“I’ll hire a VA” is the most common first move when a New York therapist gets overwhelmed. Sometimes it works. Often it ends with a well-meaning assistant who does not know what an ERA is, a HIPAA exposure nobody thought about, and a therapist spending more time training than they saved. Here is an honest comparison of your three real options.
Option 1: A general virtual assistant
Cost: $12 to $25 per hour offshore, $25 to $45 per hour US-based through an agency.
Good for: scheduling, inbox triage, basic admin.
Watch out for: no healthcare background, so billing and insurance work is trial and error; HIPAA requires a Business Associate Agreement and training that most VA arrangements skip; turnover means re-training; you are the manager.
Option 2: A specialized practice management company
Cost: MBBCS is $30 to $35 per hour, flat. Others range from similar hourly rates to 5% to 8% of collections.
Good for: billing and denials, credentialing, policies, marketing, and admin, from one team that already knows New York payers.
Watch out for: percentage-of-collections pricing that rises as you grow; equity-backed companies that change terms after acquisition. Ask who owns the company.
Option 3: Hiring your own employee
Cost: $50,000 to $65,000 a year in New York City for a practice coordinator, plus 10% to 15% for payroll taxes, workers’ comp, disability and PFL, plus benefits if you offer them.
Good for: a group practice with enough volume to fill 40 hours a week of one person’s time.
Watch out for: you need HR, onboarding, a job description and coverage when they are out; one person rarely has billing, marketing and operations skills.
A quick decision guide
- Solo, under 15 clients a week, mostly self-pay: a few hours of specialized support, or a VA if your needs are truly only scheduling.
- Solo, 15 or more clients a week, taking insurance: specialized support. The billing alone pays for it.
- Group practice, 4 or more clinicians: a dedicated person or team, either an employee you manage or a full-time-equivalent from a practice management company you do not have to manage.
The question that settles it
Do you want to manage someone, or do you want the work done? If you want to manage, hire. If you want the work done by people who already know how, use a team. MBBCS is built for the second answer.
Quick answers
How much does a virtual assistant cost for a therapy practice?
Roughly $12 to $25 per hour offshore or $25 to $45 per hour US-based through an agency, for general admin. Specialized billing and credentialing usually require different skills.
Is it cheaper to hire an employee or use a practice management company?
For most solo and small group practices in New York, a fractional team at $30 to $35 per hour is cheaper than a $50,000 to $65,000 employee plus taxes and benefits. Employees make sense once you can fill 40 hours a week.
Does a VA need a Business Associate Agreement?
Yes, if they touch any protected health information. Many general VA arrangements skip this, which puts the therapist at risk.
Ready to talk? MBBCS is a clinician-owned practice management team in Brooklyn serving therapists across New York. Book a free 20-minute consult or get a ballpark estimate in 30 seconds.
