Does Blue Cross Blue Shield Cover Spravato?
Yes! Blue Cross Blue Shield covers Spravato (esketamine) treatment for qualifying patients. At Next Step Psychiatry, we've helped many BCBS members get their Spravato treatment approved.
BCBS Coverage Requirements
To get Spravato covered by Blue Cross Blue Shield, you typically need:
- Diagnosis of treatment-resistant depression - Failed at least 2 antidepressant trials
- OR major depressive disorder with suicidal ideation
- Prior authorization approval
- Treatment at a REMS-certified facility
BCBS Copay for Spravato
Typical costs for BCBS members:
- PPO Plans: $30-$75 per session
- HMO Plans: $20-$50 per session
- High Deductible: Varies until deductible met
With copay assistance, many patients pay as low as $10 per session.
Getting BCBS Approval
At Next Step Psychiatry, we handle the entire prior authorization process:
- We document your treatment history
- Submit PA request to BCBS
- Respond to any additional requests
- Appeal if initially denied
Our 95% approval rate with BCBS means you can start treatment quickly.
BCBS Plans We Work With
- Blue Cross Blue Shield of Georgia
- Anthem Blue Cross
- Blue Cross Blue Shield Federal Employee Program (FEP)
- Blue Cross Medicare Advantage
- All state BCBS plans
Start Your BCBS Coverage Check
Contact us at (678) 437-1659 for a free BCBS benefits verification.
Related Topics
Ready to Explore Spravato Treatment?
If you're struggling with treatment-resistant depression, Spravato could be the breakthrough you've been waiting for. Contact Next Step Psychiatry in Atlanta for a consultation.