All PlansCoverageMedium impact
Ketamine for the Treatment of Psychiatric Disorders 3.01.13
Excellus BlueCross BlueShield·Psychiatry, Pain Management, Anesthesiology·Behavioral Health (Psychiatry/Psychology)
Effective date
Jan 22, 2026
We identified it
Jun 20, 2026
Summary
Excellus BlueCross BlueShield has classified all forms of ketamine (except FDA-approved esketamine/Spravato) for psychiatric disorder treatment as investigational and non-covered. This includes ketamine administered by any route for depression, anxiety, PTSD, OCD, and substance use disorders.
Action Required
By January 22, 2026: Billing team must update system to deny coverage for ketamine treatments (all routes except esketamine/Spravato) for psychiatric conditions including depression, anxiety, PTSD, OCD, and substance use disorders. Update prior authorization systems to flag these as investigational. Inform providers that only FDA-approved esketamine nasal spray (Spravato) may be covered per separate policy 63. Claims for investigational ketamine will be denied.