Ketamine Infusion Therapy and Treatment Cost
If you are considering getting a ketamine infusion, then you will want to know how much this treatment will cost you. In this post, we outline the average price of a ketamine infusion, explain why it costs what it does, and then underscore some key factors that can influence changes in price. Understanding this information is essential before deciding if ketamine is the right choice for you.
Contents of this article
- The Cost Of A Ketamine Infusion
- The Cost-to-Treatment Ratio
- These are the Basic Infusion Plans Most Clinics Offer
- Why A Ketamine Infusion Costs What It Does
- Factors That Influence The Cost Of Ketamine Infusion
- Ketamine Therapy And Insurance
The Cost Of A Ketamine Infusion
Bear in mind that there can be an initial fee for your consultation and assessment (which will cost around $350). This initial consultation is critical, as the psychiatrist carrying it out will inform you whether any medications you take — or health conditions you have — may interfere with the ketamine treatment. If you have a problem with addiction, this also needs to be discussed during the consultation. Be aware that it may make you unsuitable for treatment.
If you signed up for just a single ketamine infusion, the overall cost will then be anywhere from $300-$1,000. Of course, if you opt for ketamine treatment, you should know that treatment plans typically involve a round of infusions, not just one.
We will get into the whether single infusions are effective later in this article. (In short, multiple infusions can help to enhance the efficacy of the treatment.)
What about Free Consultations?
Some clinics will offer free consultations or phone screenings. These can be very helpful and cost-effective under the right circumstances. However, one important thing to note is the initial consultation is crucial — and a psychiatrist should be performing this consult. But a majority of clinics do not have any psychiatric involvement, or even a therapist on staff. A consultation that is very short/brief and involves just a simple rating scale/questionnaire, and no psychiatrist, is not a high-quality standard of care. And you run the risk of being approved for ketamine when you really aren’t a suitable candidate.
Non-psychiatrists are not qualified to rule out mania or psychosis — both medically valid reasons to not infuse ketamine.
The point of a consultation is to clear you of all hurdles before providing treatment. Ask if they have a psychiatrist performing the consult.
For addiction, ketamine is very helpful in treating certain substance use disorders…but not all of them. If the clinic does not have either a psychiatrist or addiction medicine specialist, then ketamine should not be used to treat addiction. One last point about initial consultations… better clinics will spend more time on it, and a part of that time is spent educating and preparing the patient for the treatment. That is extremely important in lowering chances of a bad experience. So the shorter the consult, the less prepared you will be, in many clinics.
The Cost-to-Treatment Ratio
The total cost of ketamine treatment, then, will depend on how many infusions you get. These details will be sorted out during your consultation. A trained psychiatrist at the ketamine clinic can figure out how many infusions will be ideal. Note, however, that many clinics often offer patients six rounds of infusions (two per week). This treatment plan is based on clinical studies that investigate the effects of six infusions, finding this to be effective in alleviating depression.
These are the Basic Infusion Plans Most Clinics Offer
Almost every clinic offers multiple infusions as part of the induction series. And that number is almost always six infusions over 2-3 weeks, with most common approach being the NIMH study protocol of 3 infusions per week for two weeks.
In reality, studies show that the treatment doesn’t work better or worse if you deviate in the schedule a bit, or even four infusions vs. six infusions. The key thing to remember, though — the first three or four infusions out of a series of six infusions should be closer to 2-3 days apart than a week or more.
The last 2-3 infusions can be spread out up to a week apart if you have already gained the benefit by that point. If you are still improving with some good days and some bad days, then it is best to just stick to the regular schedule in order to get the most cumulative benefits from it.
One Infusion vs Multiple Infusions
While you can get some limited benefit from one infusion, it will be very short lived (under a week for most patients). Also, the majority of patients notice the bulk of improvement in depression/anxiety symptoms somewhere between 2nd and 4th infusion out of six. If you only try one treatment, you may never know if it would have worked or not. That’s why the accepted standard is that someone should try a minimum of four treatments to really know. While the clinicians on our medical advisory board have seen patients start responding after the 5th and 6th/final infusion as well.
It’s important to remember that the actual cost of ketamine treatment will be more than that of a single infusion.
You can expect to pay $2750-$5,150 for ketamine treatment involving six infusions and an initial assessment.
Why A Ketamine Infusion Costs What It Does
You may think that a ketamine infusion is expensive, especially when you work out the cost of multiple infusions. However, ketamine treatment is on par with other procedures that require an intravenous (IV) drip.
The ketamine itself costs around $10. So the bulk of the price really comes down to the other factors involved in treatment, not the drug itself. The price factors in the qualified staff working at the ketamine clinic, the equipment, and the kind of facility needed to administer the drug. All of these aspects are expensive and so they translate into the $400-$800 that a single infusion costs.
Factors That Influence The Cost Of Ketamine Infusion
As we can see, the cost of a ketamine infusion can differ significantly. If you pay $400 per infusion, your overall treatment will be much more affordable than committing to $800 per infusion.
A few other important factors: Whether they accept insurance or not factors, professional services and time spent by the provider, the supply/demand for ketamine clinics in that area, whether or not they offer other augmenting services like psychotherapy, TMS, or psychiatric care.
Let’s examine some of the factors that influence these differences in price. Likewise, we’ll show you how to potentially reduce the cost through a health insurance plan.
The Reputation Of The Clinic
If a particular ketamine clinic has a strong reputation for delivering a high level of care, consideration, and efficacy, then they may understandably charge a higher fee for this service. Differences in cost do not always reflect differences in quality, but sometimes they do. Be sure to take this into account when deciding whether to pay more to receive a ketamine infusion at a particular clinic.
The Cost Of Running The Clinic
Not all ketamine clinics cost the same to run. Factors that can influence the cost of maintaining a ketamine clinic include the following:
- Size and quality of the facility
- Quantity and quality of equipment
- Number of staff members (e.g. psychiatrists, psychotherapists, anesthesiologists, nurses, admin)
If a provider includes the above factors, then this will reasonably be reflected in the cost of treatment.
A ketamine provider has a relatively low cost based on the above factors. However, this does not necessarily mean they are sacrificing quality or safety. For example, they might simply have a smaller facility and fewer employees working there. Smaller ketamine clinics can still offer a high degree of care, attention, and safety.
Some insurance plans now cover IV Ketamine for treatment resistant depression. Blue Cross Blue Shield of Massachusetts, Blue Cross Blue Shield of Vermont, and some regional insurance plans in Utah. Some workers compensation plans will cover it as well. The tide is changing, and we will see more plans cover it as time goes on. The FDA approved Spravato (Esketamine) nasal spray for Treatment Resistant Depression and Suicidal ideations, which has set a new precedence.
However, most Health insurance companies don’t cover ketamine treatments for the following reasons.
- Ketamine is not an FDA-approved treatment for mental health conditions. The drug is only approved by the FDA as an anesthetic and analgesic in operating rooms and emergency departments. The FDA has not (yet) approved outpatient ketamine for depression, PTSD, anxiety, OCD, and bipolar disorder. The FDA approval process is very costly and there is little incentive for pharmaceutical companies to fund the research needed for approval since ketamine is an old, generic medication.
- Ketamine is considered an experimental drug. Since 2006, the number and size of studies on ketamine for depression has been increasing, and dramatically in the past 4 years. Although the evidence so far reveals that ketamine is highly effective in the treatment of depression, there is still not enough research in the eyes of the insurance companies.
While an insurance company probably won’t cover the entire cost of ketamine infusion, part of the treatment may get coverage. Each insurance company will cover different amounts, and different patients will often see varying results — even from the same insurer.
In Some Cases, Insurance Companies Will Offer Reimbursement
The best chance of getting reimbursement is going to a clinic where a psychotherapist is providing ketamine-assisted psychotherapy, or a psychiatrist is providing professional services by treating depression (within the scope of their specialty). Even them, reimbursement usually requires pre-authorization attempt, medical peer to peer discussions, appeal of a denial, and that the patient has failed a lot of previous treatments. It’s a lot of work. Which is why most ketamine clinics do not even accept insurance at all and/or don’t have the resources to assist the patient.
Nonetheless, some patients are able to get certain aspects of ketamine treatment covered, such as the consultation fee. There are some patients who are reimbursed by their insurance for the total cost of their treatments. But this is rare.
While you may be able to collect some money from your insurance company, it can take a lot of work.
The cost of ketamine infusion can be pricey, but there are some options. Most ketamine treatment providers accept credit cards and may offer financing options. Another option is to enroll in a clinical trial. This carries its own risk, but the benefits may outweigh those risks. This is especially true if other treatments aren’t offering the relief you need.
It is possible to receive a single ketamine infusion. But as we have said earlier, single doses have not been proven nearly as effective. You may notice some relief from a single infusion, which may lead you to accepting the cost of further infusions. But for many patients, a single ketamine infusion is enough to reduce depressive symptoms only briefly. To get sustained relief you will need the full six infusions and then ongoing maintenance treatments — anywhere from two weeks to six months at a time. It varies for everyone and for how much else is being done to complement the ketamine portion of the treatment plan.
Ketamine Therapy And Insurance
Given how much ketamine therapy costs, you may be wondering if it’s covered by insurance. As we have seen already, most ketamine infusions won’t be covered by insurance providers — but there are some caveats to be aware of. Also, the same situation doesn’t apply to Spravato.
Why Insurance Providers Don’t Cover The Cost Of Ketamine Infusions
The idea of using ketamine to treat mental illness is still relatively new. Numerous studies have, indeed, suggested that ketamine is safe and effective in the treatment of depression, for instance. However, most of the studies are small-scale. Long-term studies are also lacking.
This is one reason why insurance providers don’t cover the ketamine treatment cost — due to the lack of research.
Many people aren’t aware of ketamine therapy and how it can treat conditions like depression, anxiety, PTSD, OCD, and bipolar disorder. Nor are there any ongoing campaigns to promote the treatment, since many consider it to be an old drug. In turn, many insurance companies don’t know about its applications. They won’t cover the cost of ketamine therapy because they don’t know how it will affect the client.
In addition, not all physicians are on board with ketamine-assisted therapy; some may have legitimate concerns, whereas others may just not know enough about it. Insurance companies tend to adhere to guidelines adhered to by doctors, thus making them reluctant again to cover the cost of ketamine infusions.
Insurance providers don’t cover ketamine therapy because it is still experimental and not yet FDA-approved. When the FDA approves a drug, this means the Center for Drug Evaluation and Research (CDER) has declared it safe for consumers.
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