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Independence Blue CrossCommercial · Billing Codes · Pharmacy · Psychiatry, Pain Management, Palliative Care +2 moreHigh impact

08.01.80e, Intravenous Ketamine (Ketalar®) and Intranasal Esketamine (Spravato®)

Act
by Jan 1, 2026
Effective date
Jan 1, 2026
Identified
Oct 2, 2026

Summary

Independence Blue Cross updated policy 08.01.80e to replace HCPCS code S0013 (Esketamine, nasal spray) with J0013 effective January 1, 2026. Billing teams must update systems to use the new J0013 code for all intranasal esketamine (Spravato) claims going forward, as the old S0013 code is no longer valid under this policy.

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What to do

by Jan 1, 2026 · 5 steps
01Billing team must update all billing software and claims systems to replace HCPCS code S0013 with J0013 for intranasal esketamine (Spravato) administration.
02Remove S0013 from all active billing rules, fee schedules, and encounter templates.
03Coordinate with providers to ensure claims submitted on or after 01/01/2026 use J0013 exclusively.
04Verify that billing system is configured to pair J0013 with supervision codes G2082 or G2083 and appropriate ICD-10 diagnosis codes (F32.0, F32.1, F32.2, F32.4, F32.5, F32.89, F33.0, F33.1, etc.).
05Claims submitted with S0013 on or after the effective date will be denied.

Codes mentioned

J0013S0013G2082G208399499F32.0F32.1F32.2F32.4F32.5F32.89F33.0F33.1

Original notice

08.01.80e, Intravenous Ketamine (Ketalar®) and Intranasal Esketamine (Spravato®)
medpolicy.ibx.com · Always check the source before changing claims.
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Related changes

See all Independence Blue Cross changes →
08.01.80e, Intravenous Ketamine (Ketalar®) and Intranasal Esketamine (Spravato®)HighEffective Jan 1, 2026 · PharmacyMA08.137d, Intravenous Ketamine (Ketalar®) and Intranasal Esketamine (Spravato®)MediumEffective Dec 29, 2025 · Pharmacy08.01.80d, Intravenous Ketamine (Ketalar®) and Intranasal Esketamine (Spravato®)MediumEffective Dec 29, 2025 · PharmacyMA08.137e, Intravenous Ketamine (Ketalar®) and Intranasal Esketamine (Spravato®)HighEffective Jan 1, 2026 · PharmacyBrowse every Independence Blue Cross change in the policy list

Related policy hubs

Independence Blue Cross policiesPsychiatryPain ManagementPalliative CareAnesthesiologyPharmacyCode J0013Code S0013Code G2082Code G2083Code 99499Code F32.0Code F32.1Code F32.2Code F32.4Code F32.5Code F32.89Code F33.0Code F33.1

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