Virtual assistants for therapists: costs, tasks and when a team fits better (2026)

Where Cortexa fits

Cortexa is an operations team for independent therapy practices that runs the front desk, intake, billing, credentialing and payroll as one team. Billing runs about 3% of what you collect, and the front desk, intake and billing together about 6%. There's no long-term contract, and there's a 30-day money-back guarantee.

With Cortexa running the front desk, replies to new inquiries went from 4 hours to 5 minutes, and inquiries booking a consultation went from 30% to 54%. Kerrie Mohr at A Good Place Therapy saw first inquiries that become first sessions go from 22% to 47% in her first three months. See whether it pays for itself with your numbers.

What a virtual assistant does for a therapy practice

A therapy virtual assistant works remotely in your email, phone line and EHR, doing the admin tasks you assign for the hours you buy. The providers' own service pages list much the same tasks.

Therapy VA agencies and medical virtual assistant firms

Two kinds of provider sell virtual assistants to therapists. Therapy-focused agencies such as Move Forward Virtual Assistants, Mental Health Virtual Assistant and Therapy Practice Solutions train their assistants for therapy practices. Medical and healthcare virtual assistant firms such as Hello Rache and Portiva serve healthcare practices generally, and HelpSquad runs a separate mental health service.

Some offer more than the tasks above. HelpSquad's mental health page describes intake coordination, insurance verification and documented crisis escalation protocols. Mental Health Virtual Assistant sells a separate billing assistant service, priced by practice volume.

What a mental health virtual assistant costs in 2026

Virtual assistant providers charge either an hourly rate or a monthly block of hours, and the published rates we read run from $8 to $53 an hour.

How to compare VA prices

The hourly rate is one part of the price. Move Forward's 20-hour monthly minimum at $53 an hour comes to $1,060 a month, plus the $750 onboarding fee. Therapy Practice Solutions and Mental Health Virtual Assistant don't carry unused hours into the next month, and Time etc does. HelpSquad's published rates are for full-time schedules, and it quotes part-time work individually, starting at 20 hours a week.

Location is the other big difference. Hello Rache and Portiva, at $9.50 and $10 an hour, say their assistants are in the Philippines. Time etc, Therapy Practice Solutions and Mental Health Virtual Assistant say their assistants are in the U.S., at $36 to $48 an hour on their monthly plans.

The work that stays with the owner

A virtual assistant takes tasks off your plate, and managing the assistant stays with you.

What does managing a virtual assistant involve? First, someone writes the procedures. A VA needs your fees, insurance panels, cancellation policy, each clinician's specialties and openings, and what to do when a caller asks something new. Second, someone trains the assistant on your EHR, your phone system and how you talk to clients, then checks the work until it's reliable. Third, someone covers the phone and inbox when the assistant is sick, on vacation or out of hours for the month. Fourth, when an assistant leaves, the owner starts again with a new person, who learns from whatever was written down. Agencies differ in how much of this they take on. HelpSquad lists no charge for replacing an assistant, and Mental Health Virtual Assistant picks a candidate and sends you their resume. Writing the procedures and checking the work usually stay with the practice.

Count your own management hours when you compare a VA's price with other options. The owner admin-time guide shows how to measure them.

Virtual assistant, intake coordinator or a full team

Which of the three fits depends on how many clinicians you have, how much of the work needs someone who knows your practice, and how much managing you want to do.

What makes a virtual assistant HIPAA compliant

Do you need a BAA with a virtual assistant? If the assistant or the agency handles your clients' health information on your behalf, generally yes. HHS describes business associates as people or companies, other than a covered entity's own workforce members, that carry out functions or services for it involving protected health information. Billing and practice management are among HHS's examples. HIPAA lets your practice share that information with a business associate once you have its written assurance, a business associate agreement (BAA), that it will safeguard the information. A business associate that passes the work to a subcontractor needs its own BAA with that subcontractor, and business associates are directly liable for complying with parts of the HIPAA Rules. So when a provider calls its assistants HIPAA compliant, ask to see the signed BAA.

Providers set this up differently. HelpSquad says it signs at the company level. Hello Rache's FAQ says "Our clients have the individual HVAs sign a Business Associate Agreement (BAA) with them," and that the company doesn't sign one because it has no access to client PHI. Ask your compliance adviser which arrangement fits your practice.

HIPAA doesn't ban offshore help. HHS's cloud computing guidance says the HIPAA Rules have no requirements specific to health information that a business associate processes or stores outside the United States. The same guidance says the risks can vary greatly by location, and that practices should account for them in the risk analysis the Security Rule requires. The BAA, the safeguards and the risk analysis apply wherever the assistant works.

How Cortexa is different from a virtual assistant

The people who answer your phone work for Cortexa, as employees and contractors under our direction, on our systems and under the same confidentiality and HIPAA terms. Hiring, training and replacing them is our work, and we don't hand reception to another company.

The membership can cover the front desk and intake. We answer your phone line, return voicemails and missed calls, and respond to email, website-form and directory inquiries, following a written playbook of your services, clinicians, fees and policies. We verify insurance eligibility at intake, book consultations, send and chase intake paperwork, send reminders and keep a waitlist. Every inquiry is tracked through consultation, intake, first session, lost or transferred.

It can also cover billing and payroll. We file claims after sessions, follow up on pending and denied claims and pursue appeals where appropriate. You get a billing team that follows every claim until it's paid, and you can check the status of any claim on your dashboard, any time. Payroll runs on your existing payroll platform, and we calculate clinician pay from session-level data in your EHR.

We sign a BAA. PHI is never used to train AI models, a promise in Section 3 of our BAA, and PHI is stored on US servers (AWS). We agree the exact scope and rate before you start, and you can start with only the work you need most.