Ketamine Therapy Costs & Insurance Information Understanding Pricing, Insurance, & What to Expect Financially
The financial challenges of ketamine therapy can be daunting. At Modern Mindwork, we understand that dealing with insurance is regularly frustrating and we are here to help you navigate that process.
Ketamine is an FDA-approved drug used in medical settings and hospitals on a daily basis. The World Health Organization (WHO) recognizes it as an essential medicine and acknowledges its efficacy in the treatment of mood disorders. While it is possible for some insurances to reimburse for ketamine infusion therapy, it is not the standard response that we see. Nasal Ketamine (Spravato) is occasionally covered or can be applied to an insurance deductible, however, that is also an unpredictable path.
Thousands of patients are having success with this treatment, but it’s important to note that there is no guarantee (implied or otherwise) that ketamine therapy will be successful for every patient. In our clinic, we have seen one client in the last four years who did not respond at all. According to the literature, 7% of individuals will not experience any long-term effect. Additionally, we have had two clients who struggled to adjust to the absence of their depression and suicidal ideation.
How to Lower the Cost of Ketamine Therapy
- Check Insurance Coverage: Contact your insurance provider to verify if your policy covers ketamine therapy for your specific diagnosis. Coverage can vary significantly based on the policy, your diagnosis and the medical necessity as perceived by your insurer. More insurers now recognize the benefits of ketamine therapy, especially for treatment-resistant conditions, when compared to the financial consequences of living with certain conditions.
- Understand “Out-of-Network” Reimbursements: This is when you pay the upfront costs of ketamine therapy and your insurance provider will reimburse you directly, depending on your coverage. If ketamine therapy is not covered as an “in-network” service, you might still get reimbursed by filing an 'out-of-network' claim. In this scenario, you'll pay upfront, and your insurer may reimburse you a portion of the cost depending on your plan.
- Know Your Deductible: Your deductible is the amount you pay out-of-pocket before your insurance starts to cover any services. This varies by plan. All medical expenses, not just those for ketamine therapy, count towards meeting this deductible. Confirm this amount with your insurance to plan your treatment finances accordingly.
- Request Your “Superbill”: We are happy to generate a “superbill” for your insurance provider. This is a detailed, itemized invoice detailing the services we have provided you, which you can submit to your insurance for out-of-network coverage.
Ketamine Infusion Therapy: Prices
- Each infusion is $500 dollars.
- Depending on your diagnosis and the evaluation at intake, a recommendation of 6 or 8 induction infusions over 4 to 6 weeks is usually recommended for most mental health diagnoses.
- Some clients return on life anniversary dates, quarterly, in the fall and winter, or when they hit a life speed bump and realize their brain has taken a turn.
- Infusions for CRPS 1 or 2 and other complex pain diagnoses are longer in time and dose. Pricing is variable as treatment is specific to you, your condition and how you respond to treatment. We will discuss this during your initial consultation.
- We offer a discount to people who are working in the helping professions: healthcare, mental health, the criminal-legal system, first responders and veterans. Please let us know during your initial intake.
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Client Testimonials
I finally have found a real, long lasting reprieve from my depression. Ketamine therapy worked very fast and amazingly well
Joanna is warm and professional. She took her time and explained the process thoroughly.
Chronic depression almost killed me. Ketamine allows me to feel normally, sometimes happy, sometimes sad.
