Online Medical Consultation Startup Costs: $227K CAPEX Plus Cash Runway
The researched base case for the cost to start an online medical consultation business is $227,000 in startup CAPEX plus enough working capital to cover a $829,000 minimum cash need in Month 2 That puts practical funding planning at about $106 million before any extra financing buffer The CAPEX includes $150,000 for initial platform development, $25,000 for office setup, $15,000 for IT hardware, $10,000 for specialized software licenses, $12,000 for branding and website design, $8,000 for legal entity and regulatory setup, and $7,000 for initial marketing content Ongoing Month 1 costs also matter: fixed overhead is $10,600 per month, Year 1 payroll is $720,000, and variable costs total 170% of revenue in Year 1
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Estimates capitalized startup assets only for an online medical consultation launch.
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Exclusions This block covers capitalized startup setup only. It excludes inventory, payroll runway, deposits, debt service, working capital, monthly software subscriptions, clinician payroll, marketing after launch, and legal retainers.
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Startup cost summary
Startup cost summary for an online medical consultation platform, covering core buildout CAPEX and excluded cash needs.
Highlighted CAPEX$212,000Base planning example
Excluded cash needs$829,000Outside CAPEX total
Funding need$1,041,000CAPEX + excluded cash needs
Cost Category
Base Estimate
Main Cost Driver
CAPEX Calculator
Initial Platform Development
$150,000
Core product build and launch scope
Yes
Office Setup & Furnishings
$25,000
Workspace setup and furnishings scope
Yes
IT Hardware & Workstations
$15,000
Team hardware and workstation count
Yes
Branding & Website Design
$12,000
Brand and site build scope
Yes
Specialized Software Licenses
$10,000
Clinical and admin software setup
Yes
Operating Reserve
$829,000
Month 2 cash gap from payroll runway and post-launch operating needs
Scenario scale matters because provider count, specialties, integrations, and launch marketing move cash needs fast. Base already uses $227,000 CAPEX and $829,000 minimum cash in Month 2.
Lean, Base, and Full launch cost planning for online medical consultation.
Scenario
Lean LaunchOne-state pilot
Base LaunchFive specialties
Full LaunchMulti-state build
Launch model
Use a smaller SaaS-enabled launch with fewer providers, lighter integrations, and lower marketing intensity.
Use the modeled base case with five specialties, 28 Year 1 providers, and the researched cost stack.
Use a deeper custom platform with more specialties, more integrations, multi-state readiness, and heavier launch campaigns.
Typical setup
Start with a narrow specialty mix and limited-state coverage.
Run a multi-specialty platform with standard integrations, compliant workflows, and steady acquisition.
Expand the provider panel, add custom workflows, and prepare compliance across more states.
Cost drivers
Fewer specialists
lighter integrations
lower paid acquisition
smaller compliance load
28 Year 1 providers
five specialties
$227,000 CAPEX
$10,600 monthly overhead
$720,000 Year 1 payroll
Broader specialty mix
custom integrations
multi-state compliance
heavier launch campaigns
larger tech team
Planning rangeCAPEX only
Lower funding bandSmall pilot
$227,000 CAPEXModeled base case
Higher funding bandMulti-state ready
Best fit
Best for teams testing demand with a small provider panel in one state.
Best for teams that want a balanced launch with clear provider coverage and known fixed costs.
Best for teams that need broader coverage, deeper platform control, and stronger paid growth.
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Planning note: These scenario ranges are researched planning assumptions for model building, not exact quotes or vendor bids.
How much does it cost to start an online medical consultation business?
Starting an Online Medical Consultation business needs about $1.056 million before extra buffer: $227,000 in CAPEX plus $829,000 in minimum cash need by Month 2; for the operating KPI behind that ramp, see What Is The Most Critical Metric For The Success Of Your Online Medical Consultation Service?. CAPEX means one-time launch spend, but it’s not the full budget because wages, fixed overhead, insurance, compliance retainers, software subscriptions, and early revenue ramp also use cash.
Funding need
$227,000 CAPEX launch spend
$829,000 minimum cash by Month 2
$1.056 million base funding target
Month 2 breakeven model output
Year 1 base
10 general practitioners
5 mental health counselors
8 prescription specialists
3 pediatricians and 2 dermatologists
The model also shows an 11-month payback, but treat breakeven and payback as planning outputs, not guarantees.
What hidden costs of starting an online medical consultation business should I budget for?
If you’re budgeting for an Online Medical Consultation, the hidden costs hit before launch: about $8,000 for regulatory setup, then roughly $6,100 per month in ongoing support, as noted in How Much Does The Owner Of An Online Medical Consultation Business Typically Earn?. That monthly burn usually includes malpractice and professional liability at $2,000, legal and compliance at $1,500, cybersecurity and data privacy at $1,200, accounting and payroll at $800, and communication and utilities at $600.
Launch costs
$8,000 regulatory setup
Provider credentialing before launch
Consent workflows need setup
Payment processing fees add up
Monthly burn
$6,100 monthly support base
Customer support needs staffing
Refund handling and chargebacks hurt margin
Slower patient adoption delays break-even
How should I build an online medical consultation financial model?
Build the model from specialty-level visit volume and pricing, then test whether $301,700 in monthly revenue can cover delivery costs and cash needs. With 10 general practitioners, 5 mental health counselors, 8 prescription specialists, 3 pediatricians, and 2 dermatologists, Year 1 volume is 4,260 visits a month. Add $227,000 CAPEX, $829,000 minimum cash, Month 2 breakeven, 11-month payback, and $373,000 Year 1 EBITDA so the fundraising ask matches the runway.
This is the base build cost: $150,000 CAPEX across Months 1 to 6 for video, phone, chat, scheduling, patient intake, consent, admin dashboard, secure messaging, and the patient portal. HIPAA, or the Health Insurance Portability and Accountability Act, pushes extra work into security, access control, audit trails, and patient data handling.
Software spend
Plan for $3,500 per month in platform software licenses, plus 25% of Year 1 revenue for platform usage and cloud hosting. Estimate it from months covered and revenue forecast. SaaS keeps more cost in monthly fees, white-label sits in the middle, and custom build shifts more into upfront CAPEX.
Months covered drive license cost.
Revenue drives usage fees.
Hosting scales with volume.
Build choice
Use SaaS for speed, white-label for faster branding, and custom build only when workflow gaps justify the extra cost. Don’t trim consent tracking or audit logs; those are core HIPAA controls, not nice-to-haves. The cleanest model is simple: keep launch features tight, then price add-ons only after usage proves the need.
Lock must-have workflows first.
Price security with each quote.
Check data access rules early.
Budget split
Keep the budget split clean: one-time development in CAPEX, then monthly licenses and cloud hosting in operating spend. If you mix them, burn looks higher and launch cash looks lower than it is. That split also makes vendor quotes easier to compare on setup fee, subscription fee, and usage fee.
Provider Onboarding, Staffing, And Launch Marketing Startup Expense
Launch Setup
Before launch, this bucket covers clinician recruiting, onboarding, training, clinical protocols, customer support setup, brand launch, search content, paid ad tests, and trust materials. The base CAPEX is $19,000: $7,000 for content creation and $12,000 for branding and website design. Keep this separate from recurring payroll and patient acquisition spend.
Cost Build
Price it by phase, not guesswork. Use quotes for content, design, and website work, then add months of pre-launch labor for recruitment and training. The key input is how long you pay for setup before the first patient books, because that timing drives the real launch bill.
Growth Spend
Paid search and patient acquisition run at 35% of Year 1 revenue, so that spend belongs outside launch CAPEX. The quick split is simple: one-time setup is $19,000, while ongoing marketing scales with revenue. That keeps brand build separate from steady demand generation.
Payroll Burn
Year 1 payroll totals $720,000 across the CEO, Head of Technology, Marketing Manager, Operations Manager, Customer Support Lead, Software Developer, and half-time HR and Admin Specialist. That is about $60,000 a month before marketing, so separate fixed team burn from variable acquisition spend.
Legal, Licensing, Compliance, And Credentialing Startup Expense
Entity Setup
$8,000 covers legal entity and regulatory setup in Months 1 to 2, plus healthcare counsel on HIPAA policies, state practice rules, provider licenses, consent documents, privacy notices, and credentialing workflow design. Treat this as one-time CAPEX, then keep monthly compliance support separate so the budget stays clear.
Monthly Retainer
The ongoing legal and compliance retainer is $1,500 per month, or $18,000 in Year 1. That line pays for policy updates, state rule checks, and review of any new forms or workflows. Keep it separate from setup so founders can see the true monthly burn.
Clinician Checks
Budget provider onboarding checks for 28 Year 1 clinicians across five specialties as a separate variable line. The estimate needs a per-clinician quote for license verification, exclusion checks, consent review, and credentialing steps. Here’s the quick math: 28 checks times the vendor or counsel rate.
Validate each state license.
Confirm specialty-specific rules.
Track onboarding by clinician.
Budget Split
The known Year 1 base is $26,000 before clinician checks: $8,000 setup plus $18,000 in retainer fees. What this estimate hides is the per-clinician credentialing cost, which can move with state footprint and specialty mix, so founders should validate it with healthcare counsel before launch.
Insurance And Risk Management Startup Expense
Coverage mix
For an online medical consultation startup, the core stack is malpractice, professional liability, general liability, cyber liability, and directors and officers coverage if you’re raising capital. Base fixed cost here is $2,000 per month for general and malpractice insurance plus $1,200 per month for cybersecurity and data privacy. One clean rule: insurance is a launch gate and a monthly burn item.
What drives cost
Estimate this with carrier quotes, then test it against specialty mix, state footprint, provider count, patient volume, and claims history. A telehealth group with more prescribers or a wider state map usually pays more because the risk surface is bigger. Here’s the quick math: monthly insurance can start as a fixed line item, but the final price depends on your actual operating model.
Risk controls
Don’t buy coverage and stop there. Pair it with consent capture, clinical protocols, audit logs, incident response, and vendor security review so you lower claim risk and support underwriting. If onboarding is weak or access logs are missing, carriers may price you harder. What this estimate hides is that better controls can matter as much as the policy form.
Budget timing
Build insurance into pre-opening readiness, not just month-one burn. You need active coverage before live patient care, then you carry it as a recurring cost while the platform scales. For this model, the main budget check is simple: $2,000 plus $1,200 each month, then adjust only after you validate specialty scope, states served, and provider growth.
EHR, E-Prescribing, Billing, And Payment Startup Expense
Core data flow
EHR connectivity has to cover intake, charting, e-prescribing, labs, referrals, and message history in one record. For telehealth, the model should support cash-pay checkout, receipt logic, refunds, and reconciliation first. If payer billing is added later, add credentialing status, claim submission, denials, and collection-delay fields.
What it must cover
This expense covers the software work that links patient data to general practitioners, mental health counselors, prescription specialists, pediatricians, and dermatologists. Build inputs for visit type, prescription checks, lab orders, referral notes, payment status, and refund tracking. The main cost driver is how many workflows you connect before launch.
Map specialties to separate visit flows
Track payments by encounter
Store refund and receipt logs
How to control it
Keep the first release cash-pay only unless insurance is required, because payer billing adds denials, credentialing, and slow collections. Payment processing fees should model at 10% of Year 1 revenue, falling to 7% by Year 5. That spread is real margin, so watch checkout conversion and refund rates closely.
Start with cash-pay checkout
Add insurance only if needed
Reconcile every payout daily
Budget check
Here’s the quick math: every $100 of Year 1 revenue carries about $10 in payment fees, then about $7 by Year 5. What this estimate hides is the admin load from refunds, chargebacks, claim edits, and delayed payer cash if you expand beyond self-pay.
