Even as Spravato continues to gain clinical momentum in 2026, many practices still struggle with a persistent and frustrating reality: underpayment. Clinics deliver high-value, REMS-compliant care, invest heavily in staffing and monitoring, and follow payer rules to the letter, yet the reimbursement often doesn’t match the effort.
Why does this keep happening?
Where are practices losing revenue?
And what can you do this quarter to fix it?
This is exactly where Finnastra steps in. As a leading Spravato Billing Services Company, Finnastra ensures every clinic we support is equipped with airtight workflows, advanced coding expertise, and front-end checks that drive a 98% clean claims pass rate across Spravato, TMS, and Ketamine services.
Underpayment rarely comes from just one issue. It’s a combination of hidden bottlenecks, overlooked compliance steps, and payer-specific quirks that most clinics don’t have the bandwidth to manage.
Based on 2024–2026 claims trends across national payers, Spravato underpayments consistently stem from:
Many clinics still rely on generic depression codes (F33.2, F32.2), but subtle coding nuances, like including comorbidities or using the correct induction vs. maintenance sequencing, can change reimbursement outcomes by 12–18%.
If monitoring isn’t captured clearly or accurately, payers reduce or deny payments.
No one talks about how stringent payers have become with REMS documentation review since late 2025.
Prior Authorization for Spravato renewals must align with payer timelines, clinical response, and treatment frequency. Even a 24-hour gap can force claims into reprocessing for weeks.
Reimbursement for S0013 and related codes varies dramatically, some clinics report a 20–35% gap between cost and expected reimbursement due to outdated payer contracts.
Many clinics don’t integrate the SpravatoWithMe program into their billing and financial workflow.
This one thing changes patient affordability, reduces cancellations, and stabilizes financial forecasting, but most practices don’t operationalize it.
Still stuck with unexplained reductions or denials? Eligibility gaps are why.
A significant portion of revenue leakage happens before the patient even sits in the chair.
Between underpayments, denials, and delays, Spravato clinics lose an average of:
• $350–$600 per treatment due to payer discrepancies
• 18–22% of annual Spravato revenue from preventable errors
• 4–7 hours per week per provider chasing down claims
And in a buy-and-bill environment, those losses hit cash flow harder than most executives anticipate.
“Our Spravato Billing Services are designed to simplify…”
…every touchpoint that influences reimbursement, from eligibility to coding to payer negotiations.
We rebuild the entire front-end process:
• Verification
• REMS confirmation
• Benefits for SpravatoWithMe
• Authorization
• Coding audit
This eliminates denials before they begin.
When you work with a dedicated Spravato Billing Services Company like Finnastra, you get coding logic that reflects real payer behavior, not generic assumptions.
We analyze your current contracts and identify gaps where your rates fall below regional benchmarks.
Many clients see increases after structured renegotiation backed by our claims analytics.
We operationalize it for you so your patients save money and your cancellations drop.
Our team uses a multi-stage verification system designed specifically for behavioral health and Spravato workflows.
Practices often underestimate how critical margin modelling is.
We build financial projections so you know your profit per treatment, per payer, and per dose, before medication is ordered.
A Spravato clinic in Washington was losing nearly $22,000 per month in missed reimbursement due to incomplete monitoring documentation and prior authorization misalignment.
Within 60 days of Finnastra’s intervention:
• Reimbursement increased by 17%
• Denials dropped by 82%
• Their buy-and-bill margin stabilized across three commercial payers
These are the types of outcomes that reshape the financial stability of behavioral health practices.
• Are you receiving consistent reimbursement for S0013?
• Do your CPT codes correctly reflect induction vs. maintenance?
• Are your denials tied to REMS or monitoring?
• Are your PA renewals getting approved on the first attempt?
• Has your team operationalized the SpravatoWithMe savings program?
• Are you confident your payer contracted rates align with 2026 benchmarks?
If you hesitate on even one question, your practice is likely losing revenue.
“As a leading Spravato Billing Services Company, Finnastra ensures…” your practice has the infrastructure, intelligence, and expertise to thrive in a reimbursement environment that’s growing more complex every year.
We support:
• Spravato Billing
• TMS Billing
• Ketamine Billing
• Prior Authorization
• Coding & Compliance
• Buy & Bill Optimization
• SpravatoWithMe Savings Program
• Hospital & Outpatient Behavioral Health Billing
Our commitment is simple: we help you capture every dollar you earn, accurately and compliantly.
Finnastra helps behavioral health practices transform their Spravato reimbursement outcomes through stronger coding, better payer alignment, and smarter workflows.
Explore how we can support your practice at: https://finnastra.com/spravato-billing/
