Frequently Asked Questions

You will fill out an intake before starting and meet with Dr Roth for a 1 hr consultation during which you will receive a

• Personalized treatment plan and lab orders or prescribing as needed

• Enough time to thoughtfully diagnose and create treatment plan.

• Month of support and prescription/management.

• Option to continue care after the month with lower-priced follow-up or membership care

Continuing care for patients with active medication plans

• Annual commitment, designed for patients

• Designed for patients who want predictable, ongoing support

• Includes thoughtful coordination for prescriptions and care continuity

• Includes 6 visits over 6 months (roughly one every 2 months)

• Up to 3 monthly messages clarifications or updates

• Early cancellation fee $450

Asynchronous (email only) care for stable patients who are back at their baseline, not needing regular medication adjustments, for flare prevention and continued prescribing​

• 3 messages per month + Discounted single visits if patients' health necessitates this

• Guidance on mild-to-moderate flares

• Medication adjustment advice or prescription renewal when appropriate

• Support during transitions or regressions

• Review of symptom logs, school concerns, or sleep/appetite changes

• This is a 6 month membership

I can prescribe all medications (including psychiatric, IV, etc) except those which are controlled substances (eg benzodiazepines, adderall/ritalin) due to change laws in telemedicine. If one of those is needed, we can sometime use other non-controlled medications in place of them.

You do not need to have labs drawn. PANS is a clinical diagnosis and can be made without labs. However in some cases, they will be recommended to assist in understanding the details of the diagnoses, and if you would like to have something checked, we can certainly order it.

Less commonly, but I do see adults. PANS/PANDAS has been traditionally considered a pediatric diagnosis, but that clearly does not reflect the reality of the disorder and I occasionally work with adults.

PANS Care Policy Overview

My goal is to make sure every family feels supported, informed, and cared for as we work through PANS together. Healing from PANS often takes time, and I want you to understand what to expect and how our care model works.

1. One-Time Consult / Monthly Care Plan

When you sign up for a one-time consult ($500/month), that fee covers a full month of care — including follow-up questions, prescription management, and ongoing support during that month.

Because PANS typically takes a few months to bring under control, it’s important to have a longer-term plan in place. By the end of your first month, you should be ready to either:

• Continue care with your local primary care provider or psychiatrist using Dr. Roth’s recommendations, or

• Transition into ongoing PANS care directly with Dr. Roth if you’d like continued guidance and management.

My goal is for you to leave that first month with clarity, direction, and a solid care plan in place — whatever path you choose.

2. Yearly Plan Cancellation Policy

If you are enrolled in a yearly care plan, you may cancel at any time. A $500 cancellation fee applies, which covers the time and care involved in completing your case summary, prescriptions, and care transition — essentially the equivalent of a “close-out” consult.

This ensures that even as you transition out of care, you receive thoughtful closure and continuity.

Unfortunately, I am not set up to accept insurance at this time since that complicates practices greatly (making things more expensive) and I strive to keep my practice as straightforward for patients as possible.

Prescriptions are generally covered by your insurance. Labs as well. The only thing that insurance sometimes gives issues about is IVIG and other specialty care. We will work together to apply to your insurance to cover that as well but it is a process.

Please write me directly for alternate payment plans. I believe cost should never stop someone from getting the proper care.

If you scheduled an appointment and need to cancel before the appointment, please let me know. You will not be charged. Early cancellation of memberships will incur a fee.

The practice is telemedicine only (we meet on zoom). I live overseas and do not maintain a physical office.