Does AHCCCS cover Spravato in Arizona?
Spravato can be covered by AHCCCS health plans for eligible adults with prior authorization. Here’s what plans typically require, and what to know about ketamine.
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The short answer
Spravato (esketamine) is FDA-approved for treatment-resistant depression and for major depressive disorder with acute suicidal thoughts, so AHCCCS health plans can cover it for eligible adults. Prior authorization is required, and criteria vary by AHCCCS plan.
IV ketamine infusions for depression are an off-label use and are generally not covered by AHCCCS. Initial Spravato approvals are often time-limited and need reauthorization based on your progress.
What AHCCCS plans typically look for
Example criteria from an AHCCCS health plan’s esketamine policy (Arizona Complete Health). Your plan may differ.
- Age 18 or older with treatment-resistant major depressive disorder
- An inadequate response to two antidepressants from different classes, including plan-preferred options, at maximally tolerated doses during the current episode
- A trial of augmentation therapy (for example, an antipsychotic, lithium, or buspirone added to an antidepressant)
- Prescribed by, or in consultation with, a psychiatric provider, and used with an oral antidepressant
- Given at a REMS-certified clinic with at least two hours of monitoring, and no active substance use disorder
Different criteria apply to depression with acute suicidal thoughts. If you are in crisis, call or text 988.
How to get started
Know your plan
Find your AHCCCS health plan name on your member card. Each plan has its own prior authorization process.
Find a clinic that takes it
Look for a certified Spravato clinic that accepts your AHCCCS plan.
Gather your history
List the antidepressants and add-on medications you’ve tried, with doses and dates.
Clinic requests approval
The clinic submits prior authorization to your plan. Treatment starts after approval.
The manufacturer’s Spravato withMe savings program can’t be used with Medicaid/AHCCCS.
Other insurers
Have a different plan? See Spravato coverage by insurer, or find a Spravato clinic near you.
Sources: Arizona Complete Health (AHCCCS) clinical policy AZ.CP.PMN.199, Esketamine (Spravato); AHCCCS Fee-For-Service prior authorization (azahcccs.gov); FDA Spravato prescribing information (2025).
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AHCCCS & Spravato questions
Does AHCCCS cover Spravato?
AHCCCS health plans can cover Spravato for eligible adults with prior authorization. Criteria vary by plan and usually require documented trials of several antidepressants and augmentation.
Does AHCCCS cover ketamine therapy?
IV ketamine for depression is an off-label use and is generally not covered by AHCCCS. Spravato, the FDA-approved esketamine nasal spray, has a coverage pathway with prior authorization.
Can Same Team help AHCCCS members?
Yes. Our navigation call is free and open to everyone, including AHCCCS members. Please note that Same Team’s separate coaching services are not covered by AHCCCS/Medicaid.
What if my AHCCCS plan denies Spravato?
Your clinic can usually appeal with additional records. A Same Team navigator can help you understand your options.
Not sure where to start?
Schedule a navigation call and a Same Team navigator will help you understand your options and find care that fits.
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