Resources / Pricing
Transparent Pricing
Clear, cash pay pricing with no surprises. Our rates are the same in every state we serve, so you always know what to expect. We also provide a superbill you can submit to your insurer for possible out of network reimbursement.
Medically reviewed by Shariq Refai, MD, MBA, FAPA, board certified psychiatrist · Last reviewed September 23, 2026 · Updated October 4, 2026 · Editorial policy
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“We publish our prices because you deserve to know the cost before you book, not after. Transparent cash pay keeps your visits a full length, your records private, and your care free of insurance games.”
Shariq Refai, MD, MBA, FAPA, founder of shrinkMD
Pricing
Simple, transparent rates
The same in every state we serve.
Membership
From $49 a month after a free first 30 days. Lower follow-up prices for people in ongoing care. No sign-up fee, cancel anytime. Available to Maine patients once Maine intake opens; not yet available in Florida or Nebraska. See membership details →
Initial Evaluation
From $295 (PMHNP) to $395 (psychiatrist). A comprehensive 45 to 60 minute evaluation.
Follow Up Visits
$110 to $215 depending on visit type and membership.
The full breakdown
What each visit costs
The same in every state we serve. Membership lowers every follow-up.
| Visit | Pay per visit | Serenity Squad member |
|---|---|---|
| Initial evaluation, nurse practitioner | $295 | $295 |
| Initial evaluation, psychiatrist | $395 | $395 |
| Follow-up with a psychiatrist | $215 | $145 |
| Follow-up with a nurse practitioner | $165 | $110 |
| Serenity Squad membership | Not required | $49 / month |
Two ways to pay
Membership or pay as you go
Both give you the same clinicians and the same standards. Choose what fits how often you visit.
Pay as you go
No membership and no commitment. You pay the published rate per visit. Best if you expect only an evaluation or the occasional visit.
Serenity Squad membership
$49 a month, first 30 days free. Lower rates on every follow-up. In Maine, also covers one nonurgent message check-in a month and refill-request review. Best for ongoing care.
See membership details →What's included
What you get with shrinkMD
Real clinical time and continuity, not rushed, volume driven care.
- A comprehensive 45 to 60 minute initial evaluation.
- Non controlled medication management with structured follow up.
- Therapy coordination when it helps.
- A superbill for possible out of network reimbursement.
Transparent, cash pay pricing means you always know the cost before your visit.
What the fee covers
One price, the whole visit
Your visit fee covers the clinical work end to end: the full appointment time with your clinician, your diagnosis and treatment plan, prescriptions sent electronically to your pharmacy, and coordination notes when care involves your other clinicians.
There are no facility fees and no surprise charges. You can pay per visit with no membership, or join the optional Serenity Squad membership for lower follow-up rates (Maine, once intake opens). Either way, you see the price before you book.
Thinking it through
How to compare the real cost of care
The honest comparison isn't our fee versus a copay. It's our fee versus a high deductible that rarely gets met, weeks or months of waiting, time off work for office visits, and fifteen minute medication checks that lead to more visits, not fewer.
Most patients can pay with HSA or FSA funds, and if you've out of network benefits, the superbill we provide may bring part of the fee back. We'll never pretend that self pay is right for everyone, but for many people it's both better care and better math.
From Dr. Refai
"One thing I tell patients when comparing psychiatric practices is not to compare the visit price alone. Ask how long the first appointment is, whether you'll see the same clinician at follow-up, whether messaging costs extra, and how often the clinician expects to see you. A $50 copay for a 15-minute med check with a rotating panel usually costs more, both in dollars and in outcome, than a longer visit with one clinician who knows you."
Shariq Refai, MD, MBA, FAPA · Board Certified Psychiatrist, Founder of shrinkMD
Honest answers
Common myths about cash-pay care
Myth: Cash pay always costs more than using insurance.
Fact: Once you count premiums, a deductible that often never gets met, copays, and surprise bills, transparent cash pay is frequently less, and you always see the price before you book.
Myth: Without insurance, you can't get reimbursed at all.
Fact: Many plans reimburse part of out of network care. We give you an itemized superbill to submit, and HSA and FSA funds can be used directly.
Myth: Cash pay means lower quality care.
Fact: Here it's the opposite. Staying out of network is exactly what lets your clinician spend a full hour on your evaluation and keep your records out of insurer databases.
Out of network
How reimbursement works
If your plan has out of network mental health benefits, here is the path.
Pay for your visit
Pay the published rate at your appointment, with a card, HSA, or FSA.
Get your superbill
We provide an itemized superbill with the diagnosis and billing codes your insurer needs.
Submit to your plan
Send it to your insurer's out of network claims. Reimbursement is determined by your plan and isn't guaranteed.
Compare
How shrinkMD compares to other services
If you're weighing options, here are factual, side by side comparisons with other online psychiatry and mental health services, including who each one is right for.
Keep exploring
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Related conditions
Frequently asked questions
Good questions, clear answers
How much does it cost to start?
Your first visit is a comprehensive evaluation starting at $295. Memberships start at $49 a month (first 30 days free; Maine, once intake opens) for ongoing care, and follow ups range from $110 to $215 depending on visit and membership level.
What's included in the Serenity Squad membership?
In Maine, the $49 monthly fee covers one nonurgent secure-message check-in per active month (ordinarily answered within three business days), routine review of refill requests for noncontrolled medication already in your treatment plan (review does not guarantee a prescription), routine care coordination and records routing, member scheduling support, and patient educational resources. Visits are billed separately at member prices. Serenity Squad will be available to Maine patients once Maine intake opens. It is not yet available in Florida and is not available in Nebraska at launch. Benefits and eligibility vary by state; visits are billed separately. See membership details →
What does an initial evaluation cost?
Your first visit is a full 45 to 60 minute evaluation: $295 with a psychiatric nurse practitioner or $395 with a psychiatrist. It's the same thorough evaluation either way.
Is membership required?
No. You can pay per visit with no membership. The Serenity Squad ($49 a month, first 30 days free) simply lowers your follow-up rates, and it pays off for people who visit regularly. It will be available to Maine patients once Maine intake opens.
Do you offer therapy, and what does it cost?
Yes. Therapy is $150 per session, or $120 for Serenity Squad members. Ask us about current therapy availability.
Is the price the same in every state?
Yes. Our cash pay rates are consistent across every state we serve.
Can I get reimbursed by insurance?
We don't bill insurance directly, but we provide a superbill you can submit for possible out of network reimbursement. Check your plan's out of network mental health benefits.
Could pricing change?
Pricing shown here's current and may be updated over time. The latest rates are always on this page.
How much does an online psychiatrist cost without insurance?
At shrinkMD you pay a transparent flat fee per visit, listed before you book. Many patients find self pay costs less than expected once they compare it to high deductibles, surprise bills, and time away from work.
Why does shrinkMD not accept insurance?
Staying out of network lets clinicians spend real time with you, keeps your records private from insurers, and removes prior authorization delays. We publish pricing up front so there are never surprise bills.
Can I use my HSA or FSA to pay?
Yes. Psychiatric care is a qualified medical expense, and most patients can pay with HSA or FSA funds. We can also provide a superbill you may submit to your insurer for possible out of network reimbursement.
Are there any hidden fees?
No. You see the full visit price before you book. There are no facility fees and no charges you haven't agreed to in advance. The optional membership has its own clearly listed price.
How this page is reviewed and how to cite it
Verify independently: ORCID · Wikidata · NPI Registry · All shrinkMD credentials
shrinkMD. (2026). Pricing | Transparent Telepsychiatry Costs [Web page, medically reviewed by Shariq Refai, MD, MBA]. https://shrinkmd.com/telepsychiatry-pricingGet started with clear pricing
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