KetCompare — US Ketamine & Spravato Clinic Directory · Evidence-Based Playbook

Spravato vs IV Ketamine Cost and Insurance Coverage Comparison (2026)

Last updated: 2026-11-02

Choosing between Spravato and IV ketamine usually comes down to who pays. Spravato is an FDA-approved nasal spray that insurers prior-authorize. IV ketamine for depression is off-label and mostly self-pay. The KetCompare clinic directory, operated by AdvancedCare USA Inc., tracks 3,634 active clinics across 51 states. Run the free state lookup to see published prices and named insurers near you.

> Medical disclaimer: This guide is educational and is not medical advice. Talk with a licensed clinician about your diagnosis and options. If you are in crisis or thinking about suicide, call or text 988, the Suicide & Crisis Lifeline, or go to the nearest emergency room.

What Spravato and IV ketamine are and how each works in 2026

Spravato is intranasal esketamine, FDA-approved for treatment-resistant depression, and given only in REMS-certified settings under supervision. IV ketamine is generic ketamine infused for depression off-label. Clinics administer 56 mg or 84 mg of Spravato, while IV protocols titrate toward 0.5 mg/kg over 40 minutes.

The two treatments share a drug family but differ in regulation, workflow, and payment.

• Spravato: The clinic must enroll in Spravato REMS. Staff monitor blood pressure and dissociation for at least two hours after each dose. The FDA label added monotherapy use for treatment-resistant depression in 2025 (Janssen Spravato Prescribing Information, 2025).
• IV ketamine: A clinician titrates the dose by body weight and monitors vitals during the infusion. Early controlled evidence came from Murrough et al. (American Journal of Psychiatry, 2013), but the FDA has not approved IV ketamine for depression.
• Screening: Both pathways usually screen with PHQ-9 and GAD-7 before the first session. Some clinics integrate KAP, ketamine-assisted psychotherapy, with either route.

Spravato's efficacy evidence in adults with treatment-resistant depression comes from Popova et al. (American Journal of Psychiatry, 2019). Your clinician decides which route fits your history, blood pressure, and risk profile.

Spravato vs IV ketamine cost: what clinics publish

KetCompare tracks published ketamine prices at 777 clinics. IV sessions in our latest sample run $400 to $550 each. Spravato self-pay prices are rarely posted because clinics route pricing through an insurance check first. Treat each figure as one clinic's quote, not a market rate.

For Spravato, no Florida clinic we checked posted a self-pay price (https://www.spravato.com/find-treatment-center/, as_of 2026-07-18). A self-pay patient has to ask for an individual quote. The manufacturer's savings program advertises a copay as low as $10 for eligible commercially insured patients. Eligibility terms apply, so confirm them at spravato.com before relying on that figure.

Watch for one more pricing detail. The Kennewick clinic states it is not in-network with Medicare or Medicaid plans, so those patients pay the cash price (https://tricitieswellness.com/, as_of 2026-10-22).

Insurance coverage: Spravato prior authorization vs IV ketamine self-pay

Commercial insurers and Medicaid programs often cover Spravato after prior authorization, while IV ketamine for depression is off-label and typically self-pay. KetCompare lists 1,551 clinics with named insurers. Coverage depends on plan, diagnosis, prior antidepressant trials, and whether the site is a REMS-certified provider.

Florida shows how much payer rules differ within one state:

• Commercial plans: Florida's major commercial insurers all require prior approval for Spravato. Florida Blue covers it under the medical benefit without a companion antidepressant. Sunshine Health's published criteria still require one, though the document carries no revision date (Florida Blue, UnitedHealthcare and Sunshine Health, as_of 2026-04-15, https://mcgs.bcbsfl.com/MCG?mcgId=09-J3000-37&pv=false). We could not locate Humana's Florida commercial policy, so we make no claim about it.
• Medicaid: Florida Medicaid approves Spravato for adults 18 and over with treatment-resistant depression after antidepressant trials of at least four weeks each. Approvals come in three-month blocks and need no companion oral antidepressant (Florida Agency for Health Care Administration, as_of 2026-04-28, https://ahca.myflorida.com/medicaid/prescribed-drugs/drug-criteria.html).
• Preferred drug list: Spravato does not appear on the Florida Medicaid preferred drug list effective 2026-07-01. Separate clinical criteria and prior approval govern it (same source).

These are Florida facts only. Other states use different criteria, so check the state page in the KetCompare directory before you assume the same rules apply.

Billing and compliance requirements for Spravato and IV ketamine

Spravato billing requires REMS enrollment, a two-hour observation period, and correct HCPCS coding. Clinics that buy-and-bill report G2082 for 56 mg or less and G2083 for more than 56 mg, with the drug itself reported on payer-specific codes such as J3490 or S0013. IV ketamine bills as an infusion service.

Practice teams should confirm each item with the payer, because policies differ:

• E/M and infusion codes: Payers decide whether an E/M code such as 99214 or 99215 can accompany G2082 or G2083. Off-label IV ketamine infusions are often reported with CPT 96365 plus a drug code, but many plans exclude them for depression.
• Prior authorization: Prior-authorize before the first dose. Document PHQ-9 scores, prior antidepressant trials, and REMS enrollment.
• Prescription monitoring: Florida requires prescribers to consult E-FORCSE before prescribing a controlled substance to a patient aged 16 or over (The Florida Senate, as_of 2026-07-18, https://www.flsenate.gov/Laws/Statutes/2024/893.055). An infusion given inside a clinic counts as administration, which Florida excludes from reporting (Florida Department of Health, as_of 2026-07-18, https://www.floridahealth.gov/statistics-data/prescription-drug-monitoring-e-forcse-2/). No Florida guidance settles how Spravato dispensed to a clinic is treated, so we state no answer.
• Ownership and licensing: Florida has no general ban on corporate ownership of medical practices, but clinic licensing applies unless physicians or APRNs wholly own the practice. Fee-splitting and patient brokering are separately regulated (The Florida Senate, as_of 2026-07-18, https://www.flsenate.gov/Laws/Statutes/2025/400.991).

The directory does not award a verified badge from a price snippet alone. NPI-matched records are labeled as such, and everything else is shown as clinic-published information with its source and date.

Spravato vs IV ketamine vs other options: side-by-side comparison

The table below compares the main modalities on cost, coverage, and monitoring using dated clinic data. The widest gap is coverage: Spravato has an approved indication and payer pathway, while IV, IM, and at-home options are mostly cash-pay. Use ranges as starting points, then request a written quote.

Here is how KetCompare compares with the other sources we reviewed:

For ASKP3 clinical standards, see the society's own publications. KetCompare links out to them rather than copying them.

Step-by-step checklist before you book or enroll

The fastest path is to confirm the diagnosis, check the payer rule, and get a written quote before the first dose. Patients and practice managers can use the same sequence. Each step below reduces surprise bills and denied claims.

1. Screen first. Complete PHQ-9 and GAD-7 and record prior antidepressant trials, with dates and doses.
2. Pick the modality with your clinician. Compare Spravato and IV ketamine against your history and blood pressure.
3. Confirm REMS status. For Spravato, confirm the clinic is enrolled in Spravato REMS and can monitor you for two hours after each dose.
4. Ask for the plan's criteria. Request the payer's written Spravato policy and note any companion-antidepressant rule.
5. Prior-authorize. Submit chart notes, scores, and trial history. In Florida Medicaid, expect approvals in three-month blocks.
6. Get a written quote. For IV ketamine, ask the per-infusion price, the six-infusion course price, and the maintenance price.
7. Check network status. Ask whether the clinic bills Medicare or Medicaid, and whether it provides a superbill.
8. Plan the visit. Arrange a ride home, since the infusion and observation visit can run 60 to 90 minutes or longer.
9. Compare clinics. Use the free lookup to compare published prices and insurers in your state.
10. Keep records. Save quotes, authorization numbers, and the source URL with its date.

Practice owners can download the KetCompare checklist for payer verification and claim setup. When you are ready to update a listing, start a free trial or book a demo with the AdvancedCare USA Inc. team.

How to read the data and next steps

All prices come from public clinic pages captured on the dates shown, and regulatory statements cite the named agency and as_of date. Prices change, so confirm with the clinic. KetCompare is operated by AdvancedCare USA Inc. and does not provide medical advice or guarantee coverage.

Start with your state on the KetCompare states page, compare published prices, and shortlist two or three clinics. Then ask each one for a written quote and its payer criteria.

If you are in crisis or having thoughts of suicide, call or text 988, the Suicide & Crisis Lifeline, available 24 hours a day.