Key takeaways

  • Medicare doesn’t currently cover ketamine infusions for treating mental health conditions since the Food and Drug Administration (FDA) only approves ketamine for use as a general anesthetic.
  • Medicare may cover Spravato (esketamine), an FDA-approved drug derived from ketamine that can help manage treatment-resistant depression.
  • Despite lacking FDA approval for mental health treatment, research suggests ketamine may have potential for treating conditions like treatment-resistant depression.

Medicare doesn’t currently cover ketamine infusions for mental health conditions, as the Food and Drug Administration (FDA) only approves ketamine as a general anesthetic.

However, it may cover Spravato, which contains esketamine. This is an FDA-approved drug that derives from ketamine and can help manage treatment-resistant depression.

Despite not yet having FDA approval, some research suggests ketamine could have considerable potential for treating mental health conditions, including treatment-resistant depression and suicidal ideation.

Ketamine comprises R-ketamine and S-ketamine, two mirror-image molecules.

R-ketamine

R-ketamine is an FDA-approved anesthetic you can receive as an intramuscular injection (shot) or intravenous (IV) infusion.

  • Medicare Part A covers anesthetic services, including R-ketamine, during an inpatient hospital or skilled nursing facility stay. After you meet your Part A deductible, which is $1,676 in 2025, you may pay nothing for eligible inpatient services for the first 60 days.
  • Medicare Part B covers anesthetic services, including R-ketamine, if you receive this in an outpatient setting, such as an emergency room or urgent care center. After you meet the 2025 Part B deductible of $257, Medicare covers 80% of eligible expenses. The remaining 20% is your coinsurance.

S-ketamine

S-ketamine, also called esketamine (Spravato), is a nasal spray with FDA approval for treatment-resistant depression and major depressive disorder with suicidal ideation.

Esketamine (Spravato) can be used by itself or in addition to an oral antidepressant.

Doctors and healthcare professionals can offer this treatment in their offices through the Spravato Risk Evaluation and Mitigation Strategy (REMS) program. Under this program, you would self-administer the medication while a medical professional supervises and monitors you for at least 2 hours to watch for any serious side effects.

Medicare Part B may cover the costs if you receive the medication in a doctor’s office or licensed medical facility. The same Part B deductible and coinsurance applies.