Wiki Spravato Billing 2023

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elevatemedical

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Hi everyone! Does anybody here know the updated CPT codes for Spravato (esketamine) E&M services for 2023? Last year, we were billing commercial insurances with 99215 90838 99417 for Spravato session, and we got paid but starting February 2023, commercial insurances no longer accept 99215 with any psychotherapy codes like 90838. We would like to know how you guys are billing for Spravato now? Thank you so much. All feedback is appreciated.
 
Hi there,
I recommend checking private payer plans to see if they're using Medicare's codes and billing rules:

G2082Office or other outpatient visit for the evaluation and management of an established patient that requires the supervision of a physician or other qualified health care professional and provision of up to 56 mg of esketamine nasal self-administration, includes 2 hours post-administration observation
G2083Office or other outpatient visit for the evaluation and management of an established patient that requires the supervision of a physician or other qualified health care professional and provision of greater than 56 mg esketamine nasal self-administration, includes 2 hours post-administration observation
 
Does anyone know if an LPN or RN can monitor the self administration of Spravato and the 2 hour post monitoring period? Does it have to be a physician/NP/PA etc. or can it be a nurse?
 
jkyles said:
Hi there,
I recommend checking private payer plans to see if they're using Medicare's codes and billing rules:

G2082Office or other outpatient visit for the evaluation and management of an established patient that requires the supervision of a physician or other qualified health care professional and provision of up to 56 mg of esketamine nasal self-administration, includes 2 hours post-administration observation
G2083Office or other outpatient visit for the evaluation and management of an established patient that requires the supervision of a physician or other qualified health care professional and provision of greater than 56 mg esketamine nasal self-administration, includes 2 hours post-administration observation
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Thank you for this!
 
Also be aware that the codes above are for when the office is supplying the medication and it is not being gotten through the patient's pharmacy benefits.
 
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