Esketamine nasal spray (Spravato)

Spravato (esketamine nasal spray) is covered for adults (≥18) only for the FDA‑approved indications—treatment‑resistant depression (as adjunct to an oral antidepressant) and major depressive disorder with acute suicidal ideation/behavior—and is excluded for non‑FDA indications or if coverage/safety criteria are unmet. Key requirements: prescribed by a psychiatrist, patient currently on an oral antidepressant, PDMP controlled‑substance check, for TRD documented nonresponse to ≥2 antidepressants from different classes each used ≥6 weeks, dosing per specified induction/maintenance schedules (induction twice weekly; TRD maintenance weekly then every 2 weeks or weekly thereafter), MDD with suicidality limited to up to 84 mg twice weekly for 4 weeks, and approval durations of 6 months (TRD) or 2 months (suicidality).

"Documentation of controlled substance prescription history check via the state PDMP, unless PDMP is unavailable in the state."