We get Spravato approved. And when it’s denied, we appeal.
Insurance approval is where many people give up on Spravato. Here, it’s a job our team does every day: you give us your insurance card, and we do the rest.
From a two-month internal review of our insurance requests and appeals, March–April 2026. The evaluation figure is a median.
What happens before your first treatment.
- Your evaluationA clinician confirms your diagnosis and goes through the antidepressants you’ve tried.
- We build the requestYour history, your diagnosis and why Spravato is the right next step, in the form your insurer asks for.
- We submit and follow upWe send it, track it and answer the insurer’s questions, so the request doesn’t stall.
- The answer95% of our requests are approved the first time. When one isn’t, we go straight to the appeal.
Almost nothing.
- Your insurance card, so we can start.
- Your treatment history, as best you remember it: which antidepressants, roughly how long.
- Occasionally, a signature or a detail only you have. We’ll tell you exactly what and why.
You won’t be asked to call your insurer, chase a fax or write a letter.
A denial is the start of the appeal, not the end of the road.
Insurers deny Spravato for reasons that usually have nothing to do with whether you need it: a missing record, a form the reviewer wanted filled differently, a rule applied too strictly. Those are fixable, and fixing them is our job.
- First appealWe ask the plan to reconsider, answering the specific reason it gave.
- Second levelIf the plan holds to its denial, we take it to the next level of review the plan offers.
- Independent external reviewIf the plan still says no, we ask for a review by an independent organization outside the insurer.
In our most recent internal review, 34 of 36 denials were overturned this way. If an appeal does run out, we help you get Spravato through the manufacturer, and our fee stays $40 a session.
Bring us your denial letter. We’ll take it from here.
Call us with your denial letter in hand, or ask us to call you. We’ll look at where things stand and tell you the next step.
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 evaluationMore than 30,000 treatments means a lot of approvals.
We’ve given more than 30,000 Spravato treatments, and every patient behind them needed an insurer to say yes first. Our team knows what each of New Jersey’s plans asks for and how each one tends to say no, so most requests go through the first time.
The figures on this page come from a two-month internal review of our insurance requests and appeals, March–April 2026.
$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.
What people ask about getting approved.
Does Spravato need prior authorization?
Almost always. Most New Jersey insurers, including NJ Medicaid and the major commercial plans, require one before they’ll pay for Spravato. We prepare and submit it for you.
What does insurance need to approve Spravato?
Generally, a diagnosis of major depression and a record of at least two antidepressants that didn’t work. The exact rules vary by plan, and we know them.
How often is Spravato approved?
In our most recent internal review, 95% of our prior authorization requests were approved the first time.
My insurance already denied Spravato. Can you still help?
Yes. Call us with the denial letter if you have it. Many denials are about missing paperwork and can be overturned on appeal. In our review, 34 of 36 were.
Do I have to do anything for the appeal?
Very little. Occasionally we’ll need your signature or a detail only you have, and we’ll tell you exactly what. Everything else, from letters to records to follow-up calls, is ours.