Comprehensive psychiatric evaluation
Every relationship begins with a full hour together: your history, what you are dealing with, what has and has not worked, and what you want to change. The plan is built around you, not around a template.
Private concierge psychiatry
Psychiatric care that moves with you.
PsyConcierge is a private-pay practice for people whose lives cross state lines. One prescriber, licensed in 35 states and Washington, DC, available on a priority basis, so your care continues wherever your work and life take you.
Psychiatric Nurse Practitioner
- 35 states + DC
- Private pay, no insurance
- Priority scheduling
- One prescriber, start to finish
The service
Built for people who cannot put their lives on hold
Founders, executives, physicians, attorneys, and frequent travelers share the same problem. Traditional psychiatric care stops at a state line, books out for weeks, and hands you to whoever is available. PsyConcierge is the opposite: a single senior prescriber who knows your history, holds licenses across most of the country, and treats access as part of the care itself.
Medication management, done precisely
Careful prescribing, honest review of what each medication is doing, and adjustments made promptly rather than at the next quarterly slot. When something is not working, it is addressed.
Specialized psychotherapy
When therapy belongs in the plan, it is available from the same clinician, including Internal Family Systems (Level 3) and Brainspotting, among a wider range of modalities.
Continuity across state lines
Licensed in 35 states and Washington, DC. Travel for work, split your time between homes, or relocate mid-treatment: your prescriber, your records, and your plan travel with you.
Priority access
Members are scheduled first, typically within two business days, and reach their prescriber between appointments through secure messaging. Short notice is the point of the service.
Complete discretion
Private pay means no insurance claims, no insurer record of your care, and no explanation owed to anyone. Your care stays between you and your prescriber.
How it works
Three steps, no waiting rooms
01
Apply
Call (800) 303-3221 or email win@psych.us. A short conversation confirms fit, licensure in your state, and whether membership or a single appointment serves you better.
02
Your first appointment
A 60-minute Comprehensive Initial Appointment by secure video, from wherever you are in a licensed state. History, diagnosis, medications, and goals, with a plan you understand before the call ends.
03
Ongoing care
Follow-up appointments on a priority basis, prescriptions managed without friction, and continuity when you travel. Membership keeps all of it in place, month after month.
Coverage
Licensed where you live, work, and travel
Care is provided by telehealth in every state listed below, under an active license in that state. If you are physically in a covered state, you can be seen.
- Alaska
- Arizona
- Arkansas
- California
- Colorado
- Connecticut
- Delaware
- District of Columbia
- Florida
- Hawaii
- Idaho
- Iowa
- Kansas
- Kentucky
- Louisiana
- Maryland
- Montana
- Nebraska
- Nevada
- New Jersey
- New Mexico
- New York
- North Dakota
- Ohio
- Oklahoma
- Oregon
- South Dakota
- Tennessee
- Texas
- Utah
- Vermont
- Virginia
- Washington
- West Virginia
- Wisconsin
- Wyoming
Licensure in progress: Illinois, Massachusetts, Guam, and Mississippi.
Membership and fees
Simple, private, and agreed in advance
PsyConcierge is cash pay only. No insurance billing, no claims, no surprises. Two ways to begin:
Private Appointment
$350 per appointment
- A full appointment with your prescriber
- Comprehensive Initial Appointment, 60 minutes
- Prescriptions prescribed and managed
- A clear plan before the appointment ends
- Ideal for a single consultation or occasional care
The concierge standard
Concierge Membership
$595 per month
or $5,950 per year
- One appointment included every month
- Priority scheduling, typically within two business days
- Direct secure messaging between appointments
- Care in every licensed state when you travel
- Additional appointments at $250 each
- Coordination with your other clinicians, on request
| Private Appointment | Concierge Membership | |
|---|---|---|
| Appointments | $350 each | One included monthly, then $250 |
| Scheduling | Standard availability | Priority, typically within two business days |
| Between-visit access | By appointment | Direct secure messaging |
| Care while traveling | Any licensed state | Any licensed state, continuity assured |
| Coordination with your clinicians | On request | Included, on request |
Membership is intentionally limited, so that access stays immediate for the people who hold it. Membership can be paused or ended at any time; there is no long-term contract.
Your prescriber
Dr. Karel Winner
Psychiatric Nurse Practitioner, Doctor of Nursing Practice
Dr. Karel Winner is a Psychiatric Nurse Practitioner who holds a clinical doctorate, the Doctor of Nursing Practice, from Vanderbilt University, together with a graduate degree in education from Vanderbilt University that qualifies him to provide education at any level up to doctoral level.
He is board certified as a Psychiatric Mental Health Nurse Practitioner (PMHNP-BC, ANCC) and holds active licenses in 35 states and Washington, DC. His practice combines comprehensive psychiatric evaluation and medication management with specialized psychotherapies, including Internal Family Systems at Level 3 and certified Brainspotting.
PsyConcierge is his private practice within Solutions Psychiatry, created for clients who need senior-level psychiatric care without the delays, handoffs, and state-line interruptions of conventional care.
Dr. Karel Winner, DNP, PMHNP-BC, NE-PMC, CAMS-II, CTP, IFS-L3, BSP-P5, CLC, PATP, ADHD-CCSP, ASDCS, CYMHS, RDMS, RVT, RCPod
Questions
Before you apply
Do you accept insurance?
No. PsyConcierge is private pay by design. It keeps your care off insurance records, removes prior authorizations and network limits, and lets scheduling follow your needs rather than an insurer's rules. Fees are agreed in advance: $350 per appointment, or $595 per month for membership.
In which states can you see me?
In the 35 states and Washington, DC listed under Coverage, by telehealth, wherever you are physically located in a covered state at the time of the appointment. Licensure for Illinois, Massachusetts, Guam, and Mississippi is in progress.
How quickly can I be seen?
Members are scheduled on a priority basis, typically within two business days. The first step for everyone is the 60-minute Comprehensive Initial Appointment.
What does membership include?
One appointment each month, priority scheduling, direct secure messaging between appointments, continuity of care across every licensed state when you travel, additional appointments at $250, and coordination with your other clinicians on request. Membership is $595 per month or $5,950 per year, and can be paused or ended at any time.
Can I begin with a single appointment?
Yes. A Private Appointment is $350 and includes the full Comprehensive Initial Appointment. Many members begin this way and convert once they see how the service fits their lives.
Is PsyConcierge an emergency service?
No. PsyConcierge is scheduled, ongoing care. If you are in crisis or may act on thoughts of harming yourself, call or text 988 in the United States, or call 911.