How much does a virtual medical assistant cost in 2026?

Ask five agencies what a virtual medical assistant costs and you will get five answers, three of which hide the real number behind a sales call. Here is the market, plainly.

The market rates

Healthcare VA services in 2026 cluster into three tiers. Marketplace freelancers are the cheapest option on paper, but you vet, train and replace them yourself, and HIPAA compliance is your problem. Managed healthcare VA agencies price by role and seniority, and published rates vary widely. Premium staffing firms with US account management sit at the top of that band and often add setup fees on top.

Ask Velma charges $10 per hour for the first 90 days and $10.50 thereafter, with no setup, recruiting or cancellation fees. The rate includes HIPAA training, a BAA, a named coordination contact, time tracking with activity visibility, replacement sourcing at no fee, and the contractor's wellness subsidy, paid by us rather than by your practice.

The comparison that matters

The real benchmark is not other agencies. It is the in-house hire the VA replaces. A US front-office employee at $20-25 per hour costs roughly $27-34 an hour fully loaded once you add payroll taxes, benefits, PTO and workers' compensation. Over a 40-hour week that is roughly $56,000 to $71,000 a year, before recruiting fees and before the cost of the next turnover cycle.

The same 40 hours with a managed VA on Ask Velma's rate card totals about $21,580 in year one. The difference, roughly $35,000 to $49,000 per seat per year, is why the category exists.

Watch for these fee patterns

• Setup or onboarding fees charged before the VA works an hour
• Recruiting fees when you want to add a second VA
• Monthly platform minimums that bill you for hours you did not use
• Cancellation fees and 90-day lock-ins
• Replacement charges when a VA leaves

A transparent provider will put the full rate and every inclusion in writing before you commit. If a provider cannot, that tells you what you need to know.