Once you complete our intake form, our team will review it to ensure we’re a good clinical fit. You’ll then receive an invitation to schedule your initial intake appointment with a provider whose specialties match your needs. We’ll send clear instructions for setting up your patient portal, completing consent forms, and preparing for your first visit.

Your initial psychiatric evaluation lasts 75–90 minutes. During this time, your provider will review your history, current symptoms, medical background, and goals for care. Together, you’ll explore what’s been tried before, what worked, what didn’t, and what you’d like to be different. The goal of this first session is clarity and collaboration—not judgment or rushed decision-making.

Follow-up sessions are either 30 minutes ($250) or 50 minutes ($350) depending on your needs and preferences. Frequency varies depending on the service.

For psychiatric care, we generally meet for the initial assessment, then again 2-4 weeks later. Appointments tend to be about monthly for the first 3-6 months, and can be spaced out as treatment is working, and you’re feeling good about the plan in place.

Gender-affirming care is generally less frequent - at a rate of every 3-6 months depending on the medication, how long you’ve been on treatment, and your clinical need.

Perimenopause treatment, hormone optimization, and sexual health visits are similar to gender-affirming care, at a frequency of approximately every 3 to 6 months after the initial assessment.

All appointments take place through a secure, HIPAA-compliant video platform. You’ll receive a private link before each session. You can join from a laptop, tablet, or smartphone in a private space. Telehealth allows us to see patients across Maryland, Massachusetts, Virginia, and Washington DC.

You’ll be matched with a provider whose background and expertise align with your goals. Each OutPsych clinician offers psychiatric care with different areas of specialization:

• Jess Romeo (he/they) – LGBTQ+ mental health, gender-affirming care, chronic illness-related psychiatry. Sees patients 10+.

• Janine Michaelson (she/her) – Trauma, anxiety, mood disorders, neurodiversity-affirming medication management, PDA profile, and child/adolescent psychiatry. Sees patients 6+.

• Teresa Vlahovich (she/her) – Reproductive and perinatal mental health, young adults, and LGBTQ+ individuals. Sees patients 16+.

• Tina Celenza Remillard, PA-C (she/her) – ADHD, PMDD, gender-affirming care, perimenopausal and menopausal mood changes, trauma-informed medication management. Sees adults 18+.

We provide care for mood and anxiety disorders, ADHD, trauma-related conditions, OCD, and the overlapping impacts of chronic illness, neurodivergence, and identity-based stress. We also offer gender-affirming hormone management and perinatal mental health care.

OutPsych is an out-of-network practice, which means we do not bill insurance directly. Many of our clients receive partial reimbursement from their insurance providers using a superbill (a detailed receipt we provide after each session). We can also check benefits and submit reimbursement claims FOR YOU using a service called Reimbursify.

You might want to connect with your insurance company to find out about their “allowable amounts” for the CPT codes below, and compare that with your reimbursement percentage to estimate out-of-pocket costs.

Below are the CPT codes and standard fees we usually use:

• 99205 – Initial intake for all services (75-90 minutes): $450-$600

• 99214 - 20-30 minute follow-up (only available with Tina Remillard, PA-C): $175

• 99214 + 90833 – 30-minute follow-up: $250

• 99214 + 90836 - 50-minute follow=up: $350

When contacting your insurance company, ask these questions:

1. What is your allowable amount for each of these billing codes (99205, 99214, 90833, & 90836)?

2. What percentage of that allowable amount can I get reimbursed?

3. Is there a deductible I must meet before I’ll see reimbursement, and have I reached it?

Once you have this information, you can estimate your likely costs. Here’s an example:

• Initial intake ($450-$600):

  • Typical allowable amounts for this service are $250-$350.

  • With a typical 50% reimbursement rate, you may receive around $125-150 back, leaving roughly $300–$400 out of pocket.

  • (the intake appt will likely be your highest out of pocket cost throughout all of treatment)

• Follow-ups (30 min, $250): Allowable amounts typically range $150–$250, so reimbursement rates tend to be higher and out-of-pocket costs lower. Many patients have up to 80% of this fee reimbursed, so that your ultimate cost is little more than an average co-pay.

Your intake appointment will be your most expensive visit. Follow-ups are generally more affordable with better coverage.

Maybe! We see patients who are located in Maryland, The District of Columbia, or Massachusetts. If you’re in any of these areas, feel free to contact us to learn more.

Yes! Most of our practitioners are queer, and strive to create a space that is welcoming for people of all identities. If you identify along the LGBTQIA+ spectrum, you will find that we honor your identity and freedom to live authentically. Some of our providers are also qualified to perform mental health assessments for Gender-Affirming Surgery, and can provide a letter when appropriate for your surgeon.

This means that we understand the role that control, trust, and empowerment play in making decisions about your treatment, including medication. When you decide to take a medication, what happens next often has as much to do with your relationship with that provider as it does with the molecule’s effects on your body. Oftentimes our patients have been prescribed medications in the past, but had negative reactions or never even took the medication because:

1. Their provider didn’t take the time to explain it

2. Didn’t prepare them for potential side effects

3. They didn’t have a strong, trusting relationship with that provider.

At a gut level, patients felt afraid, mistrustful, and not in control–all of which can be re-traumatizing, discouraging them from seeking care they might desperately need. It is a core value in our practice to give patients a sense of control over their treatment, be flexible and informative when it comes to medication choices, and create a compassionate environment that helps people feel safer taking medication.

Not at all. Integrative psychiatry is the practice of offering high-quality Western medicine approaches such as psychotropic medications, while also recommending evidence-informed complementary therapies to treat psychiatric symptoms and optimize wellness. If you’re 100% against taking psychotropic medications, it is important for us to clarify that we are not anti-medication. It is likely we will discuss the benefits of pharmaceutical interventions, but we also use non-medication approaches often and will discuss the nuances of this with you based on your particular circumstances.

Psychiatric Nurse Practitioners and Psychiatrists are both trained to assess, diagnose, and treat mental health conditions with medications and psychotherapy interventions. We often perform the same role in mental health care. Numerous studies have also found that patient outcomes for nurse practitioners are equivalent to, and in some cases better than, those of physicians.

By choosing to work with a nurse practitioner, you see someone who was trained under a nursing model-–to care for the whole patient, in addition to treating disease. Many psychiatrists adopt this philosophy of care as well, but for NPs, it’s part of our training from day 1. You do what you feel is best for you, but rest assured that with a Psychiatric-Mental Health Nurse Practitioner, your care is in very well-trained, compassionate, and capable hands.