SPRAVATO® Cost in Denver
SPRAVATO® is FDA-approved and, unlike ketamine therapy, is covered by many commercial plans, Medicare, and TRICARE when their criteria for treatment-resistant depression are met. A covered course costs the patient their plan's cost-sharing; a manufacturer savings program may reduce that further for eligible commercially insured patients. The cost has two parts — the medication, dispensed under the restricted program, and the monitored clinic visit after each dose — and both are explained in a written estimate before you start. Denver Ketamine Clinic verifies your benefits and handles prior authorization first.
The two parts of the cost
The medication itself, which is dispensed only through the SPRAVATO® restricted program to certified centers, and the clinic visit, which includes administration under supervision and the required monitoring period afterward. Plans may cover the two parts differently — sometimes under a pharmacy benefit and a medical benefit — which is why benefits verification is specific to SPRAVATO® rather than general.
Insurance criteria
Plans generally require a diagnosis of treatment-resistant depression — major depressive disorder with inadequate response to prior antidepressants — and an oral antidepressant taken alongside SPRAVATO®, with prior authorization. Our team gathers the documentation and submits it before your first dose.
Savings program
The manufacturer offers a savings program that may reduce out-of-pocket medication costs for eligible patients with commercial insurance; it does not apply to government plans. We tell you whether you qualify.
Self-pay
If your plan does not cover SPRAVATO®, self-pay is possible, and you receive a written Good Faith Estimate first. For some self-pay patients, ketamine therapy is the less expensive option; the evaluation compares both for your situation.
Frequently asked questions
Does insurance cover SPRAVATO®?
Many commercial plans, Medicare, and TRICARE cover it for treatment-resistant depression when their criteria are met and prior authorization is approved.
What does SPRAVATO® cost with insurance?
Your plan's cost-sharing for the medication and the monitored visit, possibly reduced by the manufacturer savings program if you are eligible. The exact amount depends on your plan.
How many SPRAVATO® sessions are there?
An induction phase of twice-weekly sessions over the first month, then a maintenance phase at a frequency your psychiatrist sets. The estimate covers the prescribed course.
Is SPRAVATO® or ketamine therapy cheaper?
For patients with coverage, usually SPRAVATO®; for self-pay patients, it depends. The evaluation covers both so you decide with the numbers in front of you.
Find out what your plan covers for SPRAVATO® before you decide.
Request a consultation.