Cost & Insurance FAQ for Ketamine Therapy

IV infusions typically run $400-$800 per session in the U.S., with a 6-session induction landing between $2,400-$4,800. Sublingual programs are cheaper ($150-$400/session), KAP is more ($600-$1,500/session), and Spravato sessions list at $590-$885 before any benefits.

Generic IV and IM ketamine for depression are off-label and rarely covered. Spravato (esketamine) is FDA-approved for TRD and is increasingly covered by commercial insurance and Medicare with prior authorization. Some patients can bill the therapy portion of KAP through mental-health benefits even when the medication isn't covered.

It's an insurance review confirming you meet medical-necessity criteria — typically two failed antidepressant trials, a Major Depressive Disorder diagnosis, and prescription by an approved provider. Approval usually takes 1-3 weeks.

Yes, in most cases. Ketamine therapy prescribed by a licensed clinician for a diagnosed condition qualifies as a medical expense under IRS Section 213(d). Save your superbill and the clinician's letter of medical necessity.

Most clinics offer in-house payment plans or partner with medical financing companies (CareCredit, Advance Care Card). Interest rates vary — read the deferred-interest terms carefully.

Intake/consultation fees ($200-$500), separate psychiatrist evaluation, integration therapy add-ons, medical monitoring during sessions, and renewal exams. Ask for an itemized cost-of-care document before your first session.

Telehealth-based at-home programs are generally advertised at lower per-session prices than in-clinic infusion. The trade-off is reduced medical oversight; this model is not appropriate for severe depression, cardiovascular risk, or trauma-focused work.

Medicare covers Spravato under Part B when administered in a REMS-certified clinic. Generic IV ketamine is not covered. Some Medicare Advantage plans expand coverage — check your specific plan.

Coverage varies dramatically by state. A growing number of state Medicaid programs cover Spravato; almost none cover generic ketamine. Call your state Medicaid office directly.

Yes — qualifying medical expenses above 7.5% of adjusted gross income are deductible on Schedule A. Keep all receipts, superbills, and the clinician's letter of medical necessity.