"How much does it cost to build a telemedicine app?" is the most common question we get from healthcare founders, practice owners, and health tech CTOs. The honest answer: $80,000 to $350,000 for a full-featured telemedicine platform. But that range is useless without understanding what drives the telehealth app development cost up or down.
We have quoted, scoped, and delivered telemedicine platforms across specialties -- from behavioral health to urgent care to multi-provider clinic networks. This guide breaks down every cost driver we have seen so you can budget accurately before writing a single line of code.
The total telemedicine app development cost depends on three things: which feature modules you include, how deeply you integrate with clinical systems, and whether you are building an MVP or a platform meant to scale to hundreds of providers.
Let us walk through each one.
Cost Breakdown by Feature Module
Every telehealth platform is assembled from discrete feature modules. Some are non-negotiable (video, scheduling), while others depend on your clinical workflows and business model. Here is what each module costs based on our project history.
Video Conferencing (HIPAA-Compliant): $15,000 - $40,000
Video is the core of any telemedicine platform, and it is also where most teams underestimate complexity. A HIPAA-compliant video implementation requires end-to-end encryption, adaptive bitrate streaming for unreliable mobile connections, recording with patient consent workflows, and a virtual waiting room.
You have three primary options:
- Twilio Video -- The most common choice. Reliable, well-documented, costs roughly $0.004/min per participant. Quick to integrate but licensing costs scale with usage.
- Vonage (formerly TokBox) -- Strong HIPAA compliance story with signed BAAs. Similar pricing to Twilio with good mobile SDK support.
- Jitsi (self-hosted) -- Open-source, no per-minute fees. Lower ongoing costs but higher upfront engineering effort and you own the infrastructure maintenance.
The $15K end gets you a basic one-to-one video call with encryption. The $40K end includes group sessions, screen sharing, recording with consent management, bandwidth adaptation, and automatic reconnection logic. Most platforms land around $25K-$30K for a production-ready implementation.
Patient Scheduling and Booking: $10,000 - $25,000
Scheduling sounds simple until you account for provider availability rules, timezone handling across state lines, recurring appointment series, automated SMS and email reminders, buffer time between appointments, and multi-location support.
At the lower end, you get a basic calendar with time slot selection and email confirmations. At the higher end, you get intelligent scheduling that accounts for provider licensure by state, appointment type durations, insurance verification queuing, and two-way calendar sync with Google Calendar or Outlook.
Automated reminders alone (SMS via Twilio, email via SendGrid or SES) reduce no-show rates by 25-40%, which makes this module one of the highest-ROI investments in the platform.
Patient Intake and Forms: $8,000 - $20,000
Digital intake replaces the clipboard in the waiting room. At minimum, you need custom form templates, conditional logic (show field B if field A equals X), e-signature capture, document upload for insurance cards and IDs, and PDF generation for clinical records.
The cost variation depends on how configurable the form builder needs to be. A fixed set of intake forms for a single specialty costs $8K-$12K. A drag-and-drop form builder that lets practice administrators create their own forms with conditional logic, scoring, and multi-step workflows pushes toward $20K.
Insurance card scanning with OCR (using Google Vision API or Amazon Textract) adds another $3K-$5K but dramatically reduces manual data entry errors.
E-Prescribing: $15,000 - $120,000
E-prescribing is where telemedicine platform development costs can swing wildly. We wrote a detailed breakdown in our e-prescribing integration guide, but here is the summary.
There are two integration approaches:
- iFrame/embedded integration ($15,000 - $25,000): You embed a certified e-prescribing vendor's interface directly into your application. Faster to implement, but the UX is a compromise -- your providers leave your interface to interact with the vendor's UI.
- Full API integration ($60,000 - $120,000): You build e-prescribing directly into your platform's workflow using the vendor's API. Seamless UX, but significantly more engineering effort and a longer certification process.
On top of development costs, expect ongoing middleware licensing of $50-$75 per prescriber per month. This is a non-negotiable vendor cost that many founders miss in their initial budgeting.
For MVP telehealth platforms, we typically recommend starting with the iFrame approach and migrating to full API integration once you have validated your market and have revenue to justify the investment.
Secure Messaging: $8,000 - $15,000
HIPAA-compliant messaging requires more than a chat UI. You need end-to-end encryption, message persistence with audit trails, file and image sharing with virus scanning, read receipts, typing indicators, and separate channel types for provider-patient and provider-provider communication.
We typically build this on WebSocket connections (Socket.io or native WebSockets) with messages stored encrypted at rest in PostgreSQL. The $8K end covers basic text messaging between a single provider and patient. The $15K end adds group messaging, file sharing, message search, and notification preferences.
Billing and Insurance Integration: $15,000 - $40,000
If your platform handles its own billing rather than deferring to the practice's existing billing system, this module gets complex quickly. A full billing integration includes:
- Eligibility verification (270/271 transactions) -- Real-time insurance checks before appointments
- Claim submission (837P transactions) -- Electronic claim filing to payers
- Remittance processing (835 transactions) -- Automated payment posting
- Patient payments -- Stripe or similar processor for copays and self-pay
- Superbill generation -- PDF superbills for out-of-network providers
Clearinghouse integration (via Availity, Change Healthcare, or Trizetto) handles the EDI transaction routing. Expect $500-$1,500/month in clearinghouse fees on top of development costs.
At the lower end ($15K), you get patient payment processing via Stripe and basic superbill generation. At the higher end ($40K), you get full claim lifecycle management with denial tracking and automated resubmission.
EHR Integration: $10,000 - $30,000
Most telemedicine platforms need to exchange data with existing Electronic Health Record systems. Our EHR integration development guide covers the technical details, but from a cost perspective, the range depends entirely on which EHR vendors you need to support and what data flows you require.
Common integration patterns include:
- Patient demographics sync -- Pull patient records from the EHR into your platform
- Clinical notes passback -- Push encounter notes back to the EHR after a visit
- Lab orders and results -- Order labs and receive results within the telehealth workflow
- Scheduling sync -- Bi-directional appointment synchronization
FHIR API integrations with Epic, Cerner, or Allscripts are the most common. Epic's App Orchard marketplace has streamlined this process, but certification still takes 2-4 months. Smaller or legacy EHR systems that rely on HL7 v2 or custom APIs can double integration costs.
Budget $10K for a single EHR with basic demographics sync. Budget $25K-$30K for multi-EHR support with bi-directional clinical data exchange.
Admin Dashboard: $10,000 - $25,000
Every multi-provider telehealth platform needs administrative tooling for the people running the practice or organization. A production admin dashboard includes:
- Provider management (onboarding, credentials, availability, licensure tracking)
- Reporting and analytics (visit volumes, revenue, wait times, patient satisfaction)
- Audit logs (who accessed what, when -- required for HIPAA compliance)
- User management with role-based access control
- Compliance dashboards (BAA tracking, security incident logs)
At $10K you get basic CRUD operations for provider and user management. At $25K you get a full analytics suite with exportable reports, configurable dashboards, and automated compliance alerting.
Mobile Apps (iOS + Android): $30,000 - $80,000
If your platform requires native mobile applications in addition to a web interface, this is typically the single largest line item. Our medical app development guide covers the full landscape, but for telehealth specifically:
We recommend React Native or Flutter for cross-platform development, which lets you ship iOS and Android from a single codebase. A telehealth mobile app needs:
- Push notifications for appointments and messages
- Biometric login (Face ID, fingerprint)
- Camera access for intake photo capture and document scanning
- Background audio for calls when the app is minimized
- Deep linking from reminder notifications directly into the waiting room
The $30K end covers a streamlined patient-facing app with video, messaging, and scheduling. The $80K end covers both patient and provider apps with full feature parity to the web platform, offline support, and complex navigation flows.
HIPAA Compliance Infrastructure: $15,000 - $35,000
This is not a feature users see, but it is the foundation everything else sits on. HIPAA compliance infrastructure includes:
- Encryption at rest and in transit -- AES-256 for stored data, TLS 1.3 for all connections
- Comprehensive audit logging -- Every access to PHI logged with timestamp, user, and action
- Access controls -- Role-based permissions, session management, automatic logout
- BAA management -- Tracking Business Associate Agreements with every vendor touching PHI
- Penetration testing -- Annual (now required under the 2026 HIPAA Security Rule update)
- SOC 2 preparation -- Documentation and controls for Type II certification
Skipping this module is not an option. HIPAA violations carry penalties up to $1.5 million per violation category, and the 2026 Security Rule update has made enforcement significantly stricter. We build compliance infrastructure from day one on every healthcare project -- retrofitting it later costs 2-3x more.
Total Cost Tiers: MVP to Enterprise
Here is how these modules combine into three common telemedicine platform tiers.
| Tier | Features Included | Cost Range | Timeline | Best For |
|---|---|---|---|---|
| MVP Telehealth | Video + scheduling + messaging + basic intake + HIPAA infrastructure | $80,000 - $150,000 | 3-5 months | Validating with 50-200 patients, single specialty, proving product-market fit |
| Full-Featured Platform | Everything in MVP + e-prescribing + billing + EHR integration + admin dashboard | $150,000 - $250,000 | 6-10 months | Multi-provider practices, revenue-generating platform, insurance billing |
| Enterprise Platform | Everything above + mobile apps + multi-provider workflows + analytics + white-labeling + custom integrations | $250,000 - $400,000+ | 10-14 months | Health systems, telehealth-as-a-service companies, multi-state operations |
Our recommendation for most healthcare startups: Start with the MVP tier. Validate your clinical workflow and patient experience with real users before investing in e-prescribing, billing, and EHR integration. We have seen too many founders spend $250K+ on a full platform only to discover their scheduling flow needs a fundamental redesign after the first 50 patient encounters.
A thorough discovery phase before development begins typically saves 3-5x its cost by catching these issues before they become expensive rework.
Ongoing Costs Most Founders Forget
Development cost is the number everyone fixates on, but the ongoing operational costs of running a telemedicine platform are substantial and often underestimated. Budget for these from day one.
| Cost Category | Monthly Estimate | Annual Estimate | Notes |
|---|---|---|---|
| Video API usage | $500 - $3,000 | $6,000 - $36,000 | Usage-based; scales with visit volume |
| E-prescribing middleware | $50-75/prescriber | Varies by team size | Per-prescriber licensing, non-negotiable |
| Cloud hosting (HIPAA-eligible) | $500 - $2,000 | $6,000 - $24,000 | AWS with BAA or GCP with BAA |
| Monitoring and security | $200 - $500 | $2,400 - $6,000 | Datadog, Sentry, WAF, DDoS protection |
| Maintenance and updates | $3,000 - $8,000 | $36,000 - $96,000 | Bug fixes, OS updates, dependency patches |
| HIPAA compliance (annual) | -- | $10,000 - $25,000 | Risk assessment, penetration testing, audit |
| Total ongoing | $5,000 - $14,000 | $60,000 - $150,000 | Plan for this before you build |
The maintenance line item surprises people the most. iOS and Android release new OS versions annually, breaking things. Dependencies need security patches. HIPAA requirements evolve (as we saw with the 2026 Security Rule overhaul). Video API providers change their SDKs. None of this is optional if you are handling patient data.
Build vs. Buy: When Custom Telemedicine Development Makes Sense
Not every organization needs a custom telemedicine platform. Off-the-shelf solutions have matured significantly, and for many practices, they are the right choice.
Use an Off-the-Shelf Platform If:
- You are a solo practitioner or small practice (under 10 providers)
- Your workflows are standard (video visit, note, bill)
- Your budget is under $50,000
- You need to launch in weeks, not months
- Telemedicine is a supplement to your practice, not the product itself
Popular options: Doxy.me ($0-$35/month per provider), SimplePractice ($29-$99/month), Healthie ($19-$149/month). These platforms handle HIPAA compliance, video infrastructure, and basic scheduling out of the box.
Build Custom If:
- You have 100+ providers or plan to scale there
- You need e-prescribing deeply integrated into your clinical workflow
- You are serving a specific niche with non-standard workflows (psychiatric evaluations, multi-disciplinary care teams, pediatric developmental assessments)
- Your telemedicine platform IS the product (you are a health tech startup, not a practice adding video visits)
- You need deep EHR integration or custom billing workflows
- You require white-labeling for multiple clinic brands
- Off-the-shelf per-seat costs exceed custom platform TCO at your scale
The crossover point where custom development becomes cheaper than per-seat licensing typically happens at 75-150 providers, depending on which off-the-shelf platform you are comparing against and which features you need.
When evaluating this decision, our guide on how to choose a software development partner covers what to look for in a healthcare development team.
Recommended Tech Stack for Telemedicine Platforms
Based on our experience building telehealth applications, here is the technology stack we recommend and why.
Frontend
- React with Next.js -- Server-side rendering for SEO on marketing pages, excellent developer ecosystem, strong TypeScript support. Next.js App Router with server components reduces client-side bundle size, which matters for patients on slow mobile connections.
- React Native (mobile) -- Single codebase for iOS and Android. Access to native APIs for camera, biometrics, and push notifications. Over-the-air updates via CodePush for non-critical fixes without App Store review cycles.
Backend
- Node.js with Express or Fastify -- Event-driven architecture handles concurrent WebSocket connections for video signaling and real-time messaging efficiently. Large ecosystem of healthcare-specific libraries.
- Ruby on Rails -- Strong alternative when rapid prototyping and speed-to-MVP matter more than raw concurrency performance. Convention-over-configuration approach accelerates development of CRUD-heavy admin features.
Video
- Twilio Video -- Best balance of reliability, documentation, and HIPAA compliance. Signed BAA available. Predictable per-minute pricing.
- Vonage -- Strong alternative with comparable features and compliance posture.
- Jitsi (self-hosted) -- Best for organizations with high visit volumes where per-minute API costs become prohibitive. Requires DevOps investment to maintain.
Database
- PostgreSQL -- Battle-tested, excellent JSON support for flexible clinical data schemas, transparent disk encryption (TDE) support, strong audit logging capabilities. Every major cloud provider offers managed PostgreSQL with HIPAA BAAs.
Cloud Infrastructure
- AWS with HIPAA BAA -- Most common choice. Use standard AWS services (EC2, RDS, S3, CloudFront) with a signed BAA. AWS GovCloud is available for organizations requiring FedRAMP compliance but is overkill for most commercial telehealth platforms.
- GCP with HIPAA BAA -- Strong alternative, particularly if you are leveraging Google's healthcare-specific APIs (Cloud Healthcare API for FHIR).
Authentication
- Auth0 or AWS Cognito -- Both support MFA (required under the 2026 HIPAA Security Rule), SSO for enterprise clients, and fine-grained role-based access control. Auth0 has a more polished developer experience; Cognito is cheaper at scale.
Development Timeline by Approach
How long does it take to build a telemedicine platform? Here is what realistic timelines look like, including the phases most estimates leave out.
MVP Telehealth: 3-5 Months
| Phase | Duration | Deliverables |
|---|---|---|
| Discovery and planning | 2-3 weeks | Requirements document, architecture, wireframes |
| Core infrastructure | 3-4 weeks | Auth, HIPAA compliance layer, database, CI/CD |
| Video and scheduling | 4-5 weeks | HIPAA-compliant video, calendar, booking flow |
| Messaging and intake | 3-4 weeks | Secure chat, intake forms, e-signatures |
| Testing and launch | 2-3 weeks | QA, penetration testing, staging, production deploy |
Full-Featured Platform: 6-10 Months
Add to the MVP timeline:
| Phase | Duration | Deliverables |
|---|---|---|
| E-prescribing integration | 4-8 weeks | Vendor integration, certification, testing |
| Billing and insurance | 4-6 weeks | Clearinghouse integration, payment processing |
| EHR integration | 4-8 weeks | FHIR API integration, certification (Epic/Cerner) |
| Admin dashboard | 3-4 weeks | Analytics, provider management, compliance tools |
Enterprise Platform: 10-14 Months
Add to the full platform timeline:
| Phase | Duration | Deliverables |
|---|---|---|
| Mobile apps (iOS + Android) | 8-12 weeks | React Native apps, App Store submission |
| White-labeling | 3-4 weeks | Theming engine, multi-tenant configuration |
| Advanced analytics | 3-4 weeks | Custom reporting, data warehouse, dashboards |
| Scale and performance | 2-3 weeks | Load testing, CDN, auto-scaling, optimization |
These timelines assume a dedicated team of 3-5 developers with healthcare experience. Teams without prior HIPAA compliance or healthcare integration experience should add 20-30% to these estimates for the learning curve.
Frequently Asked Questions
How much does a telemedicine MVP cost?
A minimum viable telehealth platform with HIPAA-compliant video conferencing, patient scheduling, secure messaging, and basic intake forms costs $80,000 to $150,000 and takes 3-5 months to build. This gives you a production-ready platform sufficient for validating your clinical workflow with 50-200 patients. It does not include e-prescribing, insurance billing, or EHR integration -- those are typically added in a second phase after you have confirmed product-market fit. The wide cost range depends primarily on video infrastructure choices (Twilio vs. self-hosted Jitsi) and whether you need a custom form builder or can work with fixed intake templates.
Do I need HIPAA compliance for a telehealth app?
Yes, without exception. Any application that transmits, stores, or processes Protected Health Information (PHI) on behalf of a healthcare provider must comply with HIPAA. This is not optional and not something you can "add later." Telehealth platforms handle some of the most sensitive PHI categories: video recordings of clinical encounters, prescription data, clinical notes, and insurance information. Non-compliance carries penalties up to $1.5 million per violation category, and the 2026 HIPAA Security Rule update has introduced mandatory encryption, MFA, and annual penetration testing requirements. We build HIPAA compliance infrastructure into every healthcare project from day one because retrofitting it after launch costs 2-3x more and exposes you to liability during the gap. Read our complete HIPAA compliance guide for the full technical requirements.
How long does it take to build a telemedicine platform?
Plan for 3-5 months for an MVP, 6-10 months for a full-featured platform with e-prescribing and EHR integration, and 10-14 months for an enterprise platform with mobile apps and white-labeling. The most common timeline killer is not development speed -- it is third-party certification. Epic App Orchard certification takes 2-4 months. E-prescribing vendor certification takes 4-8 weeks. App Store review for medical apps takes 2-4 weeks (longer than standard apps due to health claim scrutiny). Build these external dependencies into your timeline from the start, and run certification processes in parallel with development wherever possible.
Get an Accurate Estimate for Your Telemedicine Platform
The cost ranges in this guide reflect what we have seen across dozens of telehealth projects. Your specific number depends on your specialty, scale, integration requirements, and whether you are building an MVP or a full platform.
Planning a telehealth platform? Of Ash and Fire builds HIPAA-compliant telemedicine applications for healthcare organizations, from MVP validation to full-scale platforms. We have delivered telehealth solutions across behavioral health, primary care, and specialty medicine.
Schedule a free consultation to walk through your requirements and get a detailed estimate specific to your platform. We will tell you exactly which feature modules you need now, which can wait, and where to invest for the highest ROI.