Every Claim We Publish, and Where It Came From

This is the fourth temporary extension. Each of the previous three was issued close to its expiry date, so the position may change late in 2026.

No final rule and no withdrawal notice has been published. A rule can also be shelved without a formal withdrawal, so this should not be read as a statement that the DEA intends to finalise it.

Federal DEA telemedicine flexibilities run separately and expire at the end of 2026.

The published criteria document dates from 2022 and a newer revision may exist that we could not retrieve. Ask your clinic to confirm the current requirements before you rely on these details.

The add-on trial requirement is the hardest barrier here and is the one most often left out of summaries. Note also that this 2022 document still requires a companion oral antidepressant, which predates the FDA's January 2025 monotherapy approval — it may since have been revised, so confirm the current rule.

The programme covers the medicine, not the office visit or the two-hour observation, which is often the larger share of the bill. The official terms state that a yearly maximum applies but do not publish the amount, so we do not either. Terms are set per calendar year.

Wholesale acquisition cost is published only in paywalled pricing compendia. The figures here are seven years old and come from a secondary source, so we do not use them to produce a dollar estimate — the estimator suppresses Spravato cash figures rather than presenting a number this weak.

Deductible and premium amounts are set annually and change each January.

This is a national policy, so it reads the same wherever you live — which is why it is recorded once here rather than repeated in each state. UnitedHealthcare runs parallel medical and pharmacy versions; which one applies depends on how your clinic bills, and prior approval is needed either way.

This describes one commercial insurer. It does not describe any state Medicaid programme, none of which publishes criteria for racemic ketamine either way.

This applies to hospitals billing outpatient services, not to every Missouri provider.

Anthem's published Missouri criteria date from 2023 and still require a companion oral antidepressant, which predates the FDA's monotherapy approval — we do not present them as current.

Of nine Missouri clinic websites checked, eight publish no prices at all. Every Kansas City clinic we found with a published infusion price is physically in Kansas, not Missouri. You will have to phone to get a real number — our cost checklist lists the questions that get you one.

No Missouri clinic price sheet supports this band. It is a directory estimate, not a Missouri figure.

This is the only Missouri clinic we found publishing any prices at all, and it offers only sublingual treatment. The medicine and the session are billed separately — ask which a quoted price covers.

This is a national figure from one secondary directory, not a Missouri price. Our estimator does not produce a self-pay Spravato number from it.

Esketamine has no separate DEA listing; it is covered as an enantiomer of ketamine, and the Spravato label carries the CIII designation.

This applies to the treatment-resistant depression indication only. The separate indication for major depressive disorder with acute suicidal ideation still requires an oral antidepressant — see spravato.approval_mdd_si. Widely-cited secondary sources give 21 January 2025; that is the manufacturer's announcement date, not the FDA action date on the approval letter.

The label lists a different set for the major-depressive-disorder-with-acute-suicidality indication. The two lists should not be conflated.

This is a narrative review, not a systematic review, and it reports mixed clinical findings. It does not support any personal recovery timeline.

Commercial payers and state Medicaid programmes each publish their own prior-authorisation wording; the clinical definition and the coverage definition are not always identical.

Trial populations are selected, monitoring is intensive, and individual response cannot be predicted from group averages.

This is research evidence, not an FDA approval. Off-label use remains lawful medical practice when a licensed clinician judges it appropriate.

Do not read this as a treatment recommendation. A bipolar diagnosis changes the assessment and the risk profile; only a treating clinician can decide.

The Spravato label focuses on dissociation, sedation, abuse potential and suicidal thoughts rather than a dedicated mania-switch section; the clinical risk is also described in the bipolar-depression literature cited on this page.

Most cystitis case series describe chronic recreational exposure, not a standard six-infusion clinic course. Absence of a published clinic-dose incidence figure is not proof of zero risk.

Schedule status describes abuse potential relative to other controlled drugs; it is not a prediction that a monitored clinic course will produce dependence.

Employers, courts and sports bodies may order expanded panels. If a drug test is pending, disclose prescribed treatment to the medical review officer rather than relying on a generalisation.

Spravato cannot be taken at home under the REMS. Compounded at-home racemic products are a different regulatory pathway and are not REMS-certified substitutes.

An older Missouri lookup address is still widely circulated but no longer works. This is the current one.

Whether the sedation restriction reaches low-dose ketamine infusions for depression — as opposed to anaesthesia — is genuinely unsettled in Missouri. No board guidance, attorney general opinion or court decision resolves it, so we do not state an answer either way. It is a fair question to ask a clinic about who will be in the room.