VA vs in-house front desk cost calculator

Enter your hours, rates and an in-house salary to see what a virtual assistant and an in-house hire each cost per year, including your management time and recruiting.

Updated November 7, 2026

Second Desk rates are $14 per hour full time (40 hours) and $16 per hour part time (20 hour weekly minimum). Built for behavioral health practices and programs that need front-office and billing support. See pricing, the virtual assistant for therapists guide, or meet a candidate.

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Your numbers

Every starting value is an example. Replace each one with your own numbers.

Hours per week neededExample: 40 hours. Change it to the hours you need.VA hourly rate ($)Example: $14, Second Desk's full-time rate. Part time is $16 with a 20 hour weekly minimum.Your management hours per week for the VAExample: 3 hours. Change it to the time you expect to spend.Cost of your management time per hour ($)Example: $50 per hour. Change it to what your time is worth.In-house annual salary ($)Example: $42,000. Change it to the salary you would pay.Benefits and payroll taxes (%)Example: 20%. Change it to your own estimate.Recruiting and training cost ($)Example: $3,000. Change it to your own estimate.

Results

VA annual cost-

In-house annual cost-

Annual difference (in-house minus VA)-

VA effective cost per hour-

Starting values are examples only. Add software, equipment, turnover and quality differences to your own comparison.

How does the calculator work out each cost?

VA annual cost: hours per week times 52 times the VA hourly rate, plus your management hours per week times 52 times the cost of your time.
In-house annual cost: the salary plus benefits and payroll taxes as a percentage of salary, plus recruiting and training.
Annual difference: the in-house annual cost minus the VA annual cost.
VA effective cost per hour: the VA annual cost divided by the hours the VA works in a year.

Deciding which hours to hand off? Start with the tasks a virtual assistant can handle for a therapy practice.

Frequently asked questions

How much does a medical virtual assistant cost with Second Desk?

Part time is $16 per hour with a 20 hour weekly minimum. Full time is $14 per hour for 40 hours per week. After the first 30 days, it is month to month.

How much does an assistant cost per week?

At the published rates, the 20 hour part time minimum is $320 per week at $16 per hour, and 40 full time hours are $560 per week at $14 per hour.

Is there a contract?

Month to month after the first 30 days.

What work stays with your licensed staff?

Clinical judgment and clinical decisions, crisis triage and calls from clients in distress, clinical notes, and diagnosis and clinical history.