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Glossary / Cost per encounter

Cost per encounter

Definition

Cost per encounter is the fully loaded cost of delivering one clinical encounter in a telehealth program — clinician review, platform or infrastructure fees, pharmacy and shipping when a prescription results, payments, support, and an allocated share of fixed overhead — and it is the unit-economics denominator for programs operating at volume.

By Lithos Staff · Updated September 2026

At a glance
  • The unit-economics denominator at volume
  • Model initial and renewal encounters separately
  • Fixed share falls with volume; variable share moves with design
  • Medication is usually a pass-through, tracked separately

Why the encounter, not the patient

Patient-level metrics — acquisition cost, lifetime value — decide whether to acquire. Encounter-level cost decides whether the program is efficient, because a patient is a bundle of very different events: one initial encounter with a full intake and longer review, and a string of renewals with a check-in and a shorter one. Modeling each type separately is what makes the levers visible.

Fixed versus variable

Variable lines move with each encounter: clinician minutes, medication, shipping, payments, support tickets. Fixed lines — medical group and licensure upkeep, compliance, engineering, operations staff, platform base fees — are spread across the month’s encounters, so their per-encounter share falls as volume rises. Infrastructure pricing typically converts several fixed lines into one variable one.

  • Variable: clinician review, medication, shipping, payments, support
  • Fixed: licensing and compliance, engineering upkeep, ops staff, platform base fee
  • Per-encounter fixed share = fixed total ÷ monthly encounters

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Lithos runs the clinicians, pharmacies, and 50-state rules behind your care program — one API.

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Frequently asked questions

How is cost per encounter calculated?

Sum the variable costs attributable to the encounter, add the month’s fixed costs divided by the month’s encounters, and report the result by encounter type — initial, renewal, labs-only.

What is a good cost per encounter for telehealth?

There is no universal number; category, model, and stage differ too much. Track your own month over month, watch the fixed share, and compare initial to renewal.

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