Spravato treatment: cost, how it works, and what to expect
Spravato is the brand name for esketamine, an FDA-approved nasal spray for depression that hasn't responded to at least two standard antidepressants, used alongside an oral antidepressant or, since 2025, on its own. It works differently than typical antidepressants and is administered only in a certified, monitored setting.
The FDA approved Spravato in 2019 specifically for treatment-resistant depression, and it remains available only through certified treatment centers due to its monitoring requirements. This guide covers realistic costs, what a session actually involves, and how long treatment typically runs.
Medically reviewed by David Boguslavsky, MD, Medical Director · November 4, 2026
How much does Spravato treatment cost?
With insurance, most patients pay a copay per session, not the list price. Our Medicare patients usually pay $40 a treatment, and commercial plans charge their usual specialist copay. Patients on NJ Medicaid or NJ FamilyCare typically pay $0, since Medicaid covers Spravato when prior authorization is approved, a process our team manages on your behalf.
The $700–$900-per-session figure you see quoted online is the self-pay price without insurance — a number that rarely applies to the patients we see, because we verify your coverage before your first session so you know your actual copay upfront rather than finding out after treatment has started. Johnson & Johnson, Spravato's manufacturer, also offers Spravato withMe, which provides copay assistance for commercially insured patients and a patient assistance pathway for those with limited coverage — our team can walk you through that application if relevant.
See our insurance page for the plans we accept, or call us directly to check your specific benefits.
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How does a Spravato treatment session work?
Self-administered nasal spray
You administer the spray yourself under direct provider supervision in the office — it is never sent home with you, per FDA requirements.
Two-hour monitoring window
FDA labeling requires at least two hours of monitored observation afterward, watching for sedation, dissociation, and blood pressure changes.
Arranged ride home
You cannot drive or operate machinery until the next day — plan for someone to pick you up or arrange a ride in advance.
A typical course starts with twice-weekly sessions for the first four weeks, then tapers to weekly and eventually every-other-week dosing depending on response, usually alongside an oral antidepressant.
How long until Spravato starts working?
Many patients notice initial shifts in mood within the first few sessions of the four-week induction phase, though response varies meaningfully from person to person. Spravato works through a different brain pathway than standard antidepressants like SSRIs, which is part of why it can help when those medications alone haven't, but it isn't an instant fix — the full induction course is what gives your care team enough information to judge whether it's helping.
See our depression treatment page for how Spravato fits alongside medication management and counseling as part of a broader treatment plan.
Is Spravato available near me in New Jersey?
Spravato treatment is provided in person at our Hoboken and Nutley offices, plus two additional PremierMD Spravato centers in Morristown and Bridgewater, since the FDA-required monitoring can't be done remotely — though the rest of your psychiatric care, including follow-up medication management visits, can continue through telepsychiatry. See our Spravato treatment page for the full picture of what to expect, or our parent practice's SpravatoNJ.com, a dedicated Spravato treatment center, for patients specifically seeking this treatment.
See our Hoboken office and Nutley office pages for location details and hours.
What does the research say about Spravato's effectiveness?
The pivotal trial — TRANSFORM-2 — found that about 69% of patients with treatment-resistant depression responded over a 28-day induction with esketamine plus a new oral antidepressant, compared with 52% on the antidepressant plus a placebo spray. In the follow-up SUSTAIN-1 trial, patients who kept taking esketamine after responding were far less likely to relapse than those switched to placebo, and the SUSTAIN-2 study followed patients for up to a year.
In 2020, the FDA also approved Spravato for a second distinct indication: major depressive disorder with acute suicidal ideation or behavior (MDSI). This approval was based on rapid antidepressant effects observed within 24 hours in patients experiencing suicidal crisis — even in those without a prior diagnosis of treatment-resistant depression. If you or a loved one are experiencing a depressive episode with suicidal thoughts and haven't had multiple prior antidepressant trials, Spravato may still be a covered, appropriate option under this indication — ask your provider whether it applies to your situation.
See our Spravato treatment page and our combining medication and therapy guide for how Spravato fits into an overall care plan.
Does Medicaid cover Spravato treatment?
NJ Medicaid and NJ FamilyCare do have a coverage pathway for Spravato (esketamine), though it typically requires prior authorization and clinical documentation of prior antidepressant trials that were not effective. The prior authorization process is something our team manages on your behalf — we know the documentation requirements and submit those requests routinely. If you have Medicaid coverage and are wondering whether Spravato is financially accessible for you, the answer is worth exploring together.
QuietMind Health accepts NJ Medicaid — NJ FamilyCare, standard NJ Medicaid, CHIP, and the managed care plans: Aetna Better Health, AmeriHealth Caritas, Fidelis Care (formerly WellCare), Horizon NJ Health, UnitedHealthcare Community Plan, and Wellpoint (formerly Amerigroup). Because most of our care is delivered by telepsychiatry, there is no transportation barrier and no need to take a full day off work for an appointment that is available from your phone. People with Medicaid coverage often have the hardest time finding a psychiatrist who accepts their plan and takes new patients — we built QuietMind Health to close that gap. See all insurance we accept.
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About Spravato Treatment
How much does Spravato cost with insurance?
Most major commercial insurance plans, Medicare, and Medicaid provide some coverage for Spravato when it's prescribed for FDA-approved uses, though your specific copay depends on your plan. We verify your coverage before your first session so you know your costs upfront.
How long does a Spravato treatment session take?
The nasal spray itself takes a few minutes to administer, but FDA labeling requires a monitored observation period of at least two hours afterward, so plan for roughly two to two and a half hours per visit.
How long until Spravato starts working?
Many patients notice initial changes within the first few sessions of the induction phase, though individual response varies and the full course typically spans several weeks before effects are evaluated.
Can I drive myself home after a Spravato session?
No. FDA labeling requires that patients arrange a ride home and not drive or operate machinery until the next day, since effects from the dissociative side of esketamine can persist after the monitoring window ends.
Is Spravato the same as ketamine clinics offer?
No. Spravato is the brand name for esketamine, the specific FDA-approved nasal spray for treatment-resistant depression, usually used alongside an oral antidepressant, which is a different regulatory pathway and protocol than off-label IV or lozenge ketamine offered at some wellness clinics.