If you’d like to explore how ketamine therapy or Spravato (esketamine) treatment could help depression and anxiety, we invite you to book a complimentary consultation below. We look forward to speaking with you.
Does Blue Cross Blue Shield (BCBS) cover ketamine therapy or ketamine treatment?
Latest medical review on: July 9th, 2025. Medically reviewed by Chief Medical Officer Dr. Ben Yudkoff.
BCBS covers the FDA-approved version of ketamine called Spravato (esketamine) for depression, which can be a highly effective solution. Spravato (esketamine) is a nasal spray, and works as well as other forms of ketamine.
However, BCBS often does not cover ketamine therapy in other forms like intra-muscular ketamine therapy or IV ketamine treatment for conditions associated with depression, anxiety, or other mood disorders.
Key Takeaways: Does Blue Cross Blue Shield cover ketamine for mental health?
• BCBS covers Spravato (esketamine) for depression, which is a nasal spray formulation of ketamine boasting similar efficacy
• This is because Spravato (esketamine) has full FDA approval for the treatment of treatment-resistant depression through Johnson & Johnson
• Your coverage may vary based on your specific plan. Get in touch with Lumin Health to explore your options. We handle all prior authorization on your behalf to make this process as seamless as possible.
• This is because Spravato (esketamine) has full FDA approval for the treatment of treatment-resistant depression through Johnson & Johnson
• Your coverage may vary based on your specific plan. Get in touch with Lumin Health to explore your options. We handle all prior authorization on your behalf to make this process as seamless as possible.
Does Blue Cross Blue Shield cover Spravato (esketamine)?
Yes. BCBS covers Spravato treatment, esketamine nasal spray, for people suffering from Treatment Resistant Depression (TRD). Costs are typically a co-pay and policies oftentimes allow for ongoing treatment. Schedule a consultation with us to see if you qualify and how you might be able to receive from the benefits of Spravato (esketamine).
Does Blue Cross Blue Shield cover ketamine infusions or ketamine injections?
BCBS tyically does not cover intramuscular ketamine injections. When it comes to ketamine, BCBS will likely Spravato (esketamine) treatment and Blue Cross Blue Shield may cover ketamine IV infusions in some rare cases. We would be grateful to review your coverage with you; simply get in touch with our team.
As of the latest review in January 2025, Blue Cross Blue Shield considers ketamine treatment for psychiatric conditions investigational. "Investigational" in this context means that ketamine infusions and ketamine injections are not determined to be safe or effective based on current evidence. As a result, Spravato (esketamine) is often thought to be a suitable option for its comparable efficacy and its increased accessibility with insurance coverage. (Source from Blue Cross Blue Shield's policy on Spravato (esketamine) and ketamine therapy)
As of the latest review in January 2025, Blue Cross Blue Shield considers ketamine treatment for psychiatric conditions investigational. "Investigational" in this context means that ketamine infusions and ketamine injections are not determined to be safe or effective based on current evidence. As a result, Spravato (esketamine) is often thought to be a suitable option for its comparable efficacy and its increased accessibility with insurance coverage. (Source from Blue Cross Blue Shield's policy on Spravato (esketamine) and ketamine therapy)
Ketamine Infusions vs. Spravato (Esketamine): What's the Difference for BCBS Patients?
Spravato is the "s-enantiomer" of ketamine and has a different pathway for coverage and prior authorization than traditional ketamine therapy through intravenous or intramuscular administration. Knowing this key difference can be crucial to finding the correct coverage information.
Does Lumin Health accept BCBS for Spravato treatment?
Yes, Lumin Health accepts Blue Cross Blue Shield (BCBS) insurance for the entire ketamine treatment program, including: initial psychiatric consults, Spravato (esketamine) therapy, and ongoing care.
Esketamine therapy can be a great option for those looking for ketamine therapy, and provides very similar benefits for those dealing with mood and mental health issues.
Esketamine therapy can be a great option for those looking for ketamine therapy, and provides very similar benefits for those dealing with mood and mental health issues.
How can I get Spravato (esketamine) covered by Blue Cross Blue Shield?
The criteria for getting ketamine therapy with Spravato covered by Blue Cross Blue Shield can vary based on each case, but some commonalities are below.
Individual is 18 years of age or older
Meets Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5) criteria
Has had an inadequate response to four antidepressants from at least 2 different antidepressant classes
Individual does not have any FDA labelled contraindications to esketamine nasal spray
Learn more about the specific insurance coverage for esketamine therapy and Spravato with Blue Cross Blue Shield. For more information about how Lumin Health works with insurance, visit our insurance cost & information page.
Frequently asked questions
What is the cost of ketamine treatment with BCBS?
Is ketamine FDA-approved?
Does Blue Cross Blue Shield cover ketamine for depression, PTSD, and chronic pain?
How do I get pre-authorization for Spravato (esketamine)?
How do I know if I’m a good candidate for ketamine therapy, and how can I start treatment?
Article Reviewed by Dr. Benjamin Yudkoff, MD, MA
Dr. Yudkoff is a board-certified psychiatrist who provides the most up-to-date psychiatric care to people managing illnesses that have not satisfactorily resolved with treatment as usual, and in a way which honors principles of autonomy, self-direction, and holistic approaches. He has lectured on spirituality and ketamine therapy, is an Instructor in Psychiatry at Harvard Medical School, and has taught a humanism course to residents of the Harvard Brigham and Women’s Hospital Residency Training Program. Dr. Yudkoff has served as the Medical Director of the Brigham and Women’s Faulkner Hospital and the Medical Director of the Interventional Psychiatric Service (electroconvulsive therapy, ketamine, and esketamine). Dr. Yudkoff has published scientific articles on ketamine and psychopharmacology, and has won several teaching awards from Harvard Medical School students and Brigham and Women’s Psychiatric Residents.
.avif){kind=logo}
