Apr 20, 2026
Written by:
Arthur MacWaters
Founder, Legion Health
TLDR:
Legion Health serves Texas adults with virtual psychiatry; Refresh serves Florida with telepsychiatry and TMS
Legion includes FDA-cleared QbCheck ADHD testing at no extra cost in every evaluation
Virtual appointments at Legion are typically available within days and accept major Texas insurance
Refresh offers TMS therapy for treatment-resistant depression, but requires 5-day-a-week clinic visits
Legion Health provides individualized ADHD medication dosing without rigid caps based on clinical judgment
Looking at a mental health treatment comparison between these two organizations means understanding that they serve completely different states with meaningfully different care models. If you're a Texas adult who needs virtual psychiatry with FDA-cleared ADHD testing included, or a Florida resident considering whether device-based treatment like TMS fits your situation, knowing what each practice actually does and who it's built for makes the decision clearer.
What is Refresh Mental Health?
Refresh Mental Health is a Florida-based outpatient practice offering psychiatry and therapy to adults, children, and adolescents. They treat a broad range of conditions, including depression, anxiety, ADHD, PTSD, bipolar disorder, and OCD.
Their service model runs on two tracks:
Telepsychiatry is available to patients anywhere in Florida
In-person care at physical clinic locations throughout the state
TMS Therapy at Refresh
Refresh also operates dedicated TMS locations throughout Florida. Transcranial Magnetic Stimulation (TMS) is an FDA-cleared, non-medication treatment that uses magnetic pulses to stimulate areas of the brain associated with mood regulation. It is approved for depression, anxiety, and OCD, and is typically considered when medication alone has not produced adequate results.
This puts Refresh in a different category from most telepsychiatry-only providers. Patients who need more intensive, device-based intervention can access it without switching practices.
Serving pediatric patients alongside adults is another meaningful part of their model. Most outpatient psychiatric practices focus exclusively on adult care, so families with children or adolescents who need mental health support may find Refresh's age range useful. If you are a Florida family looking for one practice to cover multiple generations and treatment types, Refresh covers a lot of ground.
What is Legion Health?
Legion Health is a Texas-based virtual psychiatry clinic serving adults physically located in Texas. Every visit is remote via secure video, so there are no waiting rooms or commutes. Care is delivered by licensed psychiatric clinicians, and your first appointment can typically be scheduled within days through our direct online booking system.
We accept major Texas commercial insurance plans, with most patients paying around a standard specialist copay. A cash-pay option is available for those who prefer it or whose coverage changes.
What We Treat
We focus on psychiatric medication management and evaluation for adults across a range of conditions, including depression, anxiety, ADHD, and comorbid presentations where these conditions overlap.
ADHD evaluations at Legion Health include FDA-cleared QbCheck testing at no additional cost. QbCheck is a computerized test that measures attention, impulsivity, and activity levels, providing clinicians with objective data alongside the clinical interview.
One thing worth noting: we are an adult-only clinic that serves patients in person only in Texas. If you are outside Texas or seeking pediatric care, Legion Health is not the right fit.
Treatment Modality and Service Delivery
Refresh operates a hybrid model in Florida, pairing telepsychiatry and in-person visits with access to TMS therapy through affiliated Refresh TMS centers. TMS is a non-invasive, FDA-cleared treatment for depression, anxiety, and OCD, typically delivered five days a week over four to six weeks at a physical clinic. For patients who haven't responded to medications alone, having that option within the same organization is genuinely useful.
The tradeoff is the time commitment. Five days a week for over a month means repeated travel to a clinic, which isn't realistic for everyone.
Legion Health works differently. Every visit is virtual, conducted by licensed psychiatric clinicians over secure video. No travel, no waiting rooms. New patient appointments are typically available within days.
There are real limits to acknowledge: Legion does not offer therapy services or device-based treatments like TMS. If you need either, separate referrals would be required. What Legion does offer is focused psychiatric medication management, including objective ADHD testing, available to patients anywhere in Texas.
Feature | Legion Health | Refresh Mental Health |
|---|---|---|
Geographic Coverage | Texas adults only, virtual care statewide | Florida residents only, telepsychiatry and physical clinics in Davie, West Palm Beach, Miami, and Orlando |
Service Delivery Model | 100% virtual appointments via secure video, no physical locations | Hybrid model with telepsychiatry and in-person visits at clinic locations |
Age Groups Served | Adults only (18+) | Adults, children, and adolescents |
ADHD Evaluation Approach | Includes FDA-cleared QbCheck computerized testing at no additional cost in every evaluation, measuring attention, impulsivity, and activity levels | Clinical interviews and standardized rating scales, and pharmacogenomic testing are available |
Treatment Modalities | Psychiatric medication management and evaluation only, no therapy or TMS | Psychiatry, therapy, and TMS (transcranial magnetic stimulation) for treatment-resistant depression, anxiety, and OCD |
Appointment Availability | Typically, within days through direct online booking, no referral needed | Standard scheduling through clinic locations; availability varies by location |
Insurance and Payment | Accepts major Texas commercial insurance with specialist copays, cash-pay option available | Insurance accepted at Florida locations, specific plans vary by clinic |
TMS Treatment Commitment | Not offered, would require external referral | Available at dedicated TMS centers, requires five days per week for four to six weeks at a physical clinic |
Geographic Coverage and Accessibility
Both organizations are state-bound by licensing rules, so where you live determines which one is even an option.
Refresh serves Florida residents through telepsychiatry and physical clinic locations in cities like Davie, West Palm Beach, Miami, and Orlando. If you need TMS, you'll need to be close to a clinic so you can attend sessions five days a week for several weeks. Florida-only coverage means no access for patients outside the state, even remotely.
Legion Health covers adults anywhere in Texas through virtual-only care. No physical office to drive to means patients in rural areas, where psychiatric providers are often scarce, can access care just as easily as those in Houston or Austin. Appointments are available online without a referral, typically within days.
Who does virtual care reach
"Over 160 million Americans live in areas with mental health professional shortages," according to 2023 data. Virtual care does not solve that problem everywhere, but it removes one of the biggest barriers: geography.
For Texans, this gap is real. A virtual-first model means a patient in Lubbock or Laredo gets the same access as someone in a major metro area.
The honest tradeoff: Legion cannot serve patients outside Texas, or anyone under 18, and in-person procedures require outside referrals.
ADHD Evaluation and Diagnostic Approach
Refresh treats ADHD alongside other conditions using clinical interviews and standardized rating scales. Their team of psychiatrists and psychiatric nurse practitioners also offers pharmacogenomic testing to guide medication selection based on genetic factors. For patients who prefer in-person assessment, their physical locations in Florida make that possible. What Refresh does not appear to include is computerized objective ADHD testing as a standard part of the evaluation.
Legion Health takes a different approach. Every ADHD evaluation includes QbCheck, an FDA-cleared computerized test measuring attention, impulsivity, and activity levels, at no additional cost. That objective data sits alongside the clinical interview without replacing it, giving clinicians a clearer picture when symptom overlap with anxiety or depression makes diagnosis less straightforward.
Patients can repeat QbCheck testing throughout treatment at no extra cost, which matters for tracking whether a medication adjustment is actually working. For comorbid presentations, having a measurable baseline changes how clinicians interpret progress.
There is also a coordination layer worth noting: we work with primary care physicians for health evaluations and follow strict safety protocols for controlled-substance prescribing. Controlled medications are prescribed only when clinically appropriate and require careful evaluation and ongoing monitoring.
If you are a Texas adult looking for ADHD care where objective testing is built into the process, Legion Health includes that by default instead of as a separate, costly add-on.
Why Legion Health is the Better Choice
Neither organization is a bad choice. They serve different patients in different states with meaningfully different models.
Refresh works well for Florida residents who want psychiatry and therapy in one practice, or for patients with treatment-resistant depression where TMS may be worth considering after medication trials. Their hybrid model also suits families who need pediatric care alongside adult services.
For Texas adults, Legion Health is the stronger fit. Here is the short version of why:
Virtual appointments are typically available within days, not weeks, so you spend less time waiting and more time getting care.
Major Texas insurance is accepted, with cash pay as a backup option for those without coverage.
FDA-cleared QbCheck testing is included in every ADHD evaluation at no extra cost, giving your clinician objective data to work with.
Comorbid conditions like ADHD with anxiety or depression are treated together, not in separate silos.
Individualized medication dosing without rigid caps supports more personalized treatment plans.
The honest answer is that geography settles most of this comparison before anything else. If you are in Florida, Refresh is worth a look, especially if TMS is on the table. If you are a Texas adult who needs psychiatric evaluation and medication management, accessible from home and covered by insurance, Legion Health is built for exactly that.
Book an evaluation to verify your coverage and schedule your first visit.
Final Thoughts on Telepsychiatry and TMS Treatment
Both organizations serve their respective states well with different treatment approaches. Telepsychiatry vs TMS isn't really the right comparison since Legion Health focuses on virtual medication management for Texas adults while Refresh offers device-based treatments and therapy in Florida. If you're in Texas and want psychiatric care with objective ADHD testing included, fast scheduling, and no travel required, Legion Health covers that. Schedule your evaluation to verify coverage and book your first visit.
FAQs
How should I decide between Legion Health and Refresh Mental Health?
Your state determines most of this decision: Legion Health serves Texas, adults only, while Refresh serves Florida residents. Beyond geography, choose based on what you need. Legion Health works well for virtual psychiatric medication management with objective ADHD testing, while Refresh offers therapy, pediatric care, and TMS for treatment-resistant depression.
What is the main difference in how these practices handle ADHD evaluations?
Legion Health includes FDA-cleared QbCheck testing at no additional cost in every ADHD evaluation, giving clinicians objective data on attention, impulsivity, and activity levels alongside clinical interviews. Refresh uses clinical interviews and standardized rating scales, but does not appear to include computerized objective testing as a standard part of their ADHD assessment process.
Who is Legion Health best suited for?
Legion Health works best for Texas adults who need psychiatric medication management and can access care virtually. If you have overlapping conditions like ADHD with anxiety or depression, need objective ADHD testing, or live in a rural area with limited local psychiatric providers, the virtual-first model may be a good fit.
Can I receive therapy or TMS treatment through Legion Health?
No, Legion Health focuses exclusively on psychiatric medication management and evaluation. We do not offer therapy services or device-based treatments such as TMS, so those would require separate referrals to other providers if clinically indicated.
How quickly can I schedule my first appointment with Legion Health?
Most Texas adults can book a new patient psychiatric evaluation within days through our direct online booking system at app.legionhealth.com/portal/join/fit, where you can verify your insurance coverage and schedule your first visit without needing a referral.
This article is for informational purposes and is not medical advice. If you think you may have symptoms of a mental health condition, a psychiatric evaluation can help.
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