metrics (current denial rate, average days in A/R, clinician admin hours per week) so you can measure impact objectively.

Run a short paid pilot (30–90 days) with clear KPIs and a simple reporting cadence: track denial rate change, collections uplift ($), average days in A/R, hours billed by the VMA, and clinician time recovered. Require compliance checks up front, such as signed BAA, HIPAA training proof, and confirmation of secure EHR access, and ensure the contract separates one-time setup fees from ongoing monthly charges.

At pilot end, compare results against your baseline and your budgeted break-even point; if the VMA meets or exceeds targets, scale in controlled stages and negotiate volume discounts or longer-term pricing. If outcomes fall short, narrow the scope (focus on high-impact tasks, such as denials) or end the engagement. The pilot should leave you with clear data, not just impressions.

The Valuable Gist

VMAs change how practices think about staffing costs by shifting fixed payroll obligations into flexible operating spend. Budgeting for VMAs means planning beyond headline rates and accounting for the recurring items that quietly inflate monthly expenses.

Choosing a pricing model is a financial tradeoff. Some models favor predictability while others favor flexibility, and the right choice depends on your clinic’s tolerance for oversight and administrative effort. Compliance and secure operations should be treated as explicit budget items rather than afterthoughts, because investing in privacy and controls reduces legal and financial exposure.

A short, time-limited pilot with measurable performance targets is the most reliable way to validate cost and value before making a longer commitment. When managed as a repeatable financial program rather than a one-off hire, VMAs become a strategic lever to control costs, improve collections, and allow clinical staff to focus on patient care.

Frequently Asked Questions

1. How should I classify VMA costs in my accounting?

Treat VMA fees as operating expenses for contracted services, while any large, one-off software integration costs may be evaluated for capitalization with your accountant.

2. What clause should I include to manage price increases over multi-year VMA contracts?

Include a clear escalation clause that ties rate changes to a known index or scheduled renegotiation windows to limit unpredictable cost drift.

3. How can I allocate VMA costs to specific services or departments?

Divide total monthly VMA expense by encounter volume or relative RVU contribution per service line to assign a per-encounter cost for profitability tracking.

4. How much contingency should I budget for VMA provider transition or turnover?

Reserve a small percentage of annual VMA spend for transition costs to cover overlap staffing, recruitment, and short-term productivity loss during VMA agency changes.

5. Can VMA costs be included in value-based care budgets or shared-savings models?

Yes. Position VMA spending as part of care-management overhead and track attribution of outcomes so that VMA-driven savings can be reported within shared-savings calculations.