Insurance & Coverage

At Psychvisit in Amityville, NY, we support comprehensive insurance coordination for Spravato:

Coverage under major insurers:

• Government programs: Medicare Part B typically covers Spravato administered in-clinic (80% of allowable charges) 

• Private carriers: We are in-network Aetna, Cigna, United Healthcare, Empire Blue Cross Blue Shield or can pursue single-case agreements with other Insurance Carriers.

Prior Authorization Needed: Approval generally requires documentation of:

1. DSM‑5 diagnosis (TRD or MDD with suicidal ideation).

2. Trial and failure of ≥2 antidepressants (≥8 weeks each)

3. Clinical rating scale scores (e.g., MADRS, PHQ‑9, BDI) at baseline and during treatment.

4. Administration in a REMS‑certified clinical environment.

How Psychvisit Supports You:

1. Insurance Verification – We check your plan’s benefits and network status.

2. Prior Authorization Handling – We prepare and submit the necessary clinical documentation, including chart notes and assessment scores.

3. Benefits Maximization – We work with insurers or request single-case agreements for out-of-network plans to minimize your out-of-pocket expenses.

4. Cost Transparency – We clarify expected costs, including medication (Spravato kits) and facility services (administration, observation), sharing them clearly before treatment begins.

5. Ongoing Authorization & Monitoring – We track clinical progress and submit renewal documentation to keep your treatment ongoing without interruption.

💡 Additional Financial Support Options

• Copay and deductible assistance may be available through manufacturer or Janssen CarePath programs.

• Alternative payment plans, HSAs/FSAs, and other financing options can further reduce upfront costs if coverage is partial.