Can I use my insurance for treatment?
Yes
Insurance covers nasal esketamine under the brand name Spravato for Treatment Resistant Depression.
Yes
Insurance covers TMS (including Theta Burst) for Treatment Resistant Depression. Some insurance plans cover TMS for Obsessive Compulsive Disorder (OCD).
Rarely
Infused Ketamine is rarely covered by insurance, although we provide superbills to submit for partial reimbursement. We have 0% financing payment plans for patients paying out of pocket.
We are in-network with the following insurers:
Insurers that cover evaluations, nasal esketamine & brain stimulation. IV ketamine is NOT covered by insurance.
Guidelines for Spravato & TMS/TBS Coverage
These are our best understanding of insurance requirements to help guide the decision to initiate a referral. All final authorizations will be determined in coordination with the insurers and may differ from our chart.
Minimum Criteria for ALL PAYORS
- Age 18 years or older Age 18 years or older
- 1+ Oral Antidepressant During Treatment 1+ Oral Antidepressant During Treatment
- No History of Psychosis OR Benefits Outweigh Psychosis Risks No History of Psychosis OR Benefits Outweigh Psychosis Risks
- Spravato Must be Prescribed by a Psychiatrist Spravato Must be Prescribed by a Psychiatrist
- Inadequate Response ≥2 CLASSES of antidepressant + 1 augmentation Inadequate Response ≥2 CLASSES of antidepressant + 1 augmentation
- Brain Stimulation Requires Ongoing Care from Outpatient PsychiatristBrain Stimulation Requires Ongoing Care from Outpatient Psychiatrist
