Online counseling practice from home

Individuals and couples paying out of pocket, clients using insurance (if you join insurance panels), and sometimes employers or employee assistance programs.

A fee per session, usually 45 to 60 minutes. Self-pay clients pay your set rate. Insurance clients pay a copay, and the insurer pays the rest at a contracted rate.

• Active listening and empathy
• Clinical judgment and ethics
• Keeping records and managing a schedule
• Marketing yourself with a clear specialty

• State licensing: counselors generally need a state license to practice independently, so check your state board's requirements
• You usually need to be licensed in the state where the client is located during the session, so check rules for clients who travel or move
• Professional liability (malpractice) insurance, and check whether you also need general liability
• Privacy rules such as HIPAA, plus informed consent and emergency plans for telehealth
• Insurance credentialing can take months, and payments may be slow or lower than your self-pay rate

Startup costs are typically around $500 to $3,000, depending on your technology, secure video setup, insurance and how you market the practice. Working from a quiet room at home keeps premises costs out of the picture.

Monthly revenue is typically estimated at around $1,500 to $7,500, depending on how many client hours you book and your rates. Insurance payments may be slower or lower than your self-pay rate.

Check your state board's licensing requirements for independent practice. You usually need to be licensed where the client is during the session. Check professional liability insurance, HIPAA, informed consent and emergency plans, and how long insurance credentialing may take.