US Telehealth Pricing Dynamics
The US telehealth market reached $43.78 billion in 2024 and is growing at roughly 22% a year — but pricing across the field remains opaque, fragmented, and increasingly disconnected from the consumer per-visit model that defined the sector's first decade.
Teladoc Health charges $89 per visit for uninsured, pay-as-you-go consumers. General telehealth visits run $50–$79 on average versus $146–$176 for an equivalent in-person appointment. Those headline numbers, however, tell only a fraction of the story — the majority of telehealth revenue is now contracted through employers and health plans at negotiated rates that are rarely published.
The structural tension is this: buyers — employers, health plans, and Medicare — are moving away from paying for access and toward paying for outcomes. Medicare's ACCESS program, a 10-year federal initiative, now ties payments for chronic condition management (diabetes, hypertension, depression) directly to health outcomes rather than visit counts. Rock Health's 2025 data shows VC investors following the same signal, with AI-enabled and outcomes-linked platforms capturing the largest share of $14.2 billion in digital health funding. Vendors still selling per-visit access are repricing a commodity. Vendors that can demonstrate measurable outcomes are selling something harder to replace — and pricing it accordingly.
A standard telehealth visit costs $50–$79 for US consumers paying without insurance, compared to $146–$176 for an equivalent in-person appointment — a discount of roughly 55%.[Market Reports] Teladoc Health, the largest US telehealth operator by revenue, charges $89 per visit for pay-as-you-go customers with no insurance coverage, dropping to $0 for members whose health plans include Teladoc in their benefits package.[Teladoc] TeleDirectMD, a smaller cash-pay operator, charges a flat $49 per video visit with no insurance involvement at all — positioning on price simplicity rather than clinical breadth.[TeleDirectMD]
These consumer-facing rates are anchored by what Medicare will reimburse for remote patient monitoring. CMS's 2026 Physician Fee Schedule sets CPT code 99453 (device setup and patient education) at $21.71 and CPT 99454 (device supply and daily recordings) at $52.11 per month.[CMS] These are not the prices vendors charge — they are the reimbursement floor that shapes what payers are willing to accept as reasonable cost for ongoing remote care. The consumer per-visit price sits above this floor; the B2B negotiated rate sits somewhere between the two, and is almost never published.
The opacity is intentional. Telehealth vendors negotiating enterprise contracts with self-insured employers or regional health plans have strong commercial incentives not to publish transaction prices — each deal is sized to the employer's workforce, claims history, and benefit design. A vendor that publishes its floor price gives every buyer a starting point for negotiation. Most choose not to.
The market is moving from paying for visits to paying for outcomes — and Medicare is pulling the rest of the market behind it.
When the largest single payer changes what it pays for, every vendor's pricing strategy is forced to respond.
Medicare's ACCESS program — a 10-year federal initiative launched in 2025 — directly pays for measurable outcomes in chronic condition management across diabetes, hypertension, and depression, rather than for individual visit completions.[Rock Health] Copay waivers and direct enrollment make it easier for patients to participate, and flexible technology requirements mean vendors do not need to be credentialled as Medicare providers to participate in the value chain. This is the most significant structural signal in US telehealth pricing: the federal government is defining outcome achievement as the billable unit, and commercial payers are following.
Rock Health's 2025 year-end funding report documents $14.2 billion in US digital health venture funding — up 35% from $10.5 billion in 2024 — with AI-enabled and outcomes-linked platforms taking a disproportionate share of that capital.[Rock Health] The 2025 State of Digital Health Purchasing survey found that employers, health plans, and health systems remain committed to digital health investment but now demand evidence of measurable outcomes rather than engagement metrics alone. The buyer has changed what counts as proof of value — which means vendors must change what they price around.
The per-visit model is not disappearing. For urgent care and episodic needs — a skin rash, a UTI, a prescription renewal — consumers and their insurers will continue to pay per visit. What is changing is the economics of chronic condition management, behavioural health, and preventive care. These are multi-month or multi-year relationships where per-visit pricing creates the wrong incentives for both the vendor and the patient. Vendors who price chronic care by the visit are rewarded for volume, not for keeping people well. The buyers who fund most of this care — employers and Medicare — have noticed.
Only one named competitor publishes a consumer price — the rest operate behind undisclosed B2B contracts.
Price opacity is not a gap in the data. It is a deliberate commercial strategy.
Among the most cited US telehealth platforms, only Teladoc Health publishes a specific consumer price: $89 per visit for uninsured, pay-as-you-go users.[Teladoc] MDLive, Amazon Clinic, and Hims & Hers do not publish equivalent rates on their public-facing pages, and no third-party source in this report's research base confirmed transaction prices for these platforms. For B2B contracts — the employer and health plan deals that represent the majority of volume for Teladoc, MDLive, and most clinical platforms — no named vendor publishes a rate card.
Among chronic condition and behavioural health platforms — Omada Health (diabetes and obesity), Virta Health (type 2 diabetes reversal), Spring Health (mental health), Talkspace (therapy), and Cerebral (psychiatry and therapy) — no public pricing is available for their employer or health plan contracts. These platforms sell primarily to self-insured employers through benefits consultants and broker channels, where pricing is negotiated deal by deal. The absence of published pricing is confirmed, not assumed: no pricing data for these platforms was available from any Tier 1 or Tier 2 source in this research.
What this means for a founder setting prices: the comparable set is almost entirely dark. Pricing decisions in this market cannot be anchored to a published competitor schedule. They must be anchored to the buyer's ROI calculation — what the employer or health plan saves by deploying the solution — and to CMS reimbursement rates as a structural floor. The vendor that can quantify and guarantee savings with named clinical evidence will set the price. The vendor that cannot will accept whatever the broker negotiates down to.
The value metric — what the price is actually built around — determines who wins at the enterprise contract table.
A vendor priced per visit is selling throughput. A vendor priced per outcome is selling a guarantee.
The choice of value metric — the unit a vendor prices around — is the most consequential pricing decision a telehealth platform makes. Per-visit pricing is transparent and easy for consumers to compare, but it creates a volume incentive for the vendor that runs directly against what self-insured employers and health plans actually want: fewer high-cost events, not more visits. An employer paying per visit has no structural reason to believe the vendor is motivated to keep patients well between appointments.
Per-member-per-month (PMPM) pricing is the dominant model in employer-contracted digital health, because it aligns the contract length with the care relationship and creates a predictable cost line for the benefits team. But PMPM pricing without outcome guarantees is simply a subscription to access — and the employer market has grown sceptical of access-only value propositions after several years of post-pandemic rationalisation. The 2025 State of Digital Health Purchasing survey finding — that buyers now demand measurable outcome evidence — is the market's verdict on PMPM-as-access: it is necessary but no longer sufficient.
Outcomes-linked pricing — where some portion of the vendor's fee is contingent on achieving named clinical outcomes (A1C reduction, depression score improvement, readmission reduction) — is the direction the market is moving, but it is still emerging rather than dominant. Medicare's ACCESS program provides the federal template. The vendors building toward this model face a difficult transition: their historical pricing was based on engagement, their new pricing must be based on results they do not fully control. The platforms that crack this — and can show audited outcome data at scale — will command a price premium the per-visit and PMPM-only players cannot match.
Employers and Medicare are willing to pay for telehealth when the ROI is quantified — but the burden of proof sits entirely with the vendor.
$73 PMPM in Medicare savings is a data point every vendor selling into chronic care should know and price against.
No published willingness-to-pay study with named dollar thresholds by segment — employer, health plan, or individual consumer — was available in the research base for this report. What exists are structural signals that allow a pricing range to be inferred, with that limitation stated explicitly.
The most concrete anchor comes from Medicare data on remote patient monitoring: RPM and telehealth interventions for high-acuity patients generate roughly $73 PMPM in Medicare savings, primarily through reduced emergency department visits (73–85 fewer per 1,000 residents).[PMC] This is not what vendors are charging — it is what the buyer is saving. Any PMPM price above $73 requires the vendor to demonstrate additional clinical value. Any PMPM price below $73 leaves money on the table relative to demonstrable ROI. For a vendor selling chronic care management into Medicare Advantage plans or self-insured employers with comparable high-acuity populations, $73 PMPM is the anchor to price against.
For individual consumers, the comparison is simpler: a telehealth visit at $50–$89 versus an in-person visit at $146–$176 is a roughly 55% discount that already clears most consumers' willingness-to-pay threshold for episodic, low-acuity needs.[Market Reports] The consumer segment is not where pricing complexity lives — it is where price floors get set. McKinsey's finding that US medical claims costs are rising 7% annually means employers are under growing pressure to validate every line of their benefits spend, which tightens WTP for digital health tools that cannot show clinical ROI.[McKinsey]
$14.2 billion in 2025 funding is concentrating in AI and outcomes platforms — not generalist telehealth.
The funding data is a leading indicator of where pricing power will consolidate next.
US digital health venture funding reached $14.2 billion in 2025, up 35% from $10.5 billion in 2024, according to Rock Health's year-end report.[Rock Health] Rock Health characterises 2025 as 'a tale of two markets': a smaller number of deals capturing a larger share of capital, with AI-enabled and outcomes-linked platforms dominating the large rounds. Q1 2026 continued this concentration trend, with capital flowing to fewer, larger bets rather than spreading across early-stage generalists.[Rock Health]
This concentration matters for pricing because capitalised platforms can afford to hold price discipline — they do not need to discount to survive the next quarter. Under-capitalised competitors discount to close deals, which compresses margins across the segment and trains buyers to expect concessions. The bifurcation between well-funded outcomes platforms and cash-constrained access-only platforms is already visible in the funding data; it will become visible in pricing within 12–18 months as the weaker players either exit or are acquired.
Telehealth platforms specifically accounted for 43.2% of digital health market revenue in 2025.[MarketsandMarkets] But the growth capital is not flowing to generalist telehealth — it is flowing to AI-enabled diagnostic tools, chronic condition management platforms, and behavioural health solutions that can demonstrate outcome data. A founder in generalist telehealth competing on price against a well-funded outcomes platform is not in a pricing competition. They are in a product competition they are losing.
Three plausible pricing futures — differentiated by how fast outcomes-linked contracts replace access-based models.
The base case is not the safe case for vendors still priced on per-visit access.
The direction of travel in US telehealth pricing is clear: outcomes-linked contracts are gaining structural support from both federal policy (Medicare ACCESS) and private capital allocation. What is uncertain is the pace. Employer benefits decision cycles run 12–18 months; health plan contract renegotiations happen annually at best. Even a decisive shift in buyer intent takes two to three years to show up in contract structures at scale.
- AI audit tools make real-time outcome reporting cheap and credible
- CMS ACCESS program drives rapid private payer imitation
- Two or three large outcomes-linked deals get publicised, setting a market reference price
- Per-visit consumer pricing compresses toward $50 floor
- PMPM remains dominant in employer contracts through 2027
- Outcomes-linked pilots expand but do not yet set market pricing norms
- Medicare telehealth flexibilities expire without renewal post-2026
- Recession triggers employer benefits freezes, stalling new digital health contracts
- Clinical incident creates liability overhang that slows outcomes-linked contract adoption
The bull case assumes AI-enabled outcome verification accelerates the transition — vendors that can produce audited, real-time outcome data close the evidence gap faster than the market expects, and outcomes-linked contracts reach meaningful share by 2027. The base case assumes the transition happens on the current trajectory: per-visit commoditisation continues in consumer segments, PMPM holds in employer contracts, and outcomes-linked models grow from the Medicare edge inward over three to five years. The bear case is regulatory or economic disruption — a rollback of telehealth Medicare flexibilities, a recession-driven benefits freeze, or a major clinical incident that triggers liability concerns and slows adoption.
Founders pricing a new product today should build for the base case and design contract flexibility for the bull. A pricing structure that starts as PMPM with outcome-based upside — a shared savings kicker if named clinical benchmarks are hit — threads both scenarios without requiring a full reprice in either direction.
Key things to remember
About About this report
This report maps pricing structures, named competitor rates, dominant value metrics, and model shifts in the US telehealth and digital health market as of Q2 2026.
Founders setting or defending price points, investors assessing unit economics, and commercial leaders building competitive pricing playbooks.
Ren synthesised publicly available pricing data, CMS reimbursement schedules, McKinsey healthcare cost research, Rock Health funding reports, and market sizing data from named industry sources.
Market size figures are from 2024 (most recent available); funding data is from 2025; CMS reimbursement rates reflect the 2026 Physician Fee Schedule. Competitor pricing for MDLive, Amazon Clinic, Hims & Hers, and most digital health platforms is not publicly disclosed and could not be verified.
Sources Sources & Methodology
Research conducted 14 Apr 2026. All statistics carry inline citation markers.
No public pricing data confirmed for MDLive, Amazon Clinic, or Hims & Hers from any Tier 1 or Tier 2 source. These platforms' consumer and B2B rates could not be verified and are absent from the competitor pricing section.
No named pricing tiers, entry-level feature definitions, or upgrade triggers confirmed for Omada Health, Cerebral, Spring Health, Talkspace, or Virta Health. All sell through employer/payer channels at undisclosed rates.
No willingness-to-pay research with named dollar thresholds by buyer segment (employer, health plan, individual consumer) was available. WTP analysis in this report is based on structural inference from Medicare savings data and cost comparison figures, not direct WTP studies. Confidence in this section is capped at MEDIUM.
No named broker, benefits consultant, or deal structure data confirming list-to-transaction price gaps for B2B telehealth contracts. The gap exists but its magnitude could not be quantified from available sources.
Fewer than 2 Tier 1 sources directly address telehealth-specific pricing dynamics. McKinsey and CMS data provide context but not telehealth pricing benchmarks per se. Tier 2 sources (Rock Health, market sizing firms) carry the analytical weight in several sections — confidence ratings reflect this.
This report is produced for informational purposes only. It does not constitute financial, legal, or investment advice. All data is sourced from publicly available information as at the date of research. Renatus Ventures makes no representations as to the completeness or accuracy of third-party data.
