Spravato for treatment-resistant depression
When Spravato is used for treatment-resistant depression, what the label and insurers allow, what to expect, and what it costs.
Updated · Checked by the Covered Mind editorial team against cited sources
Key facts
- Last checked:
- Sources listed: 1
- Reading time: About 1 minute
- Criteria: at least two antidepressants at adequate dose and duration
- Coverage: Covered by most commercial plans, Medicare and Medicaid with prior authorization.
- Insured cost: typically $10 to $250 per session
- Medicare coinsurance: about $220 unless a supplement pays it
| Fact | Value |
|---|---|
| Last checked | |
| Sources listed | 1 |
| Reading time | About 1 minute |
| Criteria | at least two antidepressants at adequate dose and duration |
| Coverage | Covered by most commercial plans, Medicare and Medicaid with prior authorization. |
| Insured cost | typically $10 to $250 per session |
| Medicare coinsurance | about $220 unless a supplement pays it |
What is Spravato approved for in treatment-resistant depression?
Treatment-resistant depression is exactly what Spravato (esketamine) was approved for: adults with major depressive disorder who have not responded to at least two antidepressants at adequate dose and duration in the current episode. It is taken with an oral antidepressant, which you continue throughout.
See the coverage hub, the Spravato hub, and the coverage checker.
What did the trials show for Spravato for treatment-resistant depression?
In the pivotal four-week trial, about half of patients on esketamine plus an oral antidepressant responded versus about a third on placebo spray plus antidepressant. In the maintenance trial, continuing esketamine after remission cut relapse roughly in half compared with stopping.
What does meeting the criteria for Spravato for treatment-resistant depression require?
Approval turns on documentation: two adequate trials in the current episode with doses and dates, a current oral antidepressant, a baseline rating scale score, and treatment at a certified center.
See treatment-resistant depression criteria explained and how prior authorization works.
Does insurance cover Spravato for treatment-resistant depression, and what does it cost?
Covered by most commercial plans, Medicare and Medicaid with prior authorization. Insured cost is typically $10 to $250 per session; Medicare coinsurance about $220 unless a supplement pays it.
See Spravato coverage by insurer, Spravato: the complete guide and 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 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 treatment-resistant depression." https://www.coveredmind.com/conditions/treatment-resistant-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.