Telehealth isn’t optional anymore. Whether you’re a therapist seeing clients remotely, a psychiatrist doing medication management, or a practitioner offering hybrid care: you need a video platform that’s HIPAA compliant, reliable, and easy for patients to use.

The good news: there are several solid options in 2026. The bad news: they range from free to expensive, and the right choice depends on whether you need a standalone video tool or something integrated into your practice management system.

Here’s what’s actually worth your money.

Quick Comparison Table

Feature	Doxy.me	SimplePractice	Zoom Healthcare	VSee	Spruce
Pricing	Free–$50/mo	Included (Essential+)	$12.49–21.99/mo	$49/mo	$24–44/mo
HIPAA BAA	Yes	Yes	Yes	Yes	Yes
Recording	Paid plans	No	Yes	Yes	No
Screen sharing	Yes	Yes	Yes	Yes	No
Waiting room	Yes	Yes	Yes	Yes	N/A
EHR integration	Limited	Native	Via API	Yes	Limited
Mobile quality	Good	Good	Excellent	Good	Good
Client download required	No	No	Yes (app)	No	Yes (app)
Best for	Simple + free	SP users	Best video quality	Clinical features	Multi-channel

Doxy.me: Simplest HIPAA-Compliant Video

Free–$50/month

Doxy.me does one thing and does it well: browser-based, HIPAA-compliant video calls with zero friction for patients. No downloads, no accounts, no apps. You send a link, they click it, and you’re face-to-face. That’s it.

The free plan is genuinely usable. You get unlimited session time, a personal waiting room, and HIPAA compliance with a signed BAA. For a therapist who already has practice management software handling everything else and just needs reliable video, the free tier is hard to argue against.

Paid plans ($35–$50/month) add features like screen sharing, session recording, group sessions, and a customizable waiting room with your branding. The Professional plan at $35/month is the sweet spot for most solo practitioners who want the extras.

Where Doxy.me struggles: video quality can be inconsistent, especially on slower connections. It doesn’t have the bandwidth optimization that Zoom has invested billions in. You’ll occasionally get pixelation or audio lag that doesn’t happen on other platforms. For most therapy sessions this is fine: you’re not performing surgery over video: but it’s noticeable.

There’s also no EHR integration to speak of. You schedule separately, document separately, and bill separately. Doxy.me is a video tool, not a practice management platform.

Best for: practitioners who want the simplest possible telehealth setup, budget-conscious therapists, or anyone who already has a separate EHR and just needs HIPAA video.

SimplePractice Telehealth: Best if You’re Already on SimplePractice

Included with Essential ($69/mo) and Plus ($99/mo) plans

If you already use SimplePractice for practice management, their built-in telehealth is the obvious choice. It’s not sold separately: it’s woven into the platform.

The workflow is seamless: you schedule an appointment, mark it as telehealth, and the client gets a link in their appointment reminder. At session time, they click the link from their client portal or the reminder email and join. No separate login, no app download, no confusion.

Video quality is solid for one-on-one sessions. Screen sharing works for sharing worksheets or resources during sessions. The interface is clean and distraction-free.

What you don’t get: session recording (which some compliance frameworks require), group video sessions beyond a few participants, and the bandwidth optimization that dedicated video platforms invest in. If you need to record sessions for supervision or training purposes, you’ll need another solution.

The real value is integration. Your telehealth sessions are connected to the same scheduling, notes, billing, and client portal that runs your whole practice. No copy-pasting between systems, no separate logins.

Best for: anyone already on SimplePractice Essential or Plus who wants telehealth without adding another tool or monthly bill.

Zoom for Healthcare: Best Video Quality and Recording

$12.49–21.99/month per user

Yes, regular Zoom is not HIPAA compliant. But Zoom for Healthcare is. It comes with a signed BAA, encrypted sessions, disabled cloud recording by default (you enable it intentionally), and compliance controls that satisfy HIPAA requirements.

Why choose Zoom over therapy-specific options? Video quality. Zoom has invested more in video infrastructure than anyone else. The adaptive quality works on bad connections, background noise suppression is excellent, and the experience is consistently reliable. If connection quality has been an issue with other platforms, Zoom usually solves it.

Recording is straightforward: local or cloud recording for supervision, training, or documentation purposes. You control retention and access.

The downside: patients need to download the Zoom app (or use the web client, which has limited features). Some clients find this confusing or anxiety-inducing. It also looks less professional than a branded waiting room: patients see the same Zoom interface they use for work meetings.

There’s no native EHR integration. You’ll schedule in your practice management system and create Zoom links separately, though many EHRs can generate Zoom links automatically through API integration.

Best for: practitioners who prioritize video reliability above all else, need recording capabilities, or work with patients in rural areas with poor internet connections.

VSee: Best for Clinical Features

$49/month

VSee targets clinical use cases where you need more than just a video call. Think: intake forms within the video platform, in-session document sharing, multi-participant clinical consultations, and device integration for remote monitoring.

The platform supports multi-party calls well, which makes it useful for family therapy, couples counseling, or sessions involving interpreters. You can bring in multiple participants without the awkwardness of “everyone needs to find the Zoom link.”

VSee also integrates with some EHR systems and offers API access for custom workflows. Larger practices or clinics with specific technical needs appreciate this flexibility.

The interface is more clinical than consumer-friendly. Patients can use it without downloading software (browser-based option available), but the experience isn’t as polished as Doxy.me’s dead-simple “click and connect” approach.

Pricing at $49/month puts it above most competitors, but for practices that need those clinical workflow features, it fills a niche that simpler platforms can’t.

Best for: clinics with complex session types (family therapy, group consultations, interpreter services) or practices that need in-session clinical tools beyond basic video.

Spruce: Best for Text + Calls + Video Combined

$24–44/month

Spruce takes a different approach. Rather than being a dedicated video platform, it’s a patient communication hub that happens to include video. You get HIPAA-compliant texting, phone calls, video visits, and team messaging in one app.

The value proposition: instead of having separate tools for patient texting (Podium/Weave), phone calls (your office phone), and video (Doxy.me/Zoom), Spruce combines them all. One inbox, one platform, all HIPAA compliant.

Video quality is adequate but not exceptional. It works for standard telehealth sessions but doesn’t match Zoom’s quality or Doxy.me’s simplicity. The real draw is having all patient communication: texts, calls, and video: in one conversation thread.

For small practices that want to modernize patient communication without cobbling together multiple tools, Spruce is an interesting middle ground. You trade best-in-class video for a unified communication experience.

Patients do need to download the Spruce app for video calls, which adds a friction point. Text messaging works without the app, but video requires it.

Best for: solo practitioners or small practices that want HIPAA-compliant texting, calling, and video in one place without paying for multiple separate tools.

Making the Decision

Already on SimplePractice? Use their built-in telehealth. Don’t pay for another tool.

Need free and simple? Doxy.me’s free tier is legitimate. Start there.

Video quality is everything? Zoom for Healthcare. Nothing beats their infrastructure.

Want communication beyond video? Spruce if you want text + call + video. Look at your broader patient communication strategy.

Complex clinical needs? VSee for multi-party sessions and clinical workflows.

For a deeper dive into practice management platforms that include telehealth, check out our SimplePractice vs TherapyNotes vs Jane App comparison. And for SimplePractice plan details (including what’s included with telehealth), see our SimplePractice pricing breakdown.

Frequently Asked Questions

Is regular Zoom HIPAA compliant?

No. The standard Zoom plans are not HIPAA compliant. You need specifically Zoom for Healthcare (or Zoom One with the healthcare add-on), which includes a BAA, encryption, and compliance controls. Using regular Zoom for patient sessions violates HIPAA, even if you think the content isn’t sensitive.

Can patients join telehealth from their phone without downloading an app?

Doxy.me and SimplePractice both work entirely in the mobile browser: no app needed. Zoom technically has a web client but it’s limited on mobile. VSee offers a browser option. Spruce requires their app for video calls. For the lowest friction patient experience, Doxy.me and SimplePractice win.

What internet speed do patients need for telehealth?

Most platforms recommend at least 1.5 Mbps upload and download for stable video. Zoom handles poor connections best, dynamically adjusting quality. Doxy.me can struggle on connections below 2 Mbps. If your patient population has inconsistent internet, Zoom’s adaptive quality gives the most reliable experience.

Do I need telehealth if I only see patients in person?

Consider it anyway. Patients cancel less when they have the option to switch to video for mild illness, travel, or schedule conflicts. Even primarily in-person practices find that offering telehealth for follow-ups and quick check-ins reduces no-shows and improves retention.

Can I use telehealth across state lines?

This depends on your license, not your platform. Most platforms work anywhere with internet. The legal question is whether your license allows you to treat patients located in another state during the session. Many states have telehealth compacts and temporary practice provisions, but verify your specific licensing situation before seeing out-of-state patients.

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