CDPHP and Spravato™ (Esketamine) - Is it Covered?
Does CDPHP cover Spravato™ (Esketamine)?
CDPHP may cover Spravato, but approval depends on your specific health plan, diagnosis, and documented treatment history. At Libertas Mind, we help patients navigate the prior authorization process and are often successful in securing coverage so treatment can begin without delays. CDPHP follows a defined set of clinical criteria that must be met before Spravato is approved.
This typically includes confirming the diagnosis, reviewing past treatment attempts, and ensuring Spravato will be administered safely in a certified healthcare setting. Our care team guides you through every step so the process is smooth and clearly understood.
Coverage for Spravato (esketamine) under CDPHP depends on your individual health plan, diagnosis, and medical history. At Libertas Mind, we frequently assist patients in obtaining prior authorizations — and in many cases, successfully help them secure coverage for Spravato treatment.
Because Spravato must be administered through a REMS-certified clinic under medical supervision (not through a retail pharmacy), CDPHP applies specific clinical criteria to determine eligibility. Below is a summary of what CDPHP typically requires.
CDPHP’s Clinical Requirements for Spravato™ (Esketamine) Coverage
Age Requirement:
You must be 18 years or older.
Diagnosis Requirement (At least one):
Treatment-Resistant Depression (TRD):
Documented failure to respond adequately to two or more antidepressants from different classes.Major Depressive Disorder (MDD) with acute suicidal ideation or behavior.
- Age Requirement:
You must be 18 years or older.
- Diagnosis Requirement (At least one):
Treatment-Resistant Depression (TRD):
Documented failure to respond adequately to two or more antidepressants from different classes.Major Depressive Disorder (MDD) with acute suicidal ideation or behavior.
- Additional Requirements (All must be met):
Depression diagnosis confirmed via a validated assessment tool (e.g., PHQ-9 or similar).
Spravato treatment is administered in conjunction with an oral antidepressant.
Treatment must occur under direct supervision of a qualified healthcare provider in a REMS-certified facility.
Blood pressure must be monitored before and after each dose.
Post-dose monitoring for at least two hours to watch for sedation, dissociation, or other side effects.
Patient, prescriber, and facility must all be registered under the REMS program.
Prescriber agrees to monitor for clinical worsening, suicidal thoughts or behaviors, or other safety concerns.
If all these conditions are satisfied, Spravato may be eligible for coverage under CDPHP — though actual coverage depends on your specific plan details.
How to Check CDPHP Spravato™ (Esketamine)Coverage
Libertas Mind is in-network with many major insurers, including CDPHP.
If you’d like, our care coordinators can:
- Verify your CDPHP plan’s benefits and Spravato coverage eligibility
- Help with prior authorization and paperwork
- Estimate potential out-of-pocket costs
- Guide you through scheduling treatment
We simplify the insurance process so you can focus on your care.
Why Spravato™ (Esketamine) Matters for Depression Treatment
Spravato offers a potentially powerful option for adults with treatment-resistant depression or major depressive disorder who have not responded to traditional therapies. Research and clinical experience suggest that many patients see meaningful improvements — sometimes faster than with standard antidepressants.
Because Spravato is administered as a nasal spray under strict medical supervision (REMS-certified), it must be given in a clinical setting by trained professionals — ensuring safety and compliance with regulatory standards.
REMS Certification & Treatment Safety
Spravato treatment is regulated under the FDA’s REMS (Risk Evaluation and Mitigation Strategy) program. This ensures that:
Only certified clinics and trained providers can administer the medication
Patients are monitored closely for side effects (e.g., dissociation, sedation, blood pressure changes)
A post-dose observation period is mandatory
Libertas Mind adheres fully to REMS guidelines, providing a secure, controlled environment for patients undergoing Spravato therapy.
Libertas Mind Accepts CDPHP Insurance
At Libertas Mind, we’re committed to making quality mental-health care accessible.
We accept many insurance plans, including CDPHP, and support patients through every step — from verifying coverage to scheduling treatment and ongoing follow-up.
If you’d like to explore whether Spravato under CDPHP is right for you, reach out to our team. We can help you navigate the process quickly and clearly.
Libertas Mind Accepts CDPHP Insurance
At Libertas Mind, we believe quality mental health care should be accessible. We accept CDPHP and many other major insurance plans, and we help patients understand how their coverage applies to Spravato treatment.
Our team can guide you through verifying your CDPHP benefits, understanding your Spravato coverage, and starting treatment with confidence.
Learn More About Spravato Treatment
Become A Patient
Frequently Asked Questions
Yes, generally. CDPHP often provides coverage for Spravato, but it is not guaranteed and depends entirely on your specific CDPHP health plan, your diagnosis, and meeting strict clinical criteria. Prior Authorization (PA) is always required.
The primary requirement is typically a diagnosis of either Treatment-Resistant Depression (TRD) (documented failure to respond to two or more different classes of antidepressants) or Major Depressive Disorder (MDD) with acute suicidal ideation or behavior.
Yes. Coverage is limited to patients who are 18 years or older.
Yes. Spravato must be administered in conjunction with a newly initiated or optimized oral antidepressant, as part of the FDA-approved protocol and CDPHP's requirements.
Does CDPHP cover Spravato (Esketamine)? This depend’s on your specific health plan and diagnosis status. In general, Libertas Mind is successful in helping patients get successful prior authorizations so their Spravato treatment is covered. In regards to CDPHP and Spravato nasal spray – they have specific criteria to meet before approving this medication. While CDPHP coverage varies by plan type, typically CDPHP requires:
- 18 years of age or older
- Have at least one of the following:
- Treatment-resistant depression which includes an inadequate treatment response to at least two different types of antidepressants.
- Major depressive disorder (MDD) with acute suicidal ideation or behavior
- And have all of the following:
- Depression that was diagnosed with an approved scoring tool like the PHQ-9
- Is used in conjunction with an oral antidepressant
- Is administered under the supervision of a healthcare provider
- Blood pressure is to be assessed prior and after each administration
- Prescriber agrees to monitor for sedation and dissociation for at least two hours after administration
- Healthcare setting, pharmacy, and patient are registered with the The Risk Evaluation and Mitigation Strategy (REMS) program
- Prescriber agrees to monitor for clinical worsening and emergence of suicidal thoughts and behaviors
How to check CDPHP Spravato Coverage
Libertas Mind is in-network with most major insurance plans. One of our care coordinators can help you navigate your insurance coverage and help you get the care you need.
Why is Spravato or esketamine important for Depression treatment?
Spravato is a new and very effective treatment for resistant depression (TRD) and adults with major depressive disorder (MDD). Randomized trials have shown that Spravato can relieve TRD quickly. Depending on the length of Spravato treatment, studies suggest 40-60% efficacy. Click here to learn more.
Spravato or esketamine was derived from ketamine, which has a long history of helping mood disorders. Spravato was made into a nasal spray that you self administer. It can only be given in a doctor’s office.
Spravato can only be administered in a licensed healthcare setting with medical professionals trained to prescribe and distribute it. The Risk Evaluation and Mitigation Strategy (REMS) program for Spravato mandates that healthcare facilities that administer the medicine be certified. Spravato is not available at your local pharmacy.
Learn more about the science underlying Spravato treatment here
Libertas Mind Accepts CDPHP Insurance
At Libertas Mind, we belive that quality mental health services should not be a financial burden. We accept a wide range of insurance plans, including CDPHP.
Our experienced team can provide detailed information about Spravato treatment.
