Higher first-visit fees ($300–$600). Shorter follow-ups. Medication-management workflow. Telehealth scope across state lines. The mechanics that work for cash-pay psychiatry don't look like therapy marketing — and almost no agency we've seen models the difference.
A psychiatric patient isn't one transaction. They're a relationship that compounds for years — if your funnel handles the high-friction first visit and the low-friction follow-ups as two different funnels.
The initial evaluation is high-ticket and high-commitment — $300–$600, 60 minutes, the patient researched you for weeks. Follow-up med-management visits are low-friction and recurring — $150–$250, 15–30 minutes, every 4–12 weeks for years. The retention tail is where psychiatry's unit economics actually live.
Most agencies optimize the intake and ignore everything after. We model the full lifecycle. That's where 70% of LTV hides.
Your agency sells you on cost per evaluation. You should be measuring cost per 12-month retained patient.
Patients ask "do you prescribe controlled substances" on the first call. How that gets answered decides 50% of conversions.
Telehealth scope across states is your biggest growth lever and biggest compliance risk. Most agencies don't even know which states you can practice in.
No-show rates on initial evaluations run 20–28%. The lost revenue per no-show is much higher than therapy — the cadence has to be tighter.
Your reviews question is different: "will they prescribe what's working for me" matters more than "are they a good listener."
The psychiatry practices that compound aren't winning on ad spend — they're winning on full-funnel economics from initial eval through year three of follow-up.
Solo prescriber on telehealth and a multi-state group with in-person + virtual operate completely different funnels. We adjust the lever stack accordingly.
Cash-pay, often telehealth-first. Booking 8–30 new evaluations/month. Spending under $4K on ads. Looking to fill the calendar without burning out.
Multi-prescriber group, sometimes mixed psychiatry + therapy. Booking 60–200 new evaluations/month. $5K–$20K monthly ad spend. Telehealth in 3+ states.
In-person + virtual across 3+ states. Booking 200+ evaluations/month. $20K+ monthly ad spend. Already have an agency, but state-by-state targeting feels like guesswork.
For cash-pay outpatient psychiatry specifically — not generic mental-health marketing.
The high-ticket commitment moment. Most flows ask insurance questions in the wrong order and lose 30%+ of cash-pay intent.
Geo-fencing by your actual licensure footprint. Most agencies waste 20–40% of psychiatry ad spend serving impressions in states you can't practice in.
How your site and intake answer the stimulant/benzo question decides whether you get the right patients or the wrong ones.
2–6 weeks between click and booking. Email + retargeting that builds confidence in your prescribing approach without sounding promotional.
A no-show on a $450 evaluation costs more than three on a $185 therapy session. The confirmation cadence has to be tighter and the deposit/cancellation policy clear.
The lifeblood of psychiatry economics. Eval-to-first-followup conversion runs 60–75%; we get clients to 85%+ with the right close-of-visit flow.
Healthgrades, Vitals, Zocdoc + Google. Patients triangulate before booking. Slow, durable review velocity beats any "buy stars" service.
ADHD, depression, anxiety, bipolar — each has a different intent profile. Generic landing pages leave 50%+ of search intent unmonetized.
Fifteen minutes on a call. We'll tell you whether we're the right firm and where the realistic 90-day result lives for a psychiatric practice your size.
No deck. No pitch. Just a conversation.