Best Virtual Psychiatry Platforms with Primary Care Coordination (December 2025)

Think about the last time your psychiatrist asked about your recent lab work or checked in with your primary care doctor about your diabetes medication. If you're drawing a blank, you're not alone. The vast majority of psychiatric care happens in complete isolation from the rest of your healthcare, even though mental health and physical health are deeply connected. Collaborative mental health approaches treat coordination as a clinical necessity, not an afterthought. When your providers actually share information, you get treatment decisions based on your full health picture, not just your psychiatric symptoms.

TLDR:

• Primary care coordination prevents dangerous drug interactions and catches physical causes of mental health symptoms.

• Legion Health requires recent vitals and lab work before prescribing ADHD medications to ensure cardiovascular safety.

• QbCheck provides objective ADHD testing data that strengthens diagnostic accuracy beyond symptom questionnaires alone.

• Most patients pay under $30 per visit using their Texas commercial insurance with no subscription fees.

• Legion Health serves all of Texas with board-certified psychiatric providers who treat anxiety, depression, ADHD, and bipolar disorder through insurance-covered telehealth visits scheduled within days.

Why Primary Care Coordination Matters in Psychiatric Treatment

Mental health doesn't exist in a vacuum. Depression can stem from thyroid issues. Anxiety might signal cardiovascular problems. ADHD medications require baseline vitals and ongoing monitoring to protect heart health.

Yet only 3% of psychiatrists coordinate care with primary care practitioners. Legion Health was founded to change this reality.

This gap leaves most patients managing two separate worlds of healthcare, where their psychiatric provider might not know about their diabetes medication and their primary care doctor remains unaware of their new antidepressant.

Without coordination, drug interactions slip through. Physical symptoms that could explain mood changes get missed. Treatment plans ignore the full picture of someone's health. When your mental health provider communicates with your primary care doctor, you get safer prescribing decisions, more thorough monitoring, and treatment that accounts for your complete health status.

This collaborative approach becomes especially critical for conditions like ADHD, where stimulant medications require careful cardiovascular screening and regular check-ins on physical health markers.

What to Look for in a Virtual Psychiatry Service with Primary Care Integration

Virtual psychiatry services handle primary care coordination differently. Some work in complete isolation while others treat integration as a clinical necessity.

Here's what distinguishes real coordination:

Medical Screening Requirements

The best services require recent physical health evaluations before prescribing psychiatric medications. This includes current vitals, lab work, or EKG results when clinically indicated. Services that skip this step prioritize speed over safety.

Active Information Sharing

Look for providers that obtain medical records, share treatment plans, and inform your PCP of medication changes. One-way communication creates care gaps that put patients at risk.

Documented Safety Protocols

Review their prescribing guidelines, particularly for controlled substances. Services with transparent protocols around cardiovascular screening for stimulants or contraindication reviews prioritize patient safety over convenience.

Legion Health

We provide virtual psychiatric care across Texas through board-certified psychiatric providers who treat anxiety, depression, ADHD, bipolar disorder, and other mental health conditions. All visits happen via video, typically scheduled within days of requesting care.

Every patient uses their commercial insurance, with most paying only their standard copay per visit. We've contracted with all major Texas insurers, making care accessible without subscription fees or surprise bills.

Before prescribing medications that require medical oversight, we verify you've had recent in-person health checkups. This includes current vitals, relevant lab work, or EKGs depending on your treatment plan. We share medication changes and psychiatric updates with your primary care doctor to keep everyone informed about your complete health picture.

MDLIVE

MDLIVE provides telepsychiatry through video, phone, and secure messaging. The service coordinates with primary care physicians to maintain continuity of care during psychiatric treatment.

Their psychiatric providers communicate directly with your PCP to share treatment updates and consider physical health factors in medication decisions, similar to how depression specialists in Austin, TX accepting Aetna insurance coordinate care with primary care physicians.

This collaboration helps prevent drug interactions and ensures your mental health care aligns with other medical treatments you're receiving.

MDLIVE operates nationally and accepts various insurance plans, though coverage varies by state and employer.

Teladoc Mental Health

Teladoc Mental Health provides psychiatric services through video visits with board-certified psychiatric providers nationwide. The service operates 24/7, with psychiatrists and psychiatric nurse practitioners treating depression, anxiety, and bipolar disorder through medication management and treatment planning.

Their providers can request medical records and communicate with your primary care doctor when needed for treatment coordination. The service accepts most major insurance plans, with coverage varying by plan and location. Patients access care through video or phone visits, with follow-up appointments available for medication adjustments.

Talkiatry

Talkiatry provides telepsychiatry across multiple states, connecting patients with psychiatrists through video appointments. The service accepts many commercial insurance plans, though coverage varies by location.

Wait times for initial appointments depend on state and demand. Some patients schedule visits within weeks, while others wait longer as the provider network grows. Psychiatrists handle diagnostic evaluations and medication management for conditions like depression, anxiety, and ADHD.

Patients work with a dedicated psychiatrist for ongoing care rather than seeing different providers at each visit.

How Legion Health's Primary Care Coordination Works

Our coordination starts at intake. You'll share information about recent physical health checkups, including your last primary care visit and relevant medical history.

For treatments that require physical health monitoring, your psychiatric provider reviews recent vitals, lab results, or EKG findings before prescribing. ADHD medications need current cardiovascular data since stimulants affect heart rate and blood pressure.

Without recent medical evaluations, we'll guide you to schedule an appointment with your PCP or recommend options for getting those assessments completed. Treatment waits until your physical health supports the psychiatric medication plan.

After prescribing, we share relevant updates with your primary care doctor so they know which psychiatric medications you're taking and can watch for interactions or side effects during regular checkups.

The Role of Physical Health Evaluations in ADHD Treatment

Stimulant medications for ADHD elevate heart rate and blood pressure, making cardiovascular screening essential before prescribing. Pre-existing heart conditions or uncontrolled hypertension can be contraindications to this treatment.

A complete ADHD evaluation requires recent vital signs, cardiovascular history screening, and potentially an EKG based on age and risk factors. This physical health foundation prevents adverse cardiac events during stimulant treatment.

Many virtual services prescribe based solely on psychiatric symptoms without verifying recent physical exams or cardiovascular clearance. This approach trades safety for convenience.

We require documented physical health evaluations before prescribing ADHD medications. You'll need current vitals and relevant cardiovascular data on file before receiving stimulant prescriptions.

Insurance Coverage and Accessibility Across Services

We accept all major commercial insurance in Texas, with most patients paying only their copay. MDLIVE and Teladoc work with various insurance plans nationally, though coverage varies by location and employer. Talkiatry accepts commercial insurance in select states.

Geographic access differs between services. Teladoc operates nationwide with 24/7 availability. MDLIVE serves multiple states. Talkiatry continues expanding state by state. We currently serve all of Texas.

Appointment availability varies. Patients schedule first visits with us within days, sometimes next-day. Talkiatry's wait times fluctuate by demand and location. Teladoc offers immediate access through their 24/7 model.

Objective ADHD Assessment Tools

Most virtual psychiatry services rely on clinical interviews and symptom questionnaires alone to diagnose ADHD. These subjective reports capture patient experiences but miss measurable data that confirms symptom patterns.

We include QbCheck, an FDA-cleared digital assessment that measures attention, impulsivity, and hyperactivity through objective testing. Patients complete a brief computerized task while motion sensors track activity levels. The results generate quantifiable data that compares your performance to clinical benchmarks.

This objective measurement strengthens diagnostic accuracy and provides concrete insight into your symptoms. You can retake QbCheck throughout treatment to track how medications impact your attention and impulse control over time, at no additional cost with unlimited reassessments.

Safety Protocols and Responsible Prescribing

Safe prescribing of controlled substances requires strict protocols that balance patient access with appropriate oversight. When some telehealth services prioritized speed over clinical safety, regulatory scrutiny increased across the industry.

Responsible prescribing begins with screening for substance use history, diversion risk, and contraindications. This includes reviewing past prescriptions, checking state prescription monitoring databases, and assessing for medication-seeking behaviors before writing controlled medication prescriptions.

Legion Health screens all patients before prescribing controlled substances. For ADHD treatment, psychiatric providers review medical history, confirm diagnostic criteria through clinical evaluation and objective testing, and verify appropriate physical health clearances before prescribing stimulants.

Regular follow-up appointments track medication response, side effects, and appropriate use. Services that skip consistent monitoring create gaps where misuse or adverse effects go undetected. Legion Health pairs diagnostic rigor with ongoing oversight to keep controlled medications aligned with their therapeutic purpose while meeting state and federal compliance requirements.

Why Legion Health's Coordinated Approach Stands Out

True coordination requires clinical infrastructure that makes physical health data mandatory, not optional.

Most virtual psychiatry services mention coordination but don't enforce it. Legion Health requires recent physical health evaluations before prescribing medications that need cardiovascular monitoring. Your psychiatric provider reviews actual vitals and lab results, not just patient-reported health status.

Combining objective ADHD testing through QbCheck with mandatory medical screening creates diagnostic accuracy that symptom questionnaires alone can't achieve. This rigor separates responsible telehealth from services that prioritize appointment volume over clinical safety.

When primary care coordination moves from talking point to clinical requirement, psychiatric treatment becomes both safer and more effective.

Final thoughts on collaborative mental health care

Psychiatric treatment gets safer and more effective when providers communicate across specialties. Collaborative mental health care means your psychiatric provider knows about your diabetes medication and your primary care doctor stays informed about your new antidepressant. We require this coordination at Legion Health because your mental health doesn't exist separately from your physical health. Better communication between providers means better outcomes for you.

FAQ

What does primary care coordination mean in virtual psychiatry?

Primary care coordination means your psychiatric provider communicates with your primary care doctor, reviews your physical health records, and considers your complete medical picture before prescribing medications. This includes verifying recent vitals, lab work, or EKGs when needed and sharing medication changes with your PCP to prevent drug interactions and monitor your overall health.

How do I know if I need a physical exam before starting ADHD medication?

You'll need recent cardiovascular data before starting stimulant medications for ADHD, including current blood pressure, heart rate, and potentially an EKG based on your age and risk factors. If you haven't had a physical exam recently, your psychiatric provider will guide you to schedule one with your primary care doctor before prescribing stimulants, since these medications affect heart rate and blood pressure.

Can I use my insurance for virtual psychiatric care in Texas?

Most virtual psychiatry services accept commercial insurance, though coverage varies by provider and plan. Legion Health accepts all major commercial insurance plans in Texas, with most patients paying only their standard copay (typically under $30 per visit) without subscription fees or surprise bills.

What makes objective ADHD testing different from regular questionnaires?

Objective ADHD testing like QbCheck measures your attention, impulsivity, and hyperactivity through computerized tasks and motion sensors, generating quantifiable data that compares your performance to clinical benchmarks. Regular questionnaires rely only on self-reported symptoms, while objective testing provides measurable evidence that strengthens diagnostic accuracy and tracks medication effectiveness over time.

How quickly can I schedule my first virtual psychiatry appointment?

Appointment availability varies by service and location. Some virtual psychiatry providers offer appointments within days (sometimes next-day), while others have wait times of several weeks depending on demand and provider network size in your state.