If you've tried two or more antidepressants without relief, Spravato may be worth exploring with your provider. As a REMS-certified provider, Family1st offers esketamine therapy by appointment — and unlike IV ketamine, Spravato is FDA-approved and often covered by insurance.
Accepted plans:
*Based on TRANSFORM-2 & TRANSFORM-3 pivotal trials (Daly 2019, Popova 2019). Individual results vary. Spravato requires a comprehensive psychiatric evaluation and is not appropriate for all patients.
Spravato is FDA-approved for adults with treatment-resistant depression (TRD) — defined as inadequate response to at least two different antidepressants at adequate doses and duration. Also approved for depressive symptoms in MDD with acute suicidal ideation.
Treatment-resistant depression is defined as inadequate response to at least two antidepressants taken at adequate doses for adequate duration.
Current diagnosis of MDD confirmed by a licensed psychiatric provider. Spravato is not approved for bipolar depression.
You cannot drive for the rest of the day after a session due to sedation and dissociation. A designated driver or rideshare is required.
History of psychosis, certain cardiovascular conditions, aneurysmal vascular disease, or arteriovenous malformation may be contraindications. Assessed at intake.
| Code | Description | Est. Reimbursement | Notes |
|---|---|---|---|
| G2082 | Bundled 56mg dose + 2hr monitoring (Medicare) | ~$700–$800 | Medicare only; buy-and-bill via specialty distributor |
| G2083 | Bundled 84mg dose + 2hr monitoring (Medicare) | ~$900–$1,100 | Medicare; most common maintenance dose |
| J0013 | Esketamine nasal spray, per 1mg (new 2026) | Per mg billed | Replaced S0013 Jan 1, 2026; use for commercial/Medicaid |
| 99214–99215 | E/M established patient monitoring visit | $136–$177 Medicare | Select by complexity or total encounter time |
| Total bundled session (84mg + monitoring) | ~$1,200–$1,500 | Medicare ~$1,450; commercial 90–130% of Medicare | |