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Treatment Center Resources | SPRAVATO® (esketamine) HCP

Treatment Center Resources

Download these resources to learn more and educate your patients about how and when to use SPRAVATO®.
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Treatment Center Operations

Treatment Center Educational Communications Toolkit

Patient Referral for SPRAVATO® Treatment Form

Patient Treatment Progress Letter

Treatment Center Patient Treatment Progress Fax Form

REMS Considerations for Treatment Centers

Acquiring SPRAVATO®

Patient Referral Form for SPRAVATO® Treatment

Pathway to Acquire SPRAVATO® Through an Authorized Specialty Distributor

Pathway to Acquire SPRAVATO® Through a National Specialty Pharmacy

Complete List of Authorized SPRAVATO® Full-line Wholesalers and Specialty Distributors

Assignment of Benefits Form


Access, Coding, & Reimbursement Guide

Letter of Medical Necessity Template

Letter of Exception Template

Helpful Resources

Coding & Reimbursement

Drug & Procurement Coding Overview for SPRAVATO®

Evaluation & Management (E/M) Code Flashcard

Exceptions & Appeals Guide