01
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.
A private-pay practice for people whose lives cross state lines. One prescriber, licensed in 35 states and Washington, DC.
- 35 states + DC
- Private pay
- One prescriber
- Membership limited
One prescriber. Thirty-five states. No waiting room.
Continuity is the treatment
The service
Care that does not
stop at a state line
Traditional psychiatric care books out for weeks and hands you to whoever is available. PsyConcierge is a single senior prescriber who knows your history, and treats access as part of the care itself.
02
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.
03
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.
04
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.
05
Access, guaranteed in writing
Members hold a scheduling guarantee: within two business days, and the same or next business day at the Principal level. Between appointments, members reach their prescriber directly, and are answered the same business day.
06
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.
07
Natural medicine, arranged and coordinated
Dr. Winner is a Natural Medicine Clinical Facilitator (NMCF). Natural medicine services can be arranged and coordinated for clients in Oregon and Colorado.
How it works
Three steps
01
Apply
Call (800) 303-3221 or write to [email protected]. A short conversation confirms fit, and licensure in your state.
02
Your first appointment
A 60-minute Comprehensive Initial Appointment by secure video, from wherever you are in a licensed state, with a plan you understand before the call ends.
03
Ongoing care
Appointments on your level's guarantee, prescriptions managed without friction, and continuity when you travel.
Coverage
Licensed in 35 states,
and Washington, DC
Care is provided by telehealth under an active license in each state listed. If you are physically in a covered state, you can be seen.
Pacific and Mountain
- Alaska
- Arizona
- California
- Colorado
- Hawaii
- Idaho
- Montana
- Nevada
- New Mexico
- Oregon
- Utah
- Washington
- Wyoming
Central
- Arkansas
- Iowa
- Kansas
- Louisiana
- Nebraska
- North Dakota
- Oklahoma
- South Dakota
- Texas
- Wisconsin
East
- Connecticut
- Delaware
- District of Columbia
- Florida
- Kentucky
- Maryland
- New Jersey
- New York
- Ohio
- Tennessee
- Vermont
- Virginia
- West Virginia
Licensure in progress: Illinois, Massachusetts, Guam, and Mississippi.
Care from wherever you are
Membership and fees
Priced plainly,
agreed in advance
PsyConcierge is cash pay only. No insurance billing, no claims, no surprises.
I
Private Appointments
Single appointments, for a consultation or occasional care. Every relationship begins here, with the 60-minute Comprehensive Initial Appointment.
$350 per 60 minutes
$250 per 30 minutes
II
Concierge Membership
Ongoing care with a guaranteed place in the schedule, held for thirty members.
$695 per month
or $6,950 per year
Apply for membership- One full 60-minute appointment included every month
- Scheduling guaranteed within two business days
- Direct secure messaging, answered the same business day, Monday to Saturday
- Continuity of care and prescriptions in every licensed state when you travel, with a medication check before trips
- Annual comprehensive review, with a written care plan
- Coordination with your other clinicians, included
- Additional appointments at the standard rates
III · Principal
The highest level of access
PsyConcierge offers.
- Two full 60-minute appointments included every month
- Scheduling guaranteed the same or next business day
- Direct phone access during business hours, Monday to Saturday
- A review every quarter, and the annual review with a written care plan
- Continuity of care and prescriptions in every licensed state
- Additional appointments at the standard rates
$1,250 per month · $12,500 per year
Apply for PrincipalLimited to ten members · Admission is by application
Membership is limited so the access promised here stays real. The membership fee covers the services listed for your level; it does not cover medications, laboratory work, or the fees of other clinicians. Membership can be paused, or ended with 30 days notice, and any unused prepaid fees are refunded pro rata. There is no long-term contract. Secure messaging is for routine matters between appointments, is not monitored around the clock, and is never for emergencies.
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 service within Solutions Psychiatry, for clients who need senior-level care without the delays, handoffs, and state-line interruptions of conventional practice.
He is also a Natural Medicine Clinical Facilitator (NMCF). Natural medicine services can be arranged and coordinated for clients in Oregon and Colorado.
- Licensed35 states and Washington, DC
- DoctorateDoctor of Nursing Practice, Vanderbilt University
- Board certifiedPsychiatric Mental Health Nurse Practitioner, ANCC
- Natural medicineArranged and coordinated in Oregon and Colorado
Dr. Karel Winner, DNP, PMHNP-BC, NMCF
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 and based on time: $350 per 60 minutes and $250 per 30 minutes, the same for initial and follow-up appointments, or membership at $695 per month, and Principal at $1,250 per month.
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?
Concierge Members are guaranteed scheduling within two business days, and Principal members the same or next business day. The first step for everyone is the 60-minute Comprehensive Initial Appointment.
What does membership include?
One full 60-minute appointment each month, scheduling guaranteed within two business days, direct secure messaging answered the same business day, Monday to Saturday, continuity of care and prescriptions across every licensed state when you travel with a medication check before trips, an annual comprehensive review with a written care plan, coordination with your other clinicians, and additional appointments at the standard rates. Membership is $695 per month or $6,950 per year, is limited to 30 members, and can be paused or ended with 30 days notice, with unused prepaid fees refunded pro rata. The fee does not cover medications, laboratory work, or other clinicians.
What is Principal?
Principal is the highest level of access, limited to 10 members. It includes two full 60-minute appointments each month, scheduling guaranteed the same or next business day, direct phone access during business hours, Monday to Saturday, quarterly reviews in addition to the annual comprehensive review and written care plan, and everything in Concierge Membership. Principal is $1,250 per month or $12,500 per year, on the same pause and cancellation terms.
Can I join if I have Medicare?
Membership is a private arrangement and is not offered to Medicare beneficiaries. If you are covered by Medicare, Dr. Winner can see you through Solutions Psychiatry, his regular practice, which accepts Medicare in several states. Call (800) 303-3221 and we will point you to the right door.
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.