In California, Sigma is a concierge child and adolescent psychiatry practice, with the same depth of care for adults. Concierge isn't a marketing word here: the practice is held to a limited number of patients on purpose, so the time, attention, and continuity that good psychiatry depends on are actually possible.
Care always begins with an initial evaluation. Membership is offered afterward, only if ongoing concierge care is the right fit — there's nothing to commit to up front.
A comprehensive 75 to 90 minute psychiatric evaluation for children, adolescents, young adults, or adults: a detailed assessment, diagnostic formulation, medication review when appropriate, and an individualized treatment plan.
Ongoing outpatient psychiatric care with consistent follow-up, secure treatment-related messaging, and continuity with the same psychiatrist. For patients who are clinically appropriate for telehealth and want a continuous relationship.
A higher-touch model for children, adolescents, families, and adults with more complex needs, who benefit from longer visits, more frequent touchpoints, and deeper coordination with parents, therapists, schools, or other clinicians.
Additional visits beyond your included monthly time can be scheduled when clinically appropriate: 30-minute follow-up $350, 60-minute follow-up $650. All care is private pay, with a detailed superbill provided for possible out-of-network reimbursement.
Most psychiatry has been compressed into short visits and long waits. A concierge model exists to undo that compression. By holding the practice small, Dr. Ramy can give each patient the time a visit really needs, answer between visits when the situation calls for it, and stay with the plan instead of handing it off. You're a person in a relationship with your psychiatrist, not a slot on a schedule.
Membership in California is private pay. It doesn't bill insurance, though we provide a detailed superbill you can submit for possible out-of-network reimbursement. It's scheduled telehealth care during business hours, not emergency or around-the-clock coverage, and it doesn't promise any particular outcome. Care is still individualized, and we'll always tell you honestly whether what you need is something this practice can provide.
Membership isn't emergency care. Sigma offers scheduled telehealth, not 24/7 or emergency coverage. If you're in crisis, call or text 988 or go to your nearest emergency department. The full terms, and exactly what's included, are set out in a written membership agreement and a Good Faith Estimate before you join.
Because the California practice is kept small, membership is by inquiry. Reach out and we'll tell you honestly whether there's a place open and whether it's the right fit.