Cost
How much does it cost to start a peptide clinic?
Between $105,000 and $561,000 in the first year before the first client, and six to twelve months of calendar time, if you build it yourself. This page shows the ten line items behind that number, where each figure comes from, and what the same ten lines cost when a licensed practice, its pharmacies and its software already exist.
- $105k to $561k
- Own it, year one
- 10
- Line items, each sourced
- 6 to 12 months
- Own it, time to first client
- $28k
- ConduitMD, year-one fees
How the numbers were built
Two scenarios, ten lines, every rate sourced.
Every range is a low case and a high case for the same ten things a peptide clinic cannot open without. Where a figure is a published price, it is linked. Where it is our estimate, the line says so and shows the sourced rates it was built from.
Low case, $105,000
One state. One nurse practitioner on a 1099 paid per visit. A medical director at the low end of the moderate tier. Template entity paperwork from healthcare counsel. An MVP portal, an off-the-shelf EHR, and two integrations built by a contractor.
High case, $561,000
Ten states. A W-2 nurse practitioner hired through a recruiter, licensed in every state. A moderate-tier medical director. A full MSO plus a professional entity per state. A mid-to-enterprise platform build, custom integrations and a third-party HIPAA program.
Not counted
Not in either total: marketing, the medication itself, payment processing (peptide and GLP-1 merchants are underwritten as high risk at 5% to 9% when the business sells the drug), your own salary, and the six to twelve months of calendar time before the first client.
Own it or outsource it
The same ten lines, two ways.
Own it means you form the practice, hire the clinician, buy the software and carry the compliance. With ConduitMD, the practice, the pharmacies and the software already exist and you pay one setup fee and two flat fees.
| Line item | Own it, year one | With ConduitMD |
|---|---|---|
Professional entity, MSO and paperwork A physician-owned professional entity in each state where corporate practice of medicine applies, a management company you own, and the agreement between them. | $5,000 to $35,000 | Mostly included The practice, the MSO and the agreements already exist. You still bring your own counsel to review the partner agreement for your state, typically inside that same $3,500 to $10,000 advance. |
A physician who owns the protocols, reviews charts, trains staff and answers to the board for the telehealth practice. | $18,000 to $60,000 | Included The practice supplies its own medical director for the telehealth service. If your staff physically do anything to a client on your premises, you still need a facility medical director of your own. |
Program and protocol development Dosing ladders, course lengths, screening gates, contraindication lists, consent language and standard operating procedures for each program you sell. | $9,000 to $43,000 | Included Eleven designed programs with course lengths, screening gates and refill cadence, owned by the practice's medical director. You pick two or three. |
The clinician who reviews every screening and writes every prescription, licensed in every state a client lives in, with a collaborating physician where the state requires one. | $9,000 to $181,000 | Included A network of licensed clinicians, collaborating physicians where required and malpractice, all inside the flat per-visit provider fee. You never hire, license or insure a prescriber. |
Pharmacy negotiation and onboarding Accounts with enough licensed 503A compounding pharmacies to cover the states you sell in, each credentialing your prescriber before activation. | $2,000 to $6,000 | Included Pharmacy relationships and routing by the client's state, with medication and shipping passed through at the pharmacy's price. You get the live state list in writing on day one. |
Platform build: storefront, screening, patient portal The branded site, the intake, checkout, the patient portal with messaging and order tracking, and the back office your team works from. | $40,000 to $150,000 | Included Storefront on your domain, screening, patient portal, partner portal and every email in your brand, inside the flat monthly platform fee. |
Where the chart, the consent, the clinician's note and the prescription live, with an API if your portal is to talk to it. | $1,600 to $3,600 | Included The practice keeps its own record. You never hold a chart, which is also why you never need the EHR. |
Onboarding safety questionnaire The screening a client completes before a clinician sees them: contraindications, current medications, thyroid and cancer history, pregnancy, state of residence, and the auto-deny logic behind it. | $6,000 to $26,000 | Included Screening is built per program, owned by the medical director, and updated when the rules change. Your branded intake runs it. |
API integrations: EHR and compounding pharmacy The code that pushes the intake into the chart, sends the prescription to the pharmacy, and pulls order status and tracking back into the portal. | $10,000 to $40,000 | Included Already connected. Order status and tracking show in your partner portal and the client's portal. |
A security risk assessment, policies, staff training, business associate agreements, cyber liability and general liability. | $4,300 to $16,000 | Mostly included The practice and the platform carry the HIPAA program and the clinical coverage. You keep general liability for your own business, about $1,000 a year. |
| Year-one total before the first client | $105,000 to $561,000 | $28,000 in fees $4,000 one-time setup, then $2,000/mo plus $29 per visit. Medication and shipping at what the pharmacy charges. You still pay $4,300 to $11,100 for your own counsel review and liability cover. |
| Time to first client | 6 to 12 months | 14 days from signing |
What you still pay with ConduitMD
| Counsel review of the partner agreement for your state Cohen Healthcare Law | $3,500 to $10,000 |
| General liability for your own business General Liability Insure | $800 to $1,100 |
| Plus the setup and the two flat fees | $4,000 one-time setup, then $2,000/mo and $29 per visit |
Year-one cash before visits: $32,300 to $39,100, which is $28,000 in setup and twelve months of platform fees plus $4,300 to $11,100 of your own counsel and liability cover. No contract, no percentage of anything.
Timeline
Own it: 6 to 12 months. Building from scratch with compliance, prescribing and fulfillment in place typically takes six to twelve months. Clinik EHR, telehealth practice from scratch 2026
ConduitMD: 14 days from signing. Signing and kickoff on day 0, brand kit by day 5, storefront on your domain by day 12, coverage in writing and staff briefed by day 14.
The calendar time is the cost this page cannot price. Every month of build is a month your clients are buying research-use vials from someone else.
Line by line
Where each number comes from.
The range, how it was built, what it costs after year one, the sources, and what changes when the practice already exists.
01
Professional entity, MSO and paperwork
A physician-owned professional entity in each state where corporate practice of medicine applies, a management company you own, and the agreement between them.
$5,000 to $35,000 year one, own it
State filing runs $45 in California to $300 in Texas per entity; New York adds a $300 to $1,500 newspaper publication plus a $50 certificate. A registered agent is about $125 per state per year. Healthcare counsel quotes a $3,500 to $10,000 advance to structure the MSO, form the professional entity and draft the management services agreement for one state. Ten states means ten entities, ten agents and fair-market-value work on every agreement, which is where the high end comes from.
After year one: Annual reports and registered agents, roughly $150 to $1,000 per state per year; California adds an $800 franchise tax.
Mostly includedThe practice, the MSO and the agreements already exist. You still bring your own counsel to review the partner agreement for your state, typically inside that same $3,500 to $10,000 advance.
With ConduitMD, this line is inside the flat fees or stays with you as stated. Nothing here is a percentage of anything.
02
Medical director
A physician who owns the protocols, reviews charts, trains staff and answers to the board for the telehealth practice.
$18,000 to $60,000 year one, own it
A 2026 medical director retainer runs $1,500 to $8,000 or more a month. Nominal oversight (signs protocols, available by phone) is $500 to $1,500; the moderate tier a peptide program needs (chart review, staff training, protocol ownership) is $2,000 to $5,000. Hourly alternatives run $200 to $500. The range is $1,500 to $5,000 a month for twelve months. Add the agreement itself, drafted by a healthcare attorney at $250 to $500 an hour. Never a percentage of revenue; that is fee-splitting.
After year one: The same retainer every year, rising with volume and states.
Included with ConduitMDThe practice supplies its own medical director for the telehealth service. If your staff physically do anything to a client on your premises, you still need a facility medical director of your own.
With ConduitMD, this line is inside the flat fees or stays with you as stated. Nothing here is a percentage of anything.
03
Program and protocol development
Dosing ladders, course lengths, screening gates, contraindication lists, consent language and standard operating procedures for each program you sell.
$9,000 to $43,000 year one, own it
Our estimate, built from sourced rates: 40 to 120 clinician hours at $200 to $350 an hour, which is the published range for physician consulting and medical-director hourly work, plus peptide-specific training for the clinician at about $500 per module across two modules. Two programs sit at the low end; six programs with refill logic and a lab schedule sit at the high end.
After year one: Revisions every time the FDA category lists move, which happened twice in 2026.
Included with ConduitMDEleven designed programs with course lengths, screening gates and refill cadence, owned by the practice's medical director. You pick two or three.
With ConduitMD, this line is inside the flat fees or stays with you as stated. Nothing here is a percentage of anything.
04
Hiring the nurse practitioner
The clinician who reviews every screening and writes every prescription, licensed in every state a client lives in, with a collaborating physician where the state requires one.
$9,000 to $181,000 year one, own it
Two models. On a 1099, telehealth platforms pay $20 to $35 per synchronous visit and $5 to $15 per asynchronous review, so the fixed cost is licensure ($40 to $676 per state, about $526 average all-in per jurisdiction), a collaborating physician ($499 to $599 a month nationally, $300 to $2,500 by state) and self-employed malpractice ($857 to $2,329 a year). Three states on a 1099 is about $9,000 before the per-visit fees. On a W-2, the BLS median is $134,920 (May 2025), a recruiter takes 15% to 25% of first-year salary, and ten state licenses plus a collaborating physician and malpractice bring year one to about $181,000.
After year one: Salary or per-visit fees, license renewals every one to two years per state, and the collaborating physician every month.
Included with ConduitMDA network of licensed clinicians, collaborating physicians where required and malpractice, all inside the flat per-visit provider fee. You never hire, license or insure a prescriber.
With ConduitMD, this line is inside the flat fees or stays with you as stated. Nothing here is a percentage of anything.
05
Pharmacy negotiation and onboarding
Accounts with enough licensed 503A compounding pharmacies to cover the states you sell in, each credentialing your prescriber before activation.
$2,000 to $6,000 year one, own it
Pharmacies do not charge for an account, but they only open one for a licensed prescriber, and one pharmacy reaches roughly two thirds of the country, so national coverage means two or three accounts. Our estimate is 20 to 40 hours of founder time per pharmacy at a blended $100 an hour for credentialing, catalog and pricing review, packaging and billing setup. Optional e-prescribing runs about $75 per prescriber a month with a $2,000 implementation fee.
After year one: Minimums, price changes and back-orders, renegotiated as they happen.
Included with ConduitMDPharmacy relationships and routing by the client's state, with medication and shipping passed through at the pharmacy's price. You get the live state list in writing on day one.
With ConduitMD, this line is inside the flat fees or stays with you as stated. Nothing here is a percentage of anything.
06
Platform build: storefront, screening, patient portal
The branded site, the intake, checkout, the patient portal with messaging and order tracking, and the back office your team works from.
$40,000 to $150,000 year one, own it
Published 2026 ranges: a basic telemedicine MVP (profiles, scheduling, intake) is $40,000 to $70,000; a mid-complexity build with prescription management and payments is $70,000 to $100,000; an advanced platform with EHR integrations is $100,000 to $300,000. US developers bill $60 to $150 an hour. The range stops at $150,000 because the integrations are counted on their own line below.
After year one: Maintenance at 15% to 20% of the build cost per year, plus hosting.
Included with ConduitMDStorefront on your domain, screening, patient portal, partner portal and every email in your brand, inside the flat monthly platform fee.
With ConduitMD, this line is inside the flat fees or stays with you as stated. Nothing here is a percentage of anything.
07
EHR and system of record
Where the chart, the consent, the clinician's note and the prescription live, with an API if your portal is to talk to it.
$1,600 to $3,600 year one, own it
Healthie's published plans run $129.99 a month for unlimited clients and $149.99 a month for a group seat plus $50 per additional provider; comparable practice-management EHRs sit near $200 a month. API access is sold on the enterprise tier and quoted, not listed, so the high end here is subscription only and the API is an unknown on top.
After year one: The subscription every month; enterprise API tiers are annual contracts.
Included with ConduitMDThe practice keeps its own record. You never hold a chart, which is also why you never need the EHR.
With ConduitMD, this line is inside the flat fees or stays with you as stated. Nothing here is a percentage of anything.
08
Onboarding safety questionnaire
The screening a client completes before a clinician sees them: contraindications, current medications, thyroid and cancer history, pregnancy, state of residence, and the auto-deny logic behind it.
$6,000 to $26,000 year one, own it
Our estimate, built from sourced rates: 20 to 40 clinician hours at $200 to $350 an hour to write the questions and the deny rules per program, plus 40 to 80 developer hours at $50 to $150 an hour to build, version and test them. Every program you add and every category change from the FDA reopens it.
After year one: Clinical review at least annually and after every formulary change.
Included with ConduitMDScreening is built per program, owned by the medical director, and updated when the rules change. Your branded intake runs it.
With ConduitMD, this line is inside the flat fees or stays with you as stated. Nothing here is a percentage of anything.
09
API integrations: EHR and compounding pharmacy
The code that pushes the intake into the chart, sends the prescription to the pharmacy, and pulls order status and tracking back into the portal.
$10,000 to $40,000 year one, own it
A single read-only FHIR connection is quoted from $15,000; general EHR integration runs $5,000 to $30,000 or more; bidirectional multi-system work reaches $150,000. Pharmacy APIs expose order status and tracking and the pharmacy side takes days to a week, but the developer hours are yours. Two integrations, one each way, land in this range. Maintenance is $3,000 to $15,000 per interface per year as vendor APIs change.
After year one: $6,000 to $30,000 a year for two interfaces.
Included with ConduitMDAlready connected. Order status and tracking show in your partner portal and the client's portal.
With ConduitMD, this line is inside the flat fees or stays with you as stated. Nothing here is a percentage of anything.
10
HIPAA program and insurance
A security risk assessment, policies, staff training, business associate agreements, cyber liability and general liability.
$4,300 to $16,000 year one, own it
A third-party HIPAA risk assessment is $2,000 to $10,000; small practices spend $6,000 to $35,000 on the full first-year program. Cyber liability for a small telehealth business is $1,500 to $5,000 a year. General liability for a telemedicine business is $67 to $89 a month.
After year one: Insurance every year; the risk assessment repeated annually.
Mostly includedThe practice and the platform carry the HIPAA program and the clinical coverage. You keep general liability for your own business, about $1,000 a year.
With ConduitMD, this line is inside the flat fees or stays with you as stated. Nothing here is a percentage of anything.
The other way to read it
Your first-year build budget is somebody else's program revenue.
At a program price of $299 a month, $105,000 is the margin on roughly 705 client-months after landed cost. That is the number of clients you would serve before the build breaks even, and it assumes the build works the first time.
Run your own numbers on the calculator. The $150 landed-cost assumption is the low end of a month of medication and shipping plus a provider fee; your quote replaces it.
Skip the build. Keep the brand.
A twenty-minute call, then a brand kit, then a storefront on your domain with the state list in writing. One setup fee, two flat fees, no contract, no percentage of anything. Live fourteen days after signing.
Frequently asked
Peptide clinic cost: questions
How much does it cost to open a peptide clinic in 2026?
About $105,000 to $561,000 in the first year before the first client if you build it yourself. The low case is one state, one nurse practitioner on a 1099, a moderate medical director, template entity paperwork, an MVP portal and two contractor-built integrations. The high case is ten states, a salaried nurse practitioner hired through a recruiter, a full MSO with an entity per state, an enterprise-grade platform and a third-party HIPAA program.
What is the single biggest cost?
The platform build, at $40,000 to $150,000 for the storefront, screening, patient portal and back office, before integrations. In the high case the salaried nurse practitioner overtakes it at about $181,000 once salary, a recruiter, ten state licenses, a collaborating physician and malpractice are counted.
Can I skip the medical director?
Not for a program that prescribes. A physician has to own the protocols and answer to the board. The 2026 market rate is $1,500 to $8,000 a month, and it must be a flat fee or hourly at fair market value, never a share of revenue. Through a platform the practice supplies its own; you still need a facility medical director for anything your staff physically do to a client on your premises.
What does ConduitMD cost by comparison?
A $4,000 one-time setup, $2,000 a month for the platform and $29 per provider visit, with medication and shipping passed through at the pharmacy's price. That is $28,000 in year one before visits. Outside those fees you pay for your own counsel to review the partner agreement, typically $3,500 to $10,000, and about $1,000 a year of general liability for your own business.
How long does it take to open a peptide clinic?
Six to twelve months from scratch once compliance, prescribing and fulfillment are in place, and longer in states with strict corporate practice of medicine rules. Through a platform the storefront is live on your domain fourteen days after signing.
Are these numbers quotes?
No. They are 2026 published prices and rates from the linked sources, or estimates built from those rates where the line says so. Use them to size the decision, then get quotes for your states and your volume.
Figures are 2026 published prices and rates from the linked sources, or estimates built from them where marked. They are planning numbers, not quotes, and nothing on this page is legal advice. Compounded peptides are prepared by a licensed 503A pharmacy under a prescription and are not FDA-approved drugs. ConduitMD provides software and management services to an independent medical practice and its partners; it does not prescribe or dispense.