Quick answer: In Nevada, SPRAVATO® is often covered by major insurance plans, including Medicare and Medicaid, for treatment-resistant depression. Coverage typically requires prior authorization, which involves demonstrating that at least two other antidepressant treatments were not effective. Your out-of-pocket cost will vary based on your plan’s details.
How does insurance coverage for SPRAVATO® work?
Yes, most Nevada insurance plans cover SPRAVATO® (esketamine) nasal spray for treatment-resistant depression (TRD). This includes major commercial insurance, Medicare, and Nevada Medicaid. Because Calm Clinic is in-network with most major insurers, your treatment is more likely to be covered.
Before starting, your plan will require prior authorization. To get this approval, your clinician must submit documentation showing a diagnosis of major depressive disorder and that you’ve tried at least two other antidepressants without success. Coverage depends on your specific plan’s requirements.
Does Medicare or Medicaid Cover SPRAVATO®?
Yes, both Medicare and Nevada Medicaid typically cover SPRAVATO®, and Calm Clinic accepts both. Medicare coverage is usually split into two parts.
- Part B helps pay for clinical services, like the time you spend being monitored in our office.
- Part D helps pay for the SPRAVATO® medication itself.
Nevada Medicaid also covers the treatment. For either plan, your final cost will depend on your specific deductibles and copays. Our team checks your benefits before you begin so you have an idea of the cost.
What is a SPRAVATO® treatment session like?
A SPRAVATO® treatment session involves self-administering the nasal spray under clinical supervision at our certified Las Vegas office, located at 4029 Dean Martin Dr., Las Vegas, NV 89103.
According to the FDA, SPRAVATO® has a boxed warning for serious risks. These include sedation, dissociation, respiratory depression, potential for abuse and misuse, and an increased risk of suicidal thoughts and behaviors in younger adults. For these reasons, you will rest in a comfortable room for about two hours while we monitor you. You must have a ride home arranged and cannot drive until the next day after a restful sleep. For complete safety information, please visit the official SPRAVATO® website at https://www.spravato.com/.
How much will SPRAVATO® cost in Nevada?
Your final cost for SPRAVATO® depends on your insurance plan. Before your first appointment, our team will verify your benefits and provide a personalized cost estimate.
For those without insurance or who prefer to pay directly, the self-pay rate for the clinical monitoring appointment is $150. This fee does not include the separate cost of the medication itself.
You can book an initial consultation online to get started. All scheduling and billing are handled by Anywhere Clinic.
Important to Know
Please review the following information before seeking care. Medical decisions require a comprehensive evaluation by a licensed clinician. Telehealth availability may vary by state. The prescription of controlled substances is not guaranteed and may require an in-person visit where mandated by law. This content is for educational purposes and is not a substitute for professional medical advice. Calm Clinic appointments are scheduled and billed through Anywhere Clinic, a telehealth practice owned by Dr. Sam Zand. If you are in crisis, call or text 988 (Suicide & Crisis Lifeline) or call 911. Calm Clinic is not an emergency service.
Frequently Asked Questions
How long does SPRAVATO® prior authorization usually take?
The timeline varies by insurer, but it often takes from a few business days to a couple of weeks. The timing depends on how quickly your insurance company reviews the clinical information submitted by your provider.
What are the typical out-of-pocket costs for SPRAVATO® with Medicare?
Your costs depend entirely on your specific Part B and Part D plans, including your deductibles and copays. The best way to know for sure is to review your plan’s explanation of benefits or ask our team for a benefits check.
Why do I need a ride home after every SPRAVATO® treatment?
This is a strict FDA safety requirement. SPRAVATO® can cause temporary sleepiness, dissociation, and dizziness that make driving unsafe. You must have a ride home arranged before each treatment session.
What happens if my insurance denies SPRAVATO® coverage?
If coverage is denied, you have the right to appeal the decision, and your clinician can provide guidance on that process. You also have the option to pay our self-pay rate of $150 per visit, plus the separate cost of the medication.
Where is Calm Clinic’s SPRAVATO® treatment center in Nevada?
All SPRAVATO® treatments are provided in person at our certified Las Vegas clinic, located at 4029 Dean Martin Dr., Las Vegas, NV 89103. As a certified treatment center, our facility meets all requirements for safe administration and monitoring. We see patients by appointment only.