Video-based telehealth provides mental health services to underserved populations. As decision makers reevaluate service offerings following COVID-19, it remains prudent to evaluate the utility of ongoing telehealth options among rural healthcare facilities, the primary healthcare source for many rural individuals. As research continues to compare video and face-to-face services, one understudied component is attendance. Although video-based telehealth has demonstrated improved show-rates for mental health services when compared to face-to-face methods, limited work has clarified whether video improves patient punctuality for these appointments, a documented challenge prevalent for patients with mental health-related concerns. A retrospective electronic record review of psychiatry, psychology, and social work initial patient visits between 2018–2022 was conducted (N = 14,088). Face-to-face visits demonstrated a mean check-in time of -10.78 min (SD = 26.77), while video visits demonstrated a mean check-in time of -6.44 (SD = 23.87). Binary logistic regressions suggested that increased video usage was associated with a decreased likelihood of late check-in (B = -0.10, S. E. = 0.05, Exp(B) = 0.91, 95% CI = 0.83 – 1.00). Exploratory binary logistic regressions evaluated age, sex, race, ethnicity, specialty, insurance type, and diagnostic classification influence on video initial visits. Increased video usage was associated with a statistically decreased likelihood of late check-in; however, clinically, both face-to-face and video visits exhibited mean check-in times prior to the initial visit’s scheduled time. As such, mental health organizations are encouraged to continue offering both face-to-face and video as options to foster evidence-based practices to the broadest population.