CommercialCoverageMedium impact
Ketamine Infusion Therapy for the Treatment of Chronic Pain Syndromes 7.03.03
Excellus BlueCross BlueShield·Pain Management, Anesthesiology, Neurology·Drug / Medications
Effective date
Mar 19, 2026
We identified it
Jun 20, 2026
Summary
Excellus BlueCross BlueShield has established a new policy effective March 19, 2026, classifying intravenous ketamine infusion therapy for chronic pain conditions (including neuropathic pain and fibromyalgia) as investigational and therefore not covered. This policy does not affect Spravato (esketamine) coverage, which is handled under a separate pharmacy policy.
Action Required
Before March 19, 2026: Billing team must update systems to deny coverage for IV ketamine infusion therapy for chronic pain conditions under Excellus BlueCross BlueShield plans. Ensure staff understand that while IV ketamine for chronic pain is not covered, Spravato (esketamine) remains covered under pharmacy policy. Update patient financial counseling protocols to inform patients that these treatments will be patient-pay only.