Written by Deborah Tan
Medically reviewed by Dr. Ladan Eshkevari, CRNA, PhD, FAAN
Yes, the VA covers ketamine treatment for eligible veterans, and you do not have to receive it inside a VA hospital. As of July 2026, the VA’s published clinical criteria cover IV ketamine for treatment-resistant depression and for depression with severe suicidal ideation, at select VA facilities and through the Veterans Community Care Program (VCCP).[1] This guide walks through what the VA covers, who qualifies, and how to start the process. If you are in Hampton Roads, our ketamine program for Norfolk-area veterans can help you understand your options.
How to Get the VA to Cover Ketamine Therapy
Veterans seeking relief from treatment-resistant depression can find real hope in ketamine therapy, and the VA does cover it for specific, defined indications. Access can feel daunting, but two pathways exist: treatment directly at select VA hospitals, and treatment at an authorized community provider through the Community Care Program when the VA cannot deliver it in-house.[1]
This guide outlines the latest ketamine research for veterans and how to get the VA to cover ketamine therapy at little to no out-of-pocket cost today.
The Latest Research on Ketamine Therapy for Veterans
Recent research, including a study from the University of Michigan[2] and the VA Ann Arbor Healthcare System, points to ketamine’s usefulness for veterans with severe depression, even in cases where other treatments have failed.
Key findings from this study include:
- Meaningful improvement: nearly half (49%) of the 215 veterans studied experienced a significant reduction in depression scores after six weeks of IV ketamine infusions.[2]
- Strong response rate: about 25% of participants saw their depression scores drop by half, indicating a strong response to the treatment.[2]
- Full remission: about 15% of veterans achieved full remission of their depression symptoms after six weeks.[2]
- Ongoing benefits: most patients continued with infusions every few weeks, suggesting sustained benefits and continued improvement over time.[2]
Additionally, a comprehensive meta-analysis[3] published in Frontiers in Psychiatry reported improvements in pain, depression, and PTSD symptoms among veterans receiving ketamine therapy. It examined 11 studies covering 22 independent samples of active-duty service members and veterans.
Key points from this meta-analysis include:
- Significant reductions: ketamine treatment was associated with reductions in symptoms of depression, PTSD, and chronic pain, with moderate-to-large effect sizes.[3]
- Diverse administration: benefits were observed across various routes of administration (IV, nasal, oral) and treatment protocols.[3]
- Broad impact: both active-duty and veteran populations experienced improvements, highlighting ketamine’s broad applicability.[3]
These findings have contributed to a growing acceptance of ketamine therapy within the VA, the medical community, and among policymakers. They do not, however, change what the VA formally covers, which is where the next section comes in.
The VA’s Stance on Ketamine Therapy
The VA has gradually acknowledged the therapeutic potential of ketamine for veterans and taken steps to increase access over the last several years.
In 2019, the VA began a limited rollout[4] of a ketamine-derived medication, Spravato (esketamine), for treatment-resistant depression. The VA’s Medical Advisory Panel restricted its use to pre-approved, case-by-case treatment, meaning doctors needed prior approval before prescribing it. Only veterans who had not responded to other treatments for major depression were eligible.
In February 2022, the VA issued updated Spravato guidelines[5], allowing flexibility in protocol modifications to optimize treatment. VA doctors must still submit a drug request and receive prior approval before the VA will dispense it.
In 2022, the VA also released national protocols for intravenous ketamine infusions[6], which it has since revised, most recently in October 2025. The guidelines included patient selection criteria, procedures for screening and referral, and protocols for monitoring patients during and after treatment.
Despite these efforts, widespread VA ketamine access remains a challenge. Not all VA facilities offer ketamine therapy, and eligibility criteria apply. The Community Care Program (VCCP) offers an alternative pathway for veterans to receive treatment when it is not readily available within the VA system.
What the VA Covers, and What It Does Not
The VA’s clinical determination for IV ketamine (CDI 00030) lists two covered indications: treatment-resistant depression and depression with severe suicidal ideation.[1] Treatment-resistant depression means major depression that has not responded to adequate medication trials. For any condition outside those two indications, the VA currently considers IV ketamine not medically necessary.
Spravato (esketamine), the nasal spray derived from ketamine, carries FDA approval for treatment-resistant depression (2019) and for depressive symptoms in adults with major depressive disorder with acute suicidal ideation or behavior (2020).[7][8] We offer both IV ketamine and Spravato in our clinics.
What about PTSD?
The honest answer, which some clinics blur: the VA does not cover IV ketamine for PTSD as a standalone indication, and Spravato is not FDA-approved for PTSD.[1] PTSD rarely travels alone, though. Many veterans carrying a PTSD diagnosis also meet the criteria for treatment-resistant depression, and that diagnosis is the route to VA-covered care. If you have both, you may qualify. Our free consultation screens for exactly this before you ever ask your VA for a referral.
How Veterans Can Get the VA to Cover Ketamine Therapy Today
Veterans interested in ketamine therapy should speak with their VA provider. To qualify for IV ketamine under the VA’s clinical criteria, a veteran typically needs a diagnosis of major depressive disorder and either no full response after four adequate antidepressant trials from different classes, or severe suicidal depression where a rapid response matters. The criteria also look for a PHQ-9 score of 15 or higher within the past 30 days and consideration of ECT where appropriate.[1]
The VA requires a thorough clinical evaluation to confirm the veteran meets the criteria. Once approved, veterans can receive treatment at VA hospitals or at authorized community providers.
Steps to get the VA to cover ketamine therapy include:
01. Consult the VA provider
- Discuss your mental health condition with your VA provider.
- Ask whether ketamine therapy is a fit for your specific mental health needs.
02. Determine local VA offerings
- Ask whether your local VA hospital provides ketamine therapy.
- Follow the hospital’s protocols if the service is available.
03. Explore community care options
- If your local VA does not offer ketamine therapy, inquire about community care options.
- Request a referral from your VA provider to a participating community ketamine clinic in your area.
For the full referral process, eligibility criteria, and what the VA pays, see our guide to VA ketamine treatment through community care.
We treat eligible veterans through VA community care at our locations in Bethesda MD, Washington DC, Columbia MD, Tysons (Vienna) VA, and Norfolk VA (Hampton Roads). For authorized care, the VA pays us directly, so you will not receive a bill from us. Any copay follows the same VA copay rules and depends on your status, and many veterans qualify for no copay at all. Contact our team today to check eligibility.
FAQs
Does the VA cover ketamine treatment?
Yes, the VA covers ketamine treatment for eligible veterans with treatment-resistant depression or depression with severe suicidal ideation.[1] Veterans should contact their local VA Medical Center (VAMC) primary mental health provider, the community care office, or Avesta Ketamine and Wellness for further information and evaluation. Our community care referral guide explains the steps and criteria in detail.
Does ketamine work for veterans?
Studies show ketamine therapy can improve depression scores among veterans, though it is not a cure and response varies from person to person.[2] Read more about ketamine therapy for veterans with PTSD.
What are the risks?
IV ketamine for depression is relatively safe when used in a monitored clinical setting. Our team prepares patients for the dissociative experience and provides coaching to minimize discomfort. Physiological side effects include fluctuations in blood pressure and heart rate, which clinicians monitor in real time throughout the session. Veterans can request to pause or stop an IV ketamine session at any time if the mental or physical effects become uncomfortable.
How can I find a clinic that offers VA-covered ketamine for veterans?
Start by contacting your VA provider and asking for an authorized referral to an in-network ketamine clinic. You can also seek coverage through the VA’s community care network. For authorized community care, the VA pays the clinic directly, so you will not receive a bill from the clinic, and copays follow standard VA copay rules.
Schedule a free consultation with Avesta Ketamine and Wellness and we will help you understand whether VA-covered ketamine treatment is within reach.
References
- VHA Office of Integrated Veteran Care. “Clinical Determination and Indication: Intravenous Ketamine for Treatment Resistant Depression (CDI 00030).” U.S. Department of Veterans Affairs. Accessed July 21, 2026.
- Pfeiffer PN, Geller J, Ganoczy D, et al. “Clinical Outcomes of Intravenous Ketamine Treatment for Depression in the VA Health System.” Journal of Clinical Psychiatry, 2024;85(1):23m14984. Accessed July 21, 2026.
- Liu JJW, et al. “Ketamine in the effective management of chronic pain, depression, and posttraumatic stress disorder for Veterans: A meta-analysis and systematic review.” Frontiers in Psychiatry, 2024;15:1338581. PMC11228764. Accessed July 21, 2026.
- Kime P. “VA Imposes Strict Limits on Controversial Ketamine-Based Depression Treatment.” Military.com, June 24, 2019. Accessed July 21, 2026.
- U.S. Department of Veterans Affairs. “Esketamine (Spravato) Nasal Spray, VA Criteria for Use.” VA Formulary Advisor, updated 2022. Accessed July 21, 2026.
- U.S. Department of Veterans Affairs. “Ketamine Infusion for Treatment Resistant Depression: Criteria for Use.” VA Pharmacy Benefits Management Services, revised October 2025. Accessed July 21, 2026.
- U.S. Food & Drug Administration. “FDA approves new nasal spray medication for treatment-resistant depression; available only at a certified doctor’s office or clinic.” FDA, March 5, 2019. Accessed July 21, 2026.
- Johnson & Johnson (Janssen). “Janssen Announces U.S. FDA Approval of Spravato (esketamine) CIII Nasal Spray to Treat Depressive Symptoms in Adults with Major Depressive Disorder with Acute Suicidal Ideation or Behavior.” August 2020. Accessed July 21, 2026.
