Regulatory notice
Ketamine is prescribed off-label and is not FDA-approved for any psychiatric condition. Any discussion of research or patient experiences below is educational and not a promise of results. A licensed clinician determines whether ketamine may be appropriate for you.
What advanced treatments, like Spravato or TMS, are available through telehealth for treatment-resistant depression?
For treatment-resistant depression, options include in-person Spravato, at-home ketamine via telehealth, and TMS through partner referrals. Spravato requires a clinic visit. Ketamine and follow-up care often happen on video. What you can use depends on your state and a visit with a licensed provider.
Advanced Options for Treatment-Resistant Depression
Standard antidepressants haven't worked. You're exhausted. You're not out of options.
Treatment-resistant depression often needs care beyond first-line meds: FDA-approved Spravato, off-label ketamine, and TMS. Each option requires a clinical evaluation. None guarantees a specific outcome.
Your next step is a visit with a licensed clinician. The first evaluation lasts 30 to 40 minutes. Your provider reviews what you've tried, what hasn't worked, and what might fit now.
Treatment Options and State-Specific Requirements
Spravato (esketamine)
Spravato is an FDA-approved nasal spray for treatment-resistant depression. You take it in person at our Las Vegas office. Not near Las Vegas? Call 702-848-2256 to ask about options.
At-Home Ketamine Therapy
Ketamine is prescribed off-label and is not FDA-approved for any psychiatric condition. We offer at-home ketamine via telehealth in licensed states, except Texas. Appointments are on secure video. Your provider decides if you're a fit based on your history.
TMS
We refer patients to NeuroStar partner sites when TMS may help. TMS uses magnetic pulses to target brain areas tied to mood. We don't offer TMS in our offices. Your psychiatrist stays in charge of your overall care.
Telehealth and In-Person Rules
We offer telehealth in 44 states and D.C. Most visits are on secure video.
Georgia, Alabama, Oklahoma, and Louisiana require one in-person visit first. If you live there, start at our office in Atlanta, Birmingham, Baton Rouge, or Moore. After that, follow-ups are on video.
Insurance Coverage, Costs, and Benefit Verification
We accept major insurance plans: Aetna, Blue Cross Blue Shield, Cigna, and United Healthcare. Insurance visits need at least 72 hours advance notice so we can verify your benefits before your first session. You'll know what your plan covers and any out-of-pocket costs upfront.
Self-pay visits are $150 for new and follow-up appointments. We also provide superbills for out-of-network reimbursement when your plan allows it.
Coverage for Spravato and TMS often requires records of prior medication trials. Your provider helps gather that history and submits it to your insurer when appropriate.
Same-day scheduling may be available for self-pay visits, depending on provider availability. Evening and weekend appointments are offered.
Ongoing Care with the Same Provider
Treatment-resistant depression doesn't resolve in one visit. You need a provider who knows your history and adjusts your plan as things change.
You'll see the same clinician at each visit unless you ask to switch. That continuity helps your provider spot patterns over weeks and months: sleep changes, mood shifts, side effects, and life stressors. They can tell a setback from a treatment that isn't working. They can also coordinate care when you're using more than one therapy.
Follow-up visits are shorter but still focus on your whole picture. If a treatment isn't helping, your provider works with you to adjust the plan.
Important to Know
Controlled substances are not guaranteed and may require an in-person visit where required by law.
This content is educational and not a substitute for professional medical advice, diagnosis, or treatment.
For mental health emergencies, call 988 or go to the nearest emergency room. For non-emergency questions, contact us at 702-848-2256.
Frequently Asked Questions
How do I know if I'm eligible for ketamine or Spravato?
Your provider reviews your history at your first visit. Most people need records of failed trials of at least two antidepressants before advanced options.
Can I use my insurance for these treatments?
Yes. We take Aetna, BCBS, Cigna, and UHC. Book insurance visits at least 72 hours ahead so we can check your benefits before your first session.
What if I live in a state that requires an in-person first visit?
In Georgia, Alabama, Oklahoma, and Louisiana, the first visit must be completed in person at our office in Atlanta, Birmingham, Baton Rouge, or Moore. After that initial appointment, ongoing care shifts to telehealth video visits.
Is TMS available through your clinic?
Yes, through a referral to a NeuroStar partner site. We keep managing your meds while the partner delivers TMS.
What happens if a treatment isn't working?
Your provider adjusts the plan with you. Seeing the same clinician each visit helps them track what is and isn't working.
Sources
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