Last updated: 2026-09-08
The hourly rate is the simple half of a speech therapy staffing question, and at Honest Taskers it runs $10.00 to $12.65. Harder is deciding which admin jobs to hand over, because an SLP caseload generates counting work rather than call volume. Authorization is where that counting turns into money, since an expired approval turns a delivered speech pathology session into unbillable time and a denied claim. Summer moves the arithmetic again, as pediatric caseloads thin out in July and the monthly bill follows the hours you book. Front-desk payroll is the comparison most owners want, so the wage and employer-load numbers sit further down. Where these cost figures come from is set out at the end, release by release.
A speech therapy virtual medical assistant bills at $10.00 to $12.65 an hour with Honest Taskers, and where a candidate lands inside that band moves with healthcare background, the schedule you need covered, how wide the role's scope runs and where the person is based. Billing is hourly, with no weekly minimum. Buy twelve hours in a quiet week and you're billed for twelve.
Nothing rides on top of that number. No payroll tax, no health premium, no paid leave, no accrued PTO liability, no workstation in a room you're already renting. You're buying hours from a company that employs the person, which is a different transaction from putting someone on your own books, and it's the reason the two numbers can't be compared straight across.
What sets your monthly bill isn't the rate, it's the hours, and the hours come off your caseload rather than a price sheet. Count the active authorizations you're tracking, the plans of care waiting on a physician signature, the progress notes due this month and the families sitting on your waitlist. That count is the sizing exercise. Owners who want the wider pricing picture across roles can read our guide to how much a virtual medical assistant costs, then come back to the speech-specific math.
Hours are the variable worth arguing over, not cents on the rate. Ten hours a week at the top of the band costs a practice less than twenty hours at the bottom of it, so the sizing question outranks the negotiating question by a wide margin. Get the hours right and the rate looks after itself.
Ask any provider what moves a quoted rate up or down before you sign. A firm quoting one number for every role either hasn't priced the role or hasn't met the candidate yet. Honest Taskers varies the rate by candidate background, schedule, scope and location, and says which of those it's pricing on.
Authorization tracking eats the most SLP time, with plan of care paperwork and attendance chasing close behind. Outpatient and pediatric speech caseloads run on visit-limited approvals, so the administrative load is counting rather than volume. A payer approves a set number of visits inside a set window, and somebody has to know which visit a child is on.
That counter is the whole job. Run one session past the last approved visit and your therapist has done real clinical work no payer will pay for, and nobody catches it until the remittance comes back. Plan of care documents need a physician signature before the episode has billable footing. Recertification dates arrive on a schedule that gets remembered rather than tracked, which works right up until the week it doesn't.
Six queues take up most of the administrative day in a speech practice, and each one is a candidate to outsource.
None of those six needs an SLP license, and all six fall over quietly when nobody owns them. Deciding which to hand off first is a separate question, and our list of tasks to outsource to a virtual medical assistant sorts them by how cleanly they move off a clinician. Start with the one that costs you money when it slips.
Progress notes keep a rhythm of their own on top of all that. Payers want documented progress at set intervals to justify continued therapy, and a note filed late is a note that reaches the reviewer after the reviewer has decided. Tracking the interval is clerical work. Writing what goes inside the note is not, and those two jobs get confused whenever the same person handles both.
No published figure exists for how many authorizations one assistant clears in a week, and any provider quoting you one has made it up. Size the hours off your own numbers, such as active authorizations, weekly visit volume, evaluations pending a report and the length of your waitlist. Two weeks of watching those queues move tells you more than any industry average ever will.
An expired therapy authorization stalls a speech pathology claim by removing the payer's prior agreement to pay, which turns a delivered session into unbillable time. Payers approve a set number of visits across a set window. Treat past the last approved visit, or past the end date, and the claim returns denied with nothing clinically wrong in the chart.
Appeals rarely recover it, because authorization is prospective by design. The payer agreed to a block of visits, the block ran out, and asking afterward is asking for an exception rather than a correction. Practices absorb that loss one visit at a time, which is exactly why it never shows up as a line anyone argues about.
Authorization work is expensive across medicine, and speech is no exception. Physicians and their staff spend 13 hours a week on prior authorization, and 95% of them say it delays access to necessary care (Source: American Medical Association, "2025 AMA Prior Authorization Physician Survey", May 2026, 1,000 practicing physicians). Speech practices run the same errand with different paperwork, since the plan of care, the physician signature and the recertification date each carry a deadline of their own. The queue mechanics are the same everywhere, and our walkthrough of how a virtual assistant handles prior authorization lays them out step by step.
One line stays fixed no matter who tracks the counter. A remote assistant never decides clinical necessity, never writes the clinical content of a progress note, and never advises a family on therapy. Your assistant flags that the approved visits are nearly spent and that recertification falls due next month; your SLP writes the justification and makes the call. Put that boundary in the role description before the first shift, because the pressure to blur it arrives from a parent on the phone who wants an answer now rather than from the assistant.
Medicaid and early intervention programs deserve their own mention here. Both carry paperwork that looks nothing like a commercial payer's portal, both have their own renewal rhythm, and a practice carrying a mixed payer list is running two or three authorization systems at once. Teletherapy adds a smaller version of the same problem, since consent forms and platform checks have to be current before the session starts.
A speech therapy practice pays for the hours it books in a slow summer month, which is the whole point of hourly billing. Twenty hours a week works out at roughly $800 to $1,012 a month inside the $10.00 to $12.65 band. Forty hours a week lands around $1,600 to $2,024. Trim the hours in July and the bill drops with them, with no severance conversation and no rehiring in September.
Pediatric speech caseloads thin out in summer for reasons that have little to do with demand. Families travel, school-based services pause, and a child seen twice a week in April is seen twice in August. September brings the whole caseload back at once, and the waitlist is longer than the one June left behind.
Summer is when the backlog gets cleared, which argues for keeping hours running through the quiet weeks instead of pausing them. Recertifications due in the fall can be prepped in July. Authorization renewals for the September restart can go in early, before every other practice in the county files theirs. And the waitlist can be called through top to bottom, which is where a speech practice recovers the revenue it lost by not calling.
Practices still deciding whether the workload justifies any hire can size it first with our guide to the signs your practice needs a virtual assistant, then start small. A first Honest Taskers hire comes with a two-week working trial, subject to current service terms, and two weeks in August is a cheap way to learn whether your waitlist starts moving. Most placements complete within one to three weeks of a signed agreement, so a July start is a June decision.
Watch what the summer number does to your thinking, though. Owners who size the arrangement on a July caseload are understaffed by the second week of September, when intakes, re-evaluations and new authorizations all land in the same fortnight. Set the hours on your September load and let them fall in the summer, rather than the reverse.
Yes, remote speech therapy support is priced below front-desk payroll, and most of the gap sits in the employer load rather than the wage. US medical secretaries and administrative assistants earned a median $45,930 a year (Source: Bureau of Labor Statistics, "Occupational Employment and Wage Statistics", May 2025). Benefits add 48.7% on top of wages for office and administrative support work in private industry, once paid leave, supplemental pay, insurance, retirement and legally required contributions are counted as separate components (Source: Bureau of Labor Statistics, "Employer Costs for Employee Compensation", March 2026). One in-clinic front-desk seat therefore runs about $68,252 a year before a computer or a square foot of space.
Hiring cost sits outside that annual figure. Filling a non-executive role costs an average $5,475 per hire (Source: SHRM, "2025 Benchmarking Report"), and that charge lands again on every departure. Ramp sits outside it too. A new front desk needs weeks to learn which of your payers count visits and which count calendar dates, so the person is slowest on the exact queue you hired them for.
Turnover is the part that bites a small speech practice hardest. One front-desk departure walks off with the authorization calendar, and rebuilding it out of chart notes eats weeks that nobody has spare in September.
We won't print a savings percentage, because your own wage band decides it and ours would be a guess about your books. A practice in a high-cost metro with full benefits sits well above $68,252, and a rural single-clinician practice sits below it. Run the arithmetic against your payroll rather than the national median, and against the hours you'd buy rather than a full-time equivalent nobody needs.
Payroll buys something hourly doesn't, and skipping past that would be dishonest. A person in the building greets the family in the waiting room, hands a parent the home practice sheet, and works the copay drawer. Remote support covers the authorization counter, the phones, the notes chase and the waitlist, and it doesn't cover the lobby. Most speech practices settle on both, a smaller front desk with more remote hours behind it. Where the role stops is set out plainly in our explainer on what a virtual medical assistant is.
Compliance doesn't move with the hour count. A Business Associate Agreement is signed before anyone reaches protected health information, staff are HIPAA-trained under a HIPAA compliance officer, and Honest Taskers has its HIPAA compliance verified by Accountable. The company describes itself as SOC 2 audit ready, recruits in the Philippines, Latin America, India and Pakistan, and its professionals work the client's US time zone. Retention runs 99.6% average monthly, which matters when the authorization counter you handed over depends on the same person still being there in March.
Honest Taskers rates and terms come from the company's own published rate card. The band is $10.00 to $12.65 an hour, billed hourly with no weekly minimum, and a two-week working trial applies to a client's first selected professional under current service terms. Wage and employer-load figures come from the Bureau of Labor Statistics, specifically the "Occupational Employment and Wage Statistics" release for May 2025 and the "Employer Costs for Employee Compensation" series for March 2026, with the 48.7% load taken from the office and administrative support row so paid leave and legally required contributions aren't counted twice. Cost per hire comes from SHRM's 2025 Benchmarking Report. The prior authorization figures come from the American Medical Association's 2025 survey of 1,000 practicing physicians, published in May 2026.
What isn't here matters as much as what is. No per-visit revenue figure appears on this page, and no dollar cost for a missed session, because both depend on your payer mix; work them out from your own average visit revenue and your remittances. Nor does a savings percentage. And the speech-language pathology workflow described above, such as visit-limited authorizations, plan of care signatures and recertification windows, reflects general outpatient practice rather than data pulled from one clinic.
Two numbers above are arithmetic rather than published values, and both are worth naming as such. The all-in payroll total of about $68,252 is the BLS median wage with the office and administrative support load applied on top, not a salary any single person receives. Monthly figures for 20 and 40 hours a week are multiplication on the published hourly band, so a practice buying an odd schedule should run that multiplication on its own hours before budgeting.
Where the budget question is settled and you'd rather compare providers side by side, see our ranking of speech therapy virtual medical assistant companies.
Start with a two-week working trial on your authorization list.
