How to Get Spravato Covered by Insurance: Step-by-Step

How to Get Your Insurance to Cover Spravato

Getting Spravato covered doesn't have to be complicated. Follow this step-by-step guide to maximize your chances of approval.

Step 1: Verify Your Benefits

Before anything else, check your insurance:

• Is Spravato on your formulary?
• What's your specialty drug copay?
• Have you met your deductible?

We provide free benefits verification at Next Step Psychiatry.

Step 2: Gather Documentation

You'll need:

• Complete psychiatric history
• List of all medications tried (with dates, doses, outcomes)
• Current treatment plan
• Letter of medical necessity

Step 3: Choose a REMS-Certified Provider

Spravato can only be administered at certified facilities. Verify your provider is:

• REMS-certified
• In-network with your insurance
• Experienced with prior authorizations

Step 4: Submit Prior Authorization

Your provider submits:

• Completed PA form
• Supporting clinical documentation
• Medical necessity justification

Step 5: Follow Up

• Check status after 5-7 business days
• Respond promptly to requests for info
• Request peer-to-peer if needed

Step 6: Start Treatment

Once approved:

• Schedule your first session
• Apply for copay assistance
• Begin your treatment journey

We Handle Everything

At Next Step Psychiatry, we manage the entire process. Call (678) 437-1659 to get started.