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, but they do not override a stricter state rule. We have not separately checked the parallel osteopathic board rule.

Pennsylvania removed its requirement that Spravato be taken alongside an oral antidepressant, effective 5 January 2026, following the FDA's monotherapy approval. Older summaries still describe the previous 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 The official terms state that a yearly maximum applies but do not publish the amount, so we do not either.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.

Highmark's published policy dates from 2024 and still requires a companion oral antidepressant, which predates the FDA's monotherapy approval — ask whether it has been updated. We could not locate published criteria for Independence Blue Cross or UPMC Health Plan, so we make no claim about either.

Based on five Pennsylvania clinics that publish prices. Most do not, and the clinic sets the price — treat this as a guide to what a reasonable answer sounds like, not as a quote.

The wide spread is real: it reflects whether you are paying for an injection or for several hours of a clinician's time.

These are two different things and quotes often conflate them. Ask whether a price covers the medicine, the supervised session, or both.

This is a national figure from one secondary directory, not a Pennsylvania price. Our estimator does not produce a self-pay Spravato number from it, because it is not good enough evidence to build a figure on.

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.

The physician assistant rule cited is the State Board of Medicine's. Physician assistants supervised by an osteopathic physician fall under a separate parallel rule that we have not separately checked.

The doctrine rests on case law rather than a single statute, which makes it harder to cite precisely than an explicit prohibition would be.

The deadline is the close of the next business day, not 24 hours — across a weekend that is materially longer. Older material calls this system 'AWARxE', which is the former platform vendor's name; the Department of Health no longer uses it.

The Department of Health separately recommends checking before every controlled substance prescription as good practice. That is advice, not the legal trigger, and the two should not be confused.

Take-home sublingual ketamine dispensed by a pharmacy is recorded. In-clinic infusions and Spravato generally are not.