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Care Delivery & Psychedelic FacilitationPsychedelic Healthcare Implementation
Care Delivery & Psychedelic FacilitationPsychedelic Healthcare ImplementationPayer & Reimbursement Stakeholders

UnitedHealthcare

U.S. private payer with national provider-facing prior-authorization criteria for Spravato and medical policy criteria that include ketamine/esketamine use conditions.

Reimbursement & Market Access Snapshot

Insurance Payers & Reimbursement Specialists

Service Model

Private / Commercial Payer

Jurisdiction

National

Coverage

1 country

Last Verified

Apr 11, 2026

Focus Areas

Coverage Policy DesignFormulary & Access CriteriaPayment Coding Pathways

Evidence Requirements

Clinical Efficacy EndpointsComparative EffectivenessLong-Term Safety

Market Access Notes

UnitedHealthcare publishes Spravato-specific prior-notification criteria and a related ketamine/Spravato medical policy for coverage review.

Verification

Verified

Psychedelic Focus

Psychedelic-Adjacent Focus

Engagement Status

Active

Primary Access Link

Linked Stakeholders

Institute for Clinical and Economic Review (ICER)

Source Evidence

UnitedHealthcare Prior Authorization Medical Necessity: Spravato

https://www.uhcprovider.com/content/dam/provider/docs/public/prior-auth/drugs-pharmacy/commercial/r-z/PA-Med-Nec-Spravato.pdf

UnitedHealthcare Ketalar and Spravato Policy

https://ams-gateway.uhcprovider.com/content/dam/provider/docs/public/policies/comm-medical-drug/ketalar-spravato.pdf

Quick Facts

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