- 21297 Foothill Blvd, Ste 203 Hayward, CA 94541 (by appointment only)
- (415) 636-9700
- hello@exxceedwellness.com
Key facts Updated August 2026 · Reviewed by Nefretiri Abat, PMHNP-BC Spravato prior authorization is decided on the chart, not on the conversation. The packet must show: labeled diagnosis, complete antidepressant trial history, a baseline
Read MoreKey facts Updated August 2026 · Reviewed by Nefretiri Abat, PMHNP-BC Spravato coverage is usually approved in phases that follow the label: induction, then continuation and maintenance. Re-authorization turns on documented response, most often measured
Read MoreKey facts Updated August 2026 · Reviewed by Nefretiri Abat, PMHNP-BC Most Spravato denials come down to documentation, not eligibility. The four usual causes: incomplete medication-trial history, diagnosis mismatch, plan policies that still require a
Read MoreKey facts Updated August 2026 · Reviewed by Nefretiri Abat, PMHNP-BC Spravato (esketamine) can only be given in a REMS-certified healthcare setting; it is never taken home. Every dose is followed by at least 2
Read MoreKey facts Updated August 2026 · Reviewed by Nefretiri Abat, PMHNP-BC TMS prior authorization is decided on the chart: diagnosis, measured symptom severity, and a complete antidepressant trial history. Each medication trial must be documented
Read MoreKey facts Updated August 2026 · Reviewed by Nefretiri Abat, PMHNP-BC A standard insurance-authorized TMS course is 36 sessions: 5 per week for about 6 weeks, then a 6-session taper. Insurers authorize the course as
Read MoreDepression can return after a successful course of TMS, and most insurance plans anticipate that. Coverage for a second acute course, usually called re-treatment, is common when you responded the first time, symptoms have returned,
Read MoreIf the clinic you want is not in network with your plan, you are not automatically out of options. Many PPO plans reimburse a share of out-of-network care after a separate deductible, and a superbill
Read MoreWith a complete submission, most California plans decide a standard prior authorization request for TMS or Spravato within a few days to about two weeks. California law also provides for expedited review when waiting would
Read MoreBefore you start TMS or Spravato, three things decide whether treatment is covered: whether the benefit exists on your plan, whether you meet the medical necessity criteria, and whether the authorization is submitted with complete
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