SPRAVATO® Coding & Billing
Coding options vary based on acquisition method, health plan requirements, and healthcare services provided
Choose an acquisition method:
HCPCS=Healthcare Common Procedural Coding System; E/M=evaluation and management; REMS=Risk Evaluation and Mitigation Strategy.
*Prolonged codes cannot be used with the SPRAVATO® G codes (G2082 and G2083).
There is currently no unique, designated code to describe the observation and monitoring of SPRAVATO® administration as required by the REMS. Healthcare providers must consult with each patient’s insurance plan since coverage will vary. Please note that healthcare providers are responsible for selecting appropriate codes for any particular claim based on the patient’s condition, the items and services that are furnished, and any specific insurance plan requirements. It is advisable to contact your local insurance plan with regard to local payment policies.
The fact that a drug, device, procedure, or service is assigned an HCPCS code and a payment rate does not imply coverage by the Medicare and/or Medicaid program, but indicates only how the product, procedure, or service may be paid if covered by the program. Fiscal Intermediaries (FIs)/Medicare Administrative Contractors (MACs) and/or State Medicaid program administration determine whether a drug, device, procedure, or other service meets all program requirements for coverage.
This content is presented for informational purposes only and is not intended to provide reimbursement or legal advice, nor does it promise or guarantee coverage, levels of reimbursement, payment, or charge. Similarly, all CPT® and HCPCS codes are supplied for informational purposes only and represent no statement, promise, or guarantee by Janssen Pharmaceuticals, Inc., that these codes will be appropriate or that reimbursement will be made. It is not intended to increase or maximize reimbursement by any payer. Laws, regulations, and policies concerning reimbursement are complex and are updated frequently. While we have made an effort to be current as of the issue date of this document, the information may not be as current or comprehensive when you view it. We strongly recommend you consult the payer organization for its reimbursement policies.
CPT®=Current Procedural Terminology. CPT® is a registered trademark of the American Medical Association. All rights reserved.
HCPCS=Healthcare Common Procedural Coding System; E/M=evaluation and management; REMS=Risk Evaluation and Mitigation Strategy.
*Prolonged codes cannot be used with the SPRAVATO® G codes (G2082 and G2083).
There is currently no unique, designated code to describe the observation and monitoring of SPRAVATO® administration as required by the REMS. Healthcare providers must consult with each patient’s insurance plan since coverage will vary. Please note that healthcare providers are responsible for selecting appropriate codes for any particular claim based on the patient’s condition, the items and services that are furnished, and any specific insurance plan requirements. It is advisable to contact your local insurance plan with regard to local payment policies.
The fact that a drug, device, procedure, or service is assigned an HCPCS code and a payment rate does not imply coverage by the Medicare and/or Medicaid program, but indicates only how the product, procedure, or service may be paid if covered by the program. Fiscal Intermediaries (FIs)/Medicare Administrative Contractors (MACs) and/or State Medicaid program administration determine whether a drug, device, procedure, or other service meets all program requirements for coverage.
This content is presented for informational purposes only and is not intended to provide reimbursement or legal advice, nor does it promise or guarantee coverage, levels of reimbursement, payment, or charge. Similarly, all CPT® and HCPCS codes are supplied for informational purposes only and represent no statement, promise, or guarantee by Janssen Pharmaceuticals, Inc., that these codes will be appropriate or that reimbursement will be made. It is not intended to increase or maximize reimbursement by any payer. Laws, regulations, and policies concerning reimbursement are complex and are updated frequently. While we have made an effort to be current as of the issue date of this document, the information may not be as current or comprehensive when you view it. We strongly recommend you consult the payer organization for its reimbursement policies.
CPT®=Current Procedural Terminology. CPT® is a registered trademark of the American Medical Association. All rights reserved.
Have Questions About Billing and Reimbursement? We Can Help Get Answers
At Janssen, we get that there's a lot that goes into managing billing and reimbursement, so we've put together information you may need for SPRAVATO®.

Please see the SPRAVATO® Access & Reimbursement Guide for more information on coding and billing.