Medicare AdvantageCoverageMedium impact
MA08.137e, Intravenous Ketamine (Ketalar®) and Intranasal Esketamine (Spravato®)
Independence Blue Cross·Psychiatry, Anesthesiology, Pain Management·Pharmacy
Effective date
Jan 1, 2026
We identified it
Jun 19, 2026
Summary
Policy MA08.137e regarding coverage for IV ketamine (Ketalar) and intranasal esketamine (Spravato) for Medicare Advantage plans was updated but immediately removed the same day it was posted. This suggests a rapid policy revision or withdrawal that may affect current billing practices.
Action Required
Immediately: Contact Medicare Advantage plans directly to verify current coverage policies for IV ketamine and intranasal esketamine since the updated policy was removed. Do not rely on previous policy versions until clarification is received. Billing team should hold claims for these medications until coverage confirmation is obtained to avoid denials.