Spravato for depression
Spravato (esketamine) is approved for adults with major depression who have not responded to at least two antidepressants, and for adults with major depression and acute suicidal thoughts. Visits are twice a week for the first month, each about two and a half hours. Plans ask for prior authorization. An oral antidepressant stays in the plan.
Updated · Checked by the Covered Mind editorial team against cited sources
When Spravato is used for major depression, what the criteria are, what response rates look like, and how it fits with antidepressants and therapy.
Key facts
- Last checked:
- Sources listed: 1
- Reading time: About 1 minute
- Who qualifies: at least two antidepressants
- First month: Two sessions a week for the first four weeks
- Response window: within the first two weeks
- Coverage step: prior authorization
| Fact | Value |
|---|---|
| Last checked | |
| Sources listed | 1 |
| Reading time | About 1 minute |
| Who qualifies | at least two antidepressants |
| First month | Two sessions a week for the first four weeks |
| Response window | within the first two weeks |
| Coverage step | prior authorization |
Who is a candidate for Spravato for depression?
Spravato is approved for adults with major depressive disorder who have not responded adequately to at least two antidepressants, and for adults with major depression and acute suicidal thoughts. It is not a first-line treatment and is not approved for bipolar depression.
See what your plan requires in the coverage checker and read Spravato coverage by insurer. Common questions about coverage and billing are answered on the Spravato overview.
How does Spravato fit with your other depression treatment?
Spravato is added to an oral antidepressant, not used instead of one. Psychotherapy continues. The goal of the first month is a rapid response that the oral medication then helps hold.
What should you expect with Spravato for depression?
Two sessions a week for the first four weeks, each about two and a half hours at the clinic. Response is often noticed within the first two weeks. If there is no improvement after four weeks, most clinicians reassess rather than continue.
Does insurance cover Spravato for depression?
Most commercial plans, Medicare and many Medicaid programs cover Spravato with prior authorization for this diagnosis.
See Spravato coverage by insurer and Spravato: the complete guide. Read Does Medicare cover Spravato, and how much will I pay?
See Spravato vs ketamine: which is right for you? for the side-by-side.
Read What to expect at your first Spravato session and Medicaid coverage for Spravato, ketamine and TMS: state by state overview.
Related
Checked by the Covered Mind editorial team · · Editorial policy
Cite this
Covered Mind. "Spravato for depression." https://www.coveredmind.com/conditions/depression/spravato. Last checked Sep 1, 2026.
This site provides general information about insurance coverage and treatment options. It is not medical advice, not a guarantee of coverage, and not a substitute for talking with a clinician or your health plan.