Ketamine therapy cost: infusions, insurance and the covered alternative

Published prices

What one ketamine treatment costs

Clinics set their own prices, so the best evidence is a study that collected them. In March 2023, researchers read the websites of the online ketamine advertisers with at least one clinic in Maryland: 17 advertisers at 26 locations.

Source: Crane, DiStefano and Moore, JAMA Network Open, 2023, Table 1. Ranges cover only the advertisers that published a price (“7 of 13” means 7 of the 13 advertisers offering it listed one). The study notes that some offered a first-visit discount and some priced a mood disorder differently from chronic pain.

Two other reference points. The MGH Ketamine Clinic for Depression charged $550 per infusion, according to its website as reported by Psychiatric News in October 2024, and the infusion is not typically covered by insurance. In 2018, STAT found clinics charging anywhere from $350 to close to $1,000 per infusion.

The full course

What a full first series of ketamine costs

Nobody pays for one infusion. Price the first series, then the maintenance.

There is no FDA-labeled ketamine schedule for depression. In the ELEKT-D trial in the New England Journal of Medicine, ketamine was given twice a week for three weeks, which is six infusions. STAT reported in 2018 that most clinics offer a series of six infusions over two to three weeks. The table multiplies six infusions by published prices.

Arithmetic from the published prices above. A consultation ($0 to $390 in the Maryland study) and any therapy sessions are extra.

After the first series

Maintenance infusions keep adding to the cost

Each maintenance infusion costs another infusion fee, and nobody can say in advance how many you will need.

• The director of the MGH clinic says ongoing maintenance infusions are needed, and that “stopping is almost invariably associated with relapse.” She has careful conversations about financial planning and scheduling at the outset.
• A 2017 consensus statement from the American Psychiatric Association's Council of Research task force on novel biomarkers and treatments points to the “lack of longer-term data on efficacy, and limited data on safety” for ketamine in mood disorders.
• STAT found many clinics offering “boosters” as symptoms return, and noted that, according to the APA's review, the evidence on longer-term treatment such as monthly booster infusions is limited.

Before you start, ask the clinic how often its patients come back, what one maintenance infusion costs, and what happens if you stop.

Insurance

Why insurance rarely covers ketamine for depression

Ketamine is FDA-approved as an anesthetic, not for depression, and Aetna's written policy treats it as unproven for depression.

“Ketamine is not FDA approved for the treatment of any psychiatric disorder.”

FDA compounding risk alert, October 10, 2023

• Aetna. Its commercial policy (CPB 0938) lists ketamine “(intramuscular, intranasal, intravenous, oral, or subcutaneous)” as experimental, investigational, or unproven for depression, suicidal ideation, PTSD and generalized anxiety, among other uses. It says the same of ketamine-assisted therapy for depression.
• How clinics are paid. In a 2024 survey of ketamine providers (71 usable responses), the primary payment method was out of pocket in 69.23 percent of responses, against 17.31 percent for private health insurance.
• Facilities nationally. A 2024 study of the 134 US mental health facilities that reported offering ketamine infusions in a 2020 federal survey says private insurance and Medicare do not typically cover ketamine infusion therapy, and names its off-label use for depression as a prominent reason.

Your plan may differ from Aetna's. Ask your insurer in writing whether it covers IV ketamine for depression, and ask the clinic for an itemized receipt for every visit.

Cheaper on paper

At-home and compounded ketamine

Lower prices exist outside a clinic, without the monitoring a clinic gives.

In the Maryland study, one advertiser listed oral ketamine lozenges at $89 as a weekly fee. The FDA warned in October 2023 that compounded ketamine is not FDA-approved for any use, is not part of a safety program, and that “the lack of monitoring for adverse events, such as sedation and dissociation, by an onsite health care provider may put patients at risk.” The same study found that 7 of the 17 advertisers disclosed no possible adverse effects, and 3 falsely called ketamine nonaddictive.

Our ketamine and depression page explains the safety questions in more detail.

The covered option

SPRAVATO: the esketamine treatment insurance can pay for

SPRAVATO is esketamine, one form of the ketamine molecule, as a nasal spray. Unlike ketamine, it has an FDA label for depression.

“SPRAVATO is indicated for the treatment of: Treatment-resistant depression (TRD) in adults as monotherapy or in conjunction with an oral antidepressant; Depressive symptoms in adults with major depressive disorder (MDD) with acute suicidal ideation or behavior in conjunction with an oral antidepressant.”

Because it is approved, insurers write coverage rules for it. Aetna's SPRAVATO policy for commercial medical plans (CPB 0950) considers it medically necessary for treatment-resistant depression only when all of these are met:

• It is prescribed by, or in consultation with, a psychiatrist.
• A confirmed diagnosis of severe major depressive disorder (single or recurrent episode), documented by standardized rating scales, in a member 18 or older.
• Both of these, for treatment-resistant depression: an inadequate response during the current depressive episode to two antidepressants from at least two different classes with different mechanisms of action, each at the maximally tolerated labeled dose and each used for at least 8 weeks within the past 5 years; and an inadequate response to an adequate trial of augmentation therapy for at least 8 weeks within the past 5 years, or to evidence-based psychotherapy (cognitive behavioral therapy, interpersonal therapy, supportive therapy or a psychoeducational intervention) during the current depressive episode. Augmentation, in the policy's words, means two antidepressants with different mechanisms of action used together, or an antidepressant used together with a second-generation antipsychotic, lithium or thyroid hormone.
• It is given under the direct supervision of a healthcare provider, and the member is monitored by a health care provider for at least 2 hours after each dose.

Major depression with acute suicidal thoughts or behavior has its own, separate criteria in the same policy. After the first approval, Aetna considers 6 months of continued treatment for treatment-resistant depression medically necessary when rating scales document improvement from baseline.

Sources: the SPRAVATO prescribing information, Aetna CPB 0938 and CPB 0950, and the FDA alert, all read November 4, 2026.

What a SPRAVATO visit costs depends on the plan. Our SPRAVATO cost and insurance guide gives the 2026 Medicare amounts for each visit and the copay program rules. Read our SPRAVATO treatment page for side effects and the visit itself.

Value

Is ketamine worth the cost?

Trial results and real-world results differ, and the difference matters when you are paying yourself.

• In ELEKT-D, 403 patients with treatment-resistant depression were randomized; 55.4 percent of those given ketamine responded, against 41.2 percent given ECT.
• At the MGH clinic, which treats people who have already tried many treatments, the director reported that fewer than 20 percent respond, and about one-third have at least a partial response. “In clinical trials, they report a 60% to 70% response rate,” she said. “We don't see that.”

To compare ketamine with TMS and SPRAVATO on more than price, read our TMS, SPRAVATO and ketamine comparison.