Most patients pay $0 to $40 a treatment.
Spravato itself is expensive, which is exactly why almost nobody should pay for it out of pocket. Insurance covers it for most people, the manufacturer’s programs cover much of the rest, and getting the approval is our job, not yours.
What you’ll likely pay, by type of coverage.
- NJ Medicaid (NJ FamilyCare): $0. Spravato is covered with a prior authorization. Initial denials are common, and we’re incredibly persistent about appealing. We also help set up insurance-covered rides to treatment. How we handle Medicaid.
- Commercial insurance: up to $40 a treatment for most patients, after the manufacturer’s SpravatoWithMe savings program, for those who are eligible. That covers employer plans and marketplace plans, including Horizon, Aetna, Cigna, UnitedHealthcare, Oxford, AmeriHealth, Meritain Health and many others.
- Medicare: covered with the plan’s own rules. Manufacturer savings programs don’t apply to Medicare, so we check your plan and tell you your cost before you start.
- No insurance, or a plan that genuinely won’t cover it: we help you get Spravato through the manufacturer, and our fee is $40 a session.
$0 to $40 a treatment
- NJ Medicaid: $0. Initial denials are common, and we’re incredibly persistent about appealing.
- Commercial insurance: up to $40 after Janssen’s SpravatoWithMe program, for patients who are eligible. Your own plan sets the details.
- We check before you commit. Insurance verification starts the moment you reach out.
Two parts: the medication, and the visit.
Every Spravato treatment has two costs behind it. Insurance treats them separately, and so do the assistance programs.
- The medication. Spravato comes in single-use nasal spray devices that are dispensed only to certified treatment centers. The list price runs to hundreds of dollars a treatment, and this is the part SpravatoWithMe and manufacturer assistance help with most.
- The visit. Your time in the office: the clinician who supervises your dose, the blood-pressure checks, and at least two hours of monitoring afterward, which federal safety rules require every time. This is the part our $40 covers when you have no insurance.
Your first evaluation is a regular medical visit, billed to your insurance like any other.
Send us your insurance and we’ll tell you what you’d pay.
We start verifying the moment you reach out. You don’t need a referral, and you don’t need to call your insurer first.
Name, date of birth and insurer. We check your plan and call you back. No commitment.
Check my coverageRegister once, and our team starts your insurance check and reaches out to schedule your evaluation.
Request an evaluationFour steps, all of them ours.
- You reach outSend the short form. Your insurance card helps but isn’t required to start.
- We verify your benefitsWe confirm Spravato is covered under your plan and what your share would be.
- We enroll you in savingsIf you have commercial insurance, we help you sign up for SpravatoWithMe so your cost comes down.
- We get the approvalWe submit the prior authorization. 95% of ours are approved on the first try, and when one is denied, we appeal.
A denial isn’t the end of it.
Insurers sometimes say no the first time, especially NJ Medicaid plans. We appeal, and keep appealing through every level available. In our most recent internal review, 34 of 36 denials were overturned.
If your plan still won’t cover Spravato, we help you apply to get it through the manufacturer instead, and our fee stays $40 a session.
What people ask about paying for Spravato.
How much is Spravato without insurance?
The medication alone runs to hundreds of dollars a treatment at list price, which is why we don’t recommend paying for it yourself. If you have no insurance, or your plan genuinely won’t cover it, we help you get Spravato through the manufacturer, and our fee stays $40 a session, the same as it would be with insurance.
Is Spravato covered by insurance in NJ?
For most people, yes. NJ Medicaid, Medicare and the major commercial plans in New Jersey cover Spravato for treatment-resistant depression, usually with a prior authorization. We handle that paperwork, and 95% of our requests are approved the first time.
Is Spravato covered by Medicaid?
Yes. NJ Medicaid (NJ FamilyCare) covers Spravato with a prior authorization, and patients pay $0. Initial denials are common, so expect us to appeal on your behalf if the first answer is no.
What is SpravatoWithMe?
It’s the manufacturer’s patient support program. For eligible patients with commercial insurance, it helps pay the out-of-pocket cost of the medication and helps with the treatment visits, which is how most of our commercially insured patients end up paying up to $40 a treatment. We help you enroll.
Is there a charge for the evaluation?
The evaluation is a regular medical visit, billed to your insurance like any other appointment. We check your coverage before it, so there are no surprises.
Do I need a referral?
No. You can contact us directly. If you already have a psychiatrist or therapist, we’ll coordinate with them.