Psychedelic Medicine: Major Health Providers Including Blue Cross Now Cover Ketamine Treatments

Four major health insurance providers recently approved psychedelic medicine company Novamind Inc. NM NVMDF for direct billing of intravenous (IV) ketamine for treatment-resistant depression (TRD). The providers are Blue Cross Blue Shield, the University of Utah, PEHP Health & Benefits and MBA Benefit Administrators.

"This initial success with insurance coverage of ketamine is promising for the future of psychiatry because it sends a strong signal that payors are interested in more effective treatments for mental health conditions as supporting research emerges," said Dr. Reid Robison, Novamind's chief medical officer. "For ketamine therapy to reach the masses, many more insurance companies will need to adjust their coverage policies. I look forward to further informing these decisions by soon publishing the results of real-world evidence studies and hosting upcoming clinical trials examining the use of psychedelic-assisted psychotherapy."

Nothing New Here

Ketamine was approved by the FDA as an anesthetic in 1970. Over the years, it has also found use in psychiatry to treat conditions like treatment-resistant depression (TRD).

Novamind is one of the companies providing ketamine-assisted psychotherapy, administering ketamine in conjunction with psychotherapy. Preliminary evidence suggests that, when ketamine intervention is enhanced with therapeutic support, it may produce enduring benefits across a range of mental health disorders.

However, while most insurance companies cover some psychotherapy portions of this treatment, coverage for the ketamine itself is less common – when used "off label" for psychiatric disorders. In many cases, prior authorizations from insurance companies are required in advance of administering certain treatments, including IV ketamine for depression.

To support the rapid growth of its clinic network, Novamind opened a dedicated call center specialized in insurance benefits verification and prior authorizations. As Dr. Robison noted, this results in faster approval times and quicker reimbursements for patients.

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Photo: Marcelo Leal on Unsplash