Insurance coverage
Optum Behavioral Health
Optum Behavioral Health administers mental health benefits for UnitedHealthcare, plus a number of self-insured employer groups. Same Spravato rules as UnitedHealthcare. Some Optum-managed plans reimburse for ketamine-assisted psychotherapy (KAP) when billed under psychotherapy CPT codes.
Coverage at a glance
| Modality | Status |
|---|---|
| Spravato (esketamine) | Covered |
| Ketamine IV infusion | Not covered |
| Ketamine IM injection | Not covered |
| Ketamine oral/lozenge | Not covered |
| Psilocybin (Oregon licensed) | Not covered |
| Psilocybin (Colorado licensed) | Not covered |
What the plan requires
- Optum prior auth.
- TRD documentation.
Practical tips
- Optum behavioral network includes a number of tele-psychiatry groups doing Spravato referrals.
Providers accepting Optum
Always confirm in-network status with both the clinic and your plan before your first session.