Does Insurance Cover Ketamine Therapy? (Colorado Context)

Does Insurance Cover Ketamine Therapy? Cost is a real consideration. Here’s a straightforward look at how coverage tends to work — and how to check your own plan.

One of the first practical questions people ask about ketamine therapy is whether insurance will help pay for it. The honest answer depends heavily on which form of treatment you mean. Here’s how it generally breaks down (and please treat this as general information, not a guarantee about your specific plan).

IV ketamine infusions

IV ketamine for mental health is used “off-label,” meaning it’s a legitimate, evidence-based use that falls outside the medication’s original FDA approval. Because of that, most commercial plans do not directly cover IV ketamine infusions, and Medicare generally considers them investigational for mental health. Many patients pay out of pocket.

There is a common exception worth knowing: if you have a PPO plan with out-of-network benefits, you may be able to submit an itemized receipt (a “superbill”) and receive partial reimbursement, depending on your deductible and plan. It’s always worth asking.

Esketamine (Spravato)

The picture is different for Spravato, the FDA-approved nasal spray. Because it carries formal approval for treatment-resistant depression, it’s covered by many major insurers, and Medicare Part B typically covers a share of the cost after your deductible. Coverage still varies by plan and often requires prior authorization and documentation of prior treatments.

How to check your own coverage

1. Call the member services number on your insurance card and ask specifically about IV ketamine and about Spravato (esketamine) for depression.

2. Ask whether out-of-network reimbursement is available if the clinic is out-of-network.

3. Ask what documentation or prior authorization is required.

4. Ask your clinic what a self-pay plan looks like and whether they provide superbills.

The bottom line

As a rule of thumb: Spravato is more likely to be covered, while IV infusions are often out of pocket with the possibility of partial PPO reimbursement. We’re happy to walk you through the options and costs so there are no surprises.

Curious whether this could be a fit for you? Refound Center offers clinician-led care in the North Denver to Fort Collins area. Reach out to schedule a consultation and we’ll talk through your history and options together.

Medical disclaimer

This article is for general educational purposes only and is not medical advice, diagnosis, or treatment. Ketamine therapy is not appropriate for everyone. Talk with a qualified clinician about your history, medications, and goals before starting any treatment. If you are in crisis or thinking about harming yourself, call or text 988 (the Suicide & Crisis Lifeline) in the U.S.

Sources & further reading:

Healthline. Does Medicare cover ketamine infusions? — coverage overview, 2025. https://www.healthline.com/health/does-medicare-cover-ketamine-infusions

Johnson & Johnson / FDA. Spravato (esketamine) approved as the first monotherapy for treatment-resistant depression, January 2025. https://www.jnj.com/media-center/press-releases/spravato-esketamine-approved-in-the-u-s-as-the-first-and-only-monotherapy-for-adults-with-treatment-resistant-depression