Spravato Billing

Spravato® (esketamine) represents a breakthrough for patients with treatment-resistant depression (TRD). But while the treatment itself is clinically transformative, the billing and reimbursement process is uniquely complex—governed by REMS regulations, buy-and-bill requirements, insurance-specific rules, and strict documentation standards.

That’s where Finnastra steps in. As a specialized Spravato Billing Company, we offer end-to-end Spravato Billing Services that streamline operations, protect compliance, and secure maximum reimbursement.

Why Spravato Billing Is So Complex

Spravato® is unlike traditional medications. Administered under direct supervision and monitored per FDA-mandated REMS protocols, its billing involves layers of regulatory and financial coordination:

  • REMS Compliance – Requires certified prescribers, in-office monitoring, and strict recordkeeping
  • Buy-and-Bill Model – Clinics must purchase the drug upfront, administer in-office, and bill insurers post-treatment
  • Specialty Coding – Includes use of G-codes (e.g., G2082, G2083), NDC mapping, and S-codes for medication
  • Ineligible for Psychotherapy Billing – No concurrent therapy billing allowed during sessions
  • Documentation-Heavy – Prior authorizations, treatment logs, medical necessity justifications, and audits

Without specialized support, practices often suffer from:

  • Claim denials & underpayments
  • Prior auth delays
  • Improper documentation
  • Missed reimbursements & cash flow issues

What Sets Finnastra Apart?

We’re not just a billing service. We’re your strategic financial partner in Spravato care.

As a seasoned Spravato Billing Company, Finnastra understands the financial ecosystem surrounding Spravato. We’ve built an all-in-one platform that combines software automation, expert billing, and regulatory insight to give your clinic the financial confidence to grow its Spravato program.

Benefits of Choosing Finnastra for Spravato Billing

  • Spravato billing services from Finnastra reduce administrative tasks so providers can focus on what they do best—care.
  • With fewer denials, quicker reimbursements, and up-to-date compliance protocols, practices enjoy better cash flow and lower operational stress.
  • Our solutions improve staff efficiency, enhance data accuracy, and help practices navigate the insurance maze with ease.
  • By trusting a reliable Spravato billing company like Finnastra, your practice avoids revenue leaks and maintains a healthier bottom line.

Our Spravato Billing Services Include:

Buy-and-Bill Management

Spravato is typically billed under a buy-and-bill model, which places financial risk on the provider. Finnastra helps you:

  • Navigate payer-specific billing windows and terms
  • Ensure accurate evaluation and management for 56mg dose (G2082)
  • Ensure E/M services for 86 mg dose (G2083)
  • Track medication units, NDC codes, and dosage (56mg vs. 84mg)
  • Reconcile payments to verify you’re paid above acquisition cost
  • Monitor monthly treatment profitability

EHR & Workflow Integration

We connect directly with your existing EHR and practice management software to:

  • Automate patient scheduling & monitoring documentation
  • Track treatment sessions in compliance with REMS requirements
  • Sync visit notes, authorizations, and claim data for real-time accuracy
  • Generate billing-ready documentation for every Spravato encounter

Prior Authorization & Eligibility Management

We handle the time-consuming coordination before treatment begins:

  • Verify eligibility and benefits across payers (Medicare, Medicaid, Commercial)
  • Obtain and track prior authorizations, including appeals for denials
  • Ensure proper diagnosis coding (e.g., F33.2 – MDD, severe; F32.2 – single episode, severe)
  • Submit REMS registration confirmations when required

Real-Time Claims Processing & Appeals

Speed and accuracy drive better cash flow. Our billing team ensures:

  • Daily claim submission to avoid lag in reimbursement
  • Appeals for denied or underpaid claims, with clinical documentation
  • NDC-to-HCPCS validation to meet each payer’s claim formatting rules
  • Inclusion of all applicable codes and modifiers (e.g., prolonged monitoring G2212)

Denial Tracking & Revenue Recovery

  • Weekly review of claim denials and follow-ups
  • Root cause analysis to prevent recurring issues
  • Customized reports to help your team understand cash flow status
  • Payment posting and patient balance management

What Makes Finnastra your go-to Spravato Billing Company?

Clinical Awareness Meets Billing Precision

We know that Spravato isn’t just a treatment—it’s a monitored process. That’s why we account for:

  • Supervised treatment room logistics (multiple patients, one MA/NP oversight)
  • Timing requirements (120–180 mins per session)
  • REMS-registered facility and prescriber compliance
  • Monitoring staff non-billability (e.g., MA time is bundled into G-code, not billed separately)

Bulletproof Documentation Protocols

With REMS oversight and payer audits on the rise, clean, consistent documentation is critical. Finnastra ensures:

  • Compliance with medical necessity standards
  • Tracking of treatment initiation vs. continuation
  • Documentation templates for every step: diagnosis, supervision, side effects, progress
  • Audit-readiness for Medicare or commercial record requests

Transparent, Profitable Revenue Cycle

Our mission: Maximize your margins while minimizing administrative burden. With Finnastra, you get:

  • Faster reimbursement
  • Lower denial rates
  • Monthly profitability reviews
  • Insights to help you grow your Spravato program without financial risk

Who We Serve

Whether you’re a solo NP or a multi-location mental health clinic, our Spravato Billing Services scale to match your growth.

We currently support:

  • Independent Nurse Practitioners
  • Behavioral Health Clinics
  • Psychiatry Groups
  • Ketamine + Spravato Treatment Centers
  • Practices in Medicaid-heavy states (e.g., NY, DE, WA, MD)
Ambulatory Medical Billing

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    How to Get Started with Spravato Billing Services at Finnastra?

    Onboarding and Training

    Getting started is simple. Begin by contacting our team for a consultation.

    Improved Revenue Cycle Management

    We'll evaluate your current billing structure, identify optimization points, and deploy our software solution tailored to Spravato billing.

    Comprehensive Compliance

    Once integrated, our billing and collection experts handle the day-to-day processes—from preauthorizations to appeals—keeping everything running smoothly.

    Comprehensive Compliance

    With each step, Finnastra remains committed to improving your revenue cycle without disrupting patient care.

    Connect with Finnastra – Your Go-To Spravato Billing Company

    Managing Spravato billing doesn’t have to be a challenge. Finnastra offers reliable, efficient, and transparent billing services that deliver results. Whether you’re scaling your Spravato® offerings or refining current operations, we bring the support you need. Partner with us today and discover how a trusted Spravato billing company can elevate your financial operations. Reach out now to start your billing transformation.

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