How often are visits?

Twice a week for the first four weeks, then weekly, then every week or two as maintenance. There is no single stepping-down schedule: your prescriber sets and adjusts the taper around how you respond, and tracks you through it so the depression does not come back as you step down.

How long is each visit?

Plan on a little over two hours: a quick check-in, the medication, then a monitored rest period before your ride home.

What does it feel like?

Most people describe feeling floaty, dreamlike, or detached for 30 to 60 minutes. It fades before you leave. Some people get nausea or a headache; we manage both.

Will my insurance really cover it?

Spravato is the most consistently covered treatment in this category because it's FDA-approved. Most commercial plans, MO HealthNet plans, TRICARE, and Medicare cover it with prior authorization - which we file and fight for you.

What disqualifies someone?

The main ones are uncontrolled or untreated high blood pressure; an aneurysm anywhere in the body; an arteriovenous malformation (an abnormal tangle of blood vessels, sometimes called an AVM); a history of bleeding in the brain; a history of psychosis; and pregnancy. The screener checks gently; the medical evaluation checks thoroughly.

In our clinic · covered by insurance

Spravato: the next step your insurance actually covers.

Esketamine nasal spray, FDA-approved since 2019 for treatment-resistant depression - taken in our clinic, under a doctor's supervision, with your progress measured at every visit.

See if you qualify Check your coverage

The treatment room: comfortable chairs in warm light

Two hours in a comfortable chair. We watch over everything else.

Do I qualify?

You may qualify if you've tried just two antidepressants.

You're an adult with depression that's still winning.
You've had two or more adequate antidepressant trials - the most common insurance bar.
You're taking (or willing to take) an oral antidepressant alongside treatment.
No history of psychosis; blood pressure controlled - the medical evaluation confirms the rest.

Fewer than two trials? The screener will say "not yet" - and the doctor letter makes your next prescription count toward qualifying.

The visit

What a treatment day looks like.

Check in - 15 minutes

Quick symptom measures and blood pressure. Same nurse, same questions, so change is visible week to week.

The medication - a few minutes

You administer the nasal spray yourself, with the clinician right there. No IVs, no needles.

Rest and monitoring - 2 hours

A comfortable chair, dim light if you want it, vitals checked on schedule. Doze, listen to music, or just be.

Home - with a ride

Someone you trust drives you home. The FDA label is explicit: no driving until the next day, and only after a restful sleep.

Cost, honestly

Coverage does the heavy lifting.

With commercial insurance, the manufacturer's savings program (Spravato withMe) can bring your cost to as little as $10 per treatment - up to an annual limit.

The limit, stated plainly: the program covers up to $8,150 in eligible out-of-pocket costs per calendar year, and that amount resets every January 1. Once you reach it, you pay your plan's normal cost-share for the rest of that year. We open October 1, so a course that starts this year has three months against this year's limit before the new year's limit begins. We put your projected numbers, including where the limit lands for you, in writing before your first treatment.

By law the program can't be combined with Medicaid, Medicare, or TRICARE - for those plans we work the coverage directly, and patient costs are typically minimal.

Whatever your plan, you get your exact numbers in writing before your first treatment. No surprise bills. Ever.

See coverage by plan type

Two minutes tells you if this is your next step.

The screener routes you honestly - clinic, at-home, or “not yet.”

Start the 2-minute screener Book a consult

The clinic opens October 1, 2026 - we are booking consults now. A real person calls you back within one business day.