Telepsychiatry programs are springing up across the United States, but not all succeed, especially if they were developed on “soft funding.” Many telepsychiatrists have become expert in the clinical aspects of their practice, but lack the skills necessary to independently maintain their system, such as trouble shooting technical challenges, selecting the best equipment, finding new clients, and developing financial sustainability. This Workshop builds upon the basics of telepsychiatry covered in the Workshop Telepsychiatry 101: An Introductory Course on Getting Started and is intended for those currently providing telepsychiatry services. In addition to innovations in ensuring quality care, efficient processes, and evidence-based practice, the technological and financial factors involved in sustaining and growing a service are emphasized.