Does Insurance Cover Ketamine Therapy?
Insurance coverage for ketamine therapy depends on the formulation. Spravato (esketamine nasal spray) is FDA-approved and covered by most plans for treatment-resistant depression. IV ketamine infusions at private clinics are rarely covered and typically cost $400-800 per session out of pocket.
Medicare Coverage
Medicare Part B covers Spravato (esketamine) administered in certified healthcare settings for treatment-resistant depression and major depressive disorder with suicidal ideation. Standard IV ketamine infusions are NOT covered by Medicare for any indication.
Private Insurance Coverage
Most private plans cover Spravato with prior authorization for treatment-resistant depression (must have failed 2+ antidepressants). IV ketamine infusions at private clinics are excluded by nearly all private plans as off-label/experimental. Cost: $400-800 per IV session, typically 6 sessions initial course ($2,400-4,800).
What about Medicaid?
Medicaid coverage for ketamine therapy varies by state. Some states cover it under managed care plans while others do not. Contact your state Medicaid office or check your plan's benefits guide.
CPT Codes for Billing
If your provider bills insurance for ketamine therapy, these are the relevant CPT codes:
J3490Unclassified drugs (sometimes used for IV ketamine)S0013Esketamine nasal spray (Spravato)Tips for Getting Coverage
- 1
Ask about Spravato (covered) as an alternative to IV ketamine (not covered)
- 2
Spravato requires administration in a certified REMS healthcare setting
- 3
Document failed trials of 2+ antidepressants to qualify for Spravato coverage
- 4
Some IV ketamine clinics offer payment plans ($300-500/month)
- 5
Check if your plan has a specialty pharmacy benefit that covers Spravato
How to Check Your Coverage
- 1
Call the number on your insurance card
Ask: "Is ketamine therapy a covered benefit under my plan?" Get the answer in writing or note the reference number.
- 2
Ask about prior authorization
Some plans require pre-approval before treatment. Ask if a referral from your primary care doctor is needed.
- 3
Verify provider network status
In-network providers will cost significantly less. Ask your insurer for a list of covered providers in your area.
- 4
Understand your cost share
Ask about your copay, coinsurance, and deductible for this service. Out-of-network benefits may still apply.
- 5
Check HSA/FSA eligibility
Even if insurance doesn't cover ketamine therapy, you may be able to use pre-tax HSA or FSA funds. Get a letter of medical necessity from your doctor.
Cost Without Insurance
Low
$350
Average
$500
High
$800
Per
per infusion
Monthly cost: $500–$4800 (6 infusions over 2-3 weeks (induction), then monthly boosters).
Use our Cost Calculator for detailed pricing →Find Ketamine Therapy Providers
Browse our verified directory of ketamine therapy providers. Filter by insurance accepted, credentials, and location.
Frequently Asked Questions
Does Medicare cover ketamine therapy?
Does private insurance cover ketamine therapy?
Which states mandate insurance coverage for ketamine therapy?
How much does ketamine therapy cost without insurance?
Can I use HSA or FSA funds for ketamine therapy?
Other Insurance Guides
Acupuncture
Partially Covered
Chiropractic Care
Widely Covered
Massage Therapy
Partially Covered
Naturopathic Medicine
Rarely Covered
Functional Medicine
Rarely Covered
Cryotherapy
Not Covered
Float Therapy
Not Covered
Infrared Sauna Therapy
Not Covered
IV Therapy
Rarely Covered
Red Light Therapy
Not Covered
Hyperbaric Oxygen Therapy (HBOT)
Partially Covered
PEMF Therapy
Not Covered
PRP Therapy (Platelet-Rich Plasma)
Not Covered
Last updated: May 2026. Insurance coverage changes frequently. Always verify with your insurer before starting treatment.