Cash-pay · Telepsychiatry

Psychiatry,
hormones,
metabolism.

Telepsychiatry for adults anywhere in North Carolina, working up thyroid, testosterone, and metabolic markers alongside mood.

N C

Telepsychiatry in North Carolina

I'm Dr. Shantanu Baghel, DO, board certified in psychiatry and in forensic psychiatry. I see every patient on the panel myself. One flat fee of $250 / month, no insurance billed, and most patients are seen within one to two weeks.

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01 · Why this practice

How I run the practice.

a

45 to 60 minute appointments

Long enough to take a full history, read the labs, and change the plan when it needs changing.

b

Board-certified at every visit

Every visit is with Dr. Baghel, a physician board-certified in psychiatry and forensic psychiatry. The doctor who starts your care follows it through.

c

Psychiatry, hormones & metabolism

Thyroid, testosterone, and metabolic markers get worked up alongside mood. They often drive what looks like a psychiatric symptom.

d

Seen within one to two weeks

The panel is kept small on purpose, so most new patients get a first visit within one to two weeks.

02 · Services

Five lines of care, one physician.

Every line of care starts with the same workup and is managed by the same physician, visit to visit.

i

Comprehensive psychiatry

Depression, anxiety, ADHD, treatment-resistant depression, and supervised antidepressant tapering.

 ii

Testosterone therapy

TRT with full hormone and metabolic workup, monitored alongside mood and energy.

 iii

Medical weight loss

Physician-managed metabolic care, including labs and pharmacotherapy where appropriate.

 iv

Peptide therapy

Physician-supervised peptides through state-licensed 503A compounding. When legally available.

 v

Forensic psychiatry

Evaluations and expert opinion, board-certified in forensic psychiatry.

View all services and pricing

03 · Pricing

One flat fee, and that's the whole price list.

The fee covers your appointments, messaging between visits, and ordering and interpreting your labs.

Monthly $250 / mo Month to month. No contract, no minimum term.

Labs and medications are billed separately, by the laboratory and the pharmacy, directly to you at their price. There is no charge from this practice for ordering or interpreting them.

Schedule a free consultation
04 · What the fee covers

One fee, and what it covers.

I set the price against the heaviest month a patient might have. Someone stable on a maintenance dose might see me once a quarter. Someone coming off an SNRI, or three weeks into a testosterone protocol with a hematocrit that needs watching, might need me four times in four weeks. Both pay $250.

  1. Appointments as your treatment needs themEach one runs 45 to 60 minutes, long enough to take a full history, read your labs line by line, and set or revise the plan.
  2. Messaging between visitsIf a side effect shows up on day nine, you write to me on day nine.
  3. Labs ordered and interpretedThere is no extra charge for this, including for labs ordered mid-course when something needs rechecking.

Labs and medications themselves are billed separately, by the laboratory and the pharmacy, at their price. You can request a Good Faith Estimate of expected charges before scheduling, which is your right as a self-pay patient.

05 · Coverage

North Carolina, statewide.

Telepsychiatry means the visit happens by video. The evaluation is the same one I would do in a room with you.

In 2024, 25 North Carolina counties had no psychiatrist reporting a primary practice location in the county. Licensure ties me to North Carolina, so you'll need to be in the state when we meet.

Empty waiting room with a tan leather armchair, framed art, and a potted olive tree under warm afternoon window light.
Quiet warm-wood corridor in late afternoon light with a single olive tree at the far end.
01Can I see a psychiatrist without insurance?
Yes. This practice is cash-pay and doesn't bill insurance. The fee is $250 a month, flat, with no contract and no minimum term. Labs and medications are billed to you separately by the lab and the pharmacy, at their price. Ordering and interpreting them is included.
02How many appointments do I get for $250?
As many as your treatment needs. Each one runs 45 to 60 minutes. Most months that's one visit. A month with a taper or a dose change may take several, and the price doesn't move. There's no per-visit charge and no visit counter.
03Do you treat ADHD?
Yes. Adult ADHD is one of the conditions I see most. Treatment starts with a full diagnostic evaluation, including a review of sleep and the hormonal or metabolic contributors that can mimic it. I prescribe stimulant and non-stimulant medication when the diagnosis supports it, and I check cardiovascular effects, sleep, and appetite at each visit. If you already have a diagnosis, bring the records.
04Can a psychiatrist prescribe weight-loss medication?
Yes. Psychiatrists are physicians, and a North Carolina medical license is not limited by specialty, so this sits within scope. I manage it inside your psychiatric care, because some psychiatric medications drive weight gain and metabolic problems produce mood symptoms. GLP-1 medication is one option, and which one fits depends on your labs and what else you're taking.
05How soon can I be seen?
Most new patients get a first visit within one to two weeks.
06Do I have to live in North Carolina?
You need to be physically located in North Carolina at the time of each appointment. Under state licensure rules, care is treated as happening where you are. Where in the state doesn't matter, since every visit is by video.
07Can you taper my antidepressant?
Yes, and it's a significant part of what I do. In the first month, withdrawal effects and a genuine relapse are easy to confuse, so I taper slowly and check in often. The full method is written up here.

Why I Don’t Take Insurance

When a plan is involved, a share of every week goes to prior authorizations, formulary substitutions, and denied claims. I’d rather put that time into appointments.

You pay the practice directly, and the plan we make at the visit is what gets prescribed. I don’t bill insurance, so no plan receives a claim from this practice.

A message sent on Tuesday is usually answered on Tuesday.

Self-pay protects some information and not other information. I’ve written the long version: what cash-pay psychiatry costs in North Carolina and what stays private.

What’s Outside My Scope

A few things are worth knowing before you book. I treat adults, so children and adolescents are outside my scope.

This is outpatient care delivered by video. If you’re in crisis right now, call or text 988, or go to your nearest emergency department.

I do medication management and diagnostic work. For therapy, I coordinate with a therapist you already see, or help you find one.

Forensic Psychiatry and Legal Evaluations

I’m board certified in forensic psychiatry as well as psychiatry, both through the American Board of Psychiatry and Neurology.

For attorneys, that covers competency evaluations, criminal and civil forensic opinions, and expert testimony. For individuals, it most often means a psychiatric evaluation supporting a firearm-rights restoration petition after a psychiatric hold.

Forensic work is priced and scheduled separately from clinical care, and the forensic psychiatry page covers how it runs.

That work taught me to document in a way that survives cross-examination and to keep a claim inside what the evidence supports.

What Happens at a First Appointment

You start with a free consultation with me. It’s a short conversation about whether this practice fits what you need. It isn’t a clinical evaluation, so no diagnosis is made and nothing is prescribed. You decide before any money moves.

The first full appointment runs 45 to 60 minutes. I take your history, review any records or labs you bring, and order what’s missing. In most cases that includes thyroid function, a metabolic panel, and for men, morning total and free testosterone.

I usually wait on prescribing until the labs are back. A thyroid problem and a depressive episode can present the same way at intake, and the bloodwork helps tell them apart.

You’ll leave with a plan and a timeline, and you can message me between visits.

Begin

A free consultation, with the physician who'll treat you.

Schedule a free consultation (910) 612-6015