Written by Deborah Tan. Medically reviewed by Dr. Ladan Eshkevari, CRNA, PhD, FAAN.
Yes, insurance covers ketamine therapy in Maryland more often than most patients expect. Maryland Medicaid covers Spravato, Aetna and Cigna cover Spravato, Cigna covers IV ketamine, and workers compensation covers ketamine treatment for chronic pain. For the national picture across every payer, see our complete guide to whether insurance covers ketamine therapy.
Does insurance cover ketamine therapy in Maryland?
It depends on the treatment type. Spravato (esketamine) is FDA-approved for treatment-resistant depression and for depressive symptoms of major depressive disorder with acute suicidal ideation or behavior, so most Maryland plans cover it with prior authorization. IV ketamine is prescribed off-label, so most Maryland insurers do not cover the infusion itself, though Avesta is in-network with Cigna, the VA, and workers compensation for IV ketamine[1].
Which Maryland insurance plans cover ketamine at Avesta?
| Plan | IV ketamine | Spravato |
|---|---|---|
| Maryland Medicaid | Not covered (off-label) | In-network; $0 medication with approval |
| Aetna | Not covered (off-label) | In-network (new in 2026) |
| Cigna | In-network | In-network |
| Veterans Affairs (VA) | In-network | In-network |
| Workers compensation (Maryland) | In-network for chronic pain | In-network for depression |
| CareFirst | Out-of-network (contracting in process) | Out-of-network (contracting in process) |
| Medicare | Out-of-network | Out-of-network |
| United Healthcare, Kaiser | Out-of-network, we bill on your behalf | Out-of-network, we bill on your behalf |
CareFirst is Maryland’s largest insurer, and our contracting with CareFirst is in process. Until it closes, CareFirst members are out-of-network and can use superbills for reimbursement. Ask us for a benefits check and we will confirm your exact coverage before your first visit.
Does Maryland Medicaid cover ketamine or Spravato?
Maryland Medicaid covers Spravato for members who qualify and are approved, and Avesta is in-network: approved members pay $0 for the medication[2]. Maryland Medicaid does not cover IV ketamine, which remains off-label. If you have Maryland Medicaid and treatment-resistant depression, reach out with your member information and our team will check your eligibility and handle the approval paperwork.
What if my Maryland plan does not cover ketamine?
You still have options. Avesta provides a detailed superbill for every treatment, and many PPO plans reimburse part of out-of-network care after the deductible. You can file superbills through your plan’s member portal or through Reimbursify, which files the claim for you. Pre-tax HSA and FSA dollars are eligible, and Avesta partners with Advance Care Card for 6 or 14 months of interest-free financing.
What does ketamine therapy cost in Maryland?
Maryland ketamine therapy runs $300 to $1,300 per clinical session depending on treatment type and coverage; insurance can bring IV ketamine to $0 to $450 per session at Avesta. For full Maryland pricing by treatment type, see our guide to ketamine therapy cost in Maryland.
How to check your coverage at Avesta’s Maryland clinics
Avesta treats Maryland patients at Bethesda and Columbia. Before you book anything, our dedicated insurance specialist runs a free benefits check: coverage, copay, prior authorization, and whether your plan needs a referral. Bring your insurance card and we do the rest.
FAQs about ketamine insurance coverage in Maryland
Does insurance cover ketamine therapy in Maryland?
Often, yes. Maryland Medicaid, Aetna, Cigna, and the VA cover Spravato at Avesta, and Cigna, the VA, and workers compensation cover IV ketamine. CareFirst and Medicare are currently out-of-network.
Does Maryland Medicaid cover Spravato?
Yes. Avesta is in-network with Maryland Medicaid for Spravato; approved members pay $0 for the medication. IV ketamine is not covered because it is off-label.
Does CareFirst cover ketamine therapy in Maryland?
Not yet. Avesta’s CareFirst contracting is in process; until it closes, CareFirst members are out-of-network and can seek reimbursement with a superbill.
Is ketamine covered by workers comp in Maryland?
Yes. Avesta accepts Maryland workers compensation for ketamine treatment for chronic pain and Spravato treatment for depression. Have your adjuster’s information ready when you contact us.
The Bottom Line
Maryland patients have more coverage paths than the “insurance never covers ketamine” myth suggests: Medicaid, Aetna, and Cigna for Spravato, Cigna and workers comp for IV ketamine, and superbill reimbursement for the rest. Start with a free benefits check at our Bethesda or Columbia clinic, or read the national coverage guide for every payer we work with.
References
- U.S. Food and Drug Administration. Drugs@FDA: Spravato (esketamine) approval record. accessdata.fda.gov
- Maryland Department of Health. Maryland Medicaid Medical Assistance program. health.maryland.gov
- Aetna. Clinical Policy Bulletin 0938: Ketamine for the Treatment of Depression and Other Psychiatric Disorders. aetna.com
- Janssen Pharmaceuticals. SPRAVATO withMe savings and support program. spravato.com
