Is It Time to Go Fully Remote? What to Know Before Giving Up Your In-Person Office
Let’s be honest—keeping up a physical therapy office isn’t cheap. Rent, utilities, cleaning, furniture, coffee pods that mysteriously disappear faster than they should… it adds up. If you’re feeling the pull to transition your therapy practice to fully remote telehealth, you’re not alone. More and more therapists are choosing to give up their in-person space and embrace the flexibility and freedom of a fully remote model. But how do you know if it's the right move for you?
In this post, I’m breaking down what to consider, the pros and cons, and a few things you might not have thought about—like what to do about a mailing address and how insurance billing can be affected. Let’s dive in.
What to Consider Before Going Fully Remote
Your Client Base
Are your clients comfortable with telehealth? Are you attracting (or hoping to attract) a younger or tech-savvy demographic? Do your current caseload and referral sources support the shift? Most clients are on board—especially after COVID normalized remote therapy—but it’s still worth checking in.
Licensing and Legal Requirements
When you’re fully remote, you have to be even more mindful about practicing only in the states where you're licensed. You can be sitting in Georgia, but if your client is on vacation in Florida and you're not licensed there, that could be a problem.
That’s why many fully remote therapists choose to get licensed in multiple states. It opens the door to a wider client base and allows more flexibility—especially if you’re working with clients who travel or relocate often. The process can take time and money, but it may be well worth it if you're looking to expand your reach.
Insurance Billing
If you take insurance, check with each panel to make sure they allow fully remote practices. Some plans still require that a therapist have a physical location listed on file—even if no clients are seen there. Others might reimburse differently for telehealth vs. in-person. Don’t assume—it’s worth the phone call or email.
Pro tip: if you use Headway for insurance billing, they now offer multi-state license insurance paneling and can help you keep track of the rules and stay in compliance. Use my link to get started with Headway.
Your Work Style
Be honest with yourself: Do you thrive in your home office, or do you need a change of scenery to focus? Do you feel isolated without colleagues around, or do you love being in your own space with your favorite mug and zero commute?
Mailing Address + Privacy
You’ll still need a professional mailing address for things like insurance checks, legal paperwork, or business registration. But that doesn’t mean you need to rent a whole office. A virtual mailbox, UPS store box, or even a co-working space with mail services can do the trick while protecting your home address.
The Pros of a Fully Remote Practice
More Flexibility – No commute, no office hours. You set your schedule, which can open the door to better work/life balance or even seeing clients in multiple time zones.
Lower Overhead – No rent, no cleaning service, no toilet paper restocking (yes, it’s the little things).
Access to More Clients – Some clients prefer telehealth—especially those in rural areas, with busy schedules, or who feel more comfortable in their own space.
Research-Backed Effectiveness – Studies have shown that telehealth therapy is just as effective as in-person sessions for many mental health concerns. It’s not a second-best option—it’s a solid one.
Room to Expand – Getting licensed in multiple states makes it possible to grow your practice beyond your local area, especially helpful if you’re building a niche or serving specific populations.
The Cons (Let’s Be Real)
Tech Issues Happen – Wi-Fi drops, audio glitches, and platform learning curves are part of the game.
Solution: Invest in a reliable internet connection, use a backup hotspot if possible, and get comfortable with your video platform’s features. Have a quick tech-check protocol and a plan B (like switching to phone) ready for clients.
Harder to Read the Room – Subtle body language or emotional cues can be trickier to pick up on via video.
Solution: Slow things down and ask more clarifying questions. You can also adjust your camera angle so your face and upper body are visible, and encourage clients to do the same when possible. Regular check-ins on how the session format is working for them also help.
Licensing Limits – You’re bound to see clients only in states where you're licensed, even if they travel.
Solution: Consider getting licensed in multiple states to expand your client base and reduce disruptions. Prioritize states where you already have demand or personal/professional ties. Some states offer reciprocity or streamlined applications if you’re already licensed elsewhere. Communicate clear boundaries about location expectations with clients.
Insurance Rules Can Be Murky – Especially if you’re paneled with multiple companies, keeping up with their varying telehealth policies takes some diligence.
Solution: Stay proactive by regularly checking your insurance panels' telehealth policies. Join therapist forums or groups to keep up with changes. Consider consulting with someone familiar with insurance if it’s feeling overwhelming. Also, keep documentation of all your correspondence—just in case.
Making the Decision
If you’re feeling burned out by your office lease or simply want to design a lifestyle around your own needs and values, a fully remote therapy practice might be your next best move. Like any big decision, it’s a mix of practical considerations and gut instinct.
And remember: remote doesn't mean disconnected. You can still build strong therapeutic relationships, a thriving referral network, and a fulfilling practice—without stepping foot in an office building.
Ready to Go Remote? I Can Help.
If you're considering going fully remote and want support from someone who’s been there, I’d love to help. Whether you’re insurance-based or private pay, just starting out or making a big shift, I offer consultation services for therapists building the practice that fits their life—not the other way around.
Schedule a consultation with me and let’s talk about what your ideal practice could look like.
