Annual report - April 2026
First independent, license-verified count of the US psychedelic therapy marketplace. Every provider cross-checked against the issuing regulator - FDA REMS registry, Oregon Health Authority, Colorado DORA, state medical boards - between January and April 2026. Published under CC BY 4.0.
Concentration
Colorado (76), Texas (45), California (37) and Oregon (22) account for 180 of the 241 providers on the ledger. The remaining 17 states split 61 providers between them - an average of 3.6 clinics per state.
Psilocybin
Prop 122 healing centers opened in 2025 and already outnumber Oregon Measure 109 service centers by 3.5:1 (76 vs 22). The gap reflects Colorado's faster facilitator licensing pipeline and broader modality scope, not higher demand.
Access deserts
Ohio, New Jersey, Michigan and Tennessee have active clinic markets that are not yet reflected in our published set - re-verification in progress. But 22 of the 30 are genuine structural deserts: physician shortage states where patients routinely drive 3+ hours or cross state lines for treatment.
Modality mix
Of 113 FDA-regulated ketamine-family sites on the ledger, 113 offer Spravato (esketamine). Spravato is the only modality with reliable private-insurance and Medicare coverage nationally, making it the default route for patients who need insurance to work.
Regulatory
SB 219 was signed in April 2025 and authorizes licensed practitioners for PTSD, treatment-resistant depression, SUD, and end-of-life care. Rule-making is underway; first licensed practitioners are expected mid-2026. We project 8-15 verified sites by our July edition.
Veteran access
VA Medical Centers in DC, San Diego, Bay Area and San Antonio are quietly among the largest Spravato-delivering institutions in the country. Several VA programs also run ketamine IV pilots. Veterans with TRD often have better access than civilians with commercial insurance.
State by state
Tiers reflect verified supply, not regulatory permissiveness. A state can be legally open and still have near-zero verified clinic supply.
Colorado
Largest licensed psilocybin footprint in the country - first cohort from Prop 122 healing centers operational in 2025.
Texas
Second-largest Spravato network outside California; no psilocybin program.
California
Densest clinic market per capita; SB 1012 remains stalled. Psilocybin decriminalized in 5 cities, no licensed program.
Oregon
First-mover psilocybin state (Measure 109). Verified against Oregon Health Authority license registry.
Florida
Southwest Florida concentration (Naples - Bonita Springs). No state psychedelic legislation moving.
New York
A114 (psilocybin) still in committee. NYC has the densest per-square-mile Spravato availability in the US.
Washington
SB 5263 task force reported in Q1 2026. Seattle and Port Townsend decriminalized possession in 2021.
Nevada
Las Vegas Valley concentration; AB 245 task force reported 2024.
Mississippi
One verified site statewide. Jackson metro.
Connecticut
Yale Psychiatry regional access; HB 5143 working group advanced in 2024.
Georgia
Emory Brain Health Center anchors Atlanta metro.
North Carolina
Research Triangle academic access; limited commercial clinic supply on the ledger.
Virginia
Right-to-Try law (HB 458) first in the country but no licensed public pathway.
Arizona
SB 1570 funded $5M in psilocybin research grants.
Illinois
CURE Act (SB 2308) psilocybin services bill still in committee.
Maryland
Johns Hopkins dominates academic access; trial enrollment is the real pathway here.
Vermont
UVM Medical Center anchors the state; Burlington decriminalized in 2024.
Massachusetts
Question 4 failed 2024 and is expected to return; Mass General Brigham is the referral backbone.
Arkansas
UAMS-centered academic access.
Kentucky
Louisville metro only; state ibogaine fund vote reversed in 2024.
Pennsylvania
Penn Medicine runs active psychedelic research; commercial supply under-represented in our current verified set.
21 states on the ledger - 241 verified providers total
111 Spravato · 69 ket-IV · 5 ket-IM · 99 psilocybin
Access deserts
These states have no provider that has passed our license verification as of April 2026. Some will populate in the July edition as re-verification clears. Others are structural deserts - patients there routinely cross state lines or go untreated.
How we verify providersSpravato (esketamine)
111
FDA-approved, REMS registry-verifiable, insurance-covered. The default for patients who need insurance to work.
Browse spravato (esketamine)Ketamine IV
69
Off-label, cash-pay dominant. Strongest published data for treatment-resistant depression at induction dose.
Browse ketamine ivKetamine IM
5
Intramuscular injection, same drug as IV at 85-93% bioavailability. Faster throughput, lower cost per session.
Browse ketamine imLicensed psilocybin
99
Oregon Measure 109 + Colorado Prop 122 programs. No federal pathway; not insurance-covered.
Browse licensed psilocybinWhat counts as a provider
A verified provider is a clinic, licensed service center, or solo practitioner with an active license at a US address who delivers at least one of: Spravato, ketamine IV/IM/oral (off-label), or licensed psilocybin services (Oregon OHA or Colorado DORA). A single organization with multiple locations counts as multiple providers if each location has its own verifiable license.
Verification sources
What we do not count
Research-only academic trial sites with no public access pathway. Telehealth-only at-home programs (covered in a separate report). Providers advertising psychedelic therapy without a verifiable license. International retreats (covered in a separate report). Underground facilitators.
Re-verification cadence
Every listed license is re-verified against its source on a rolling 90-day cycle. If a license lapses, is surrendered, or is subject to regulatory discipline, the provider is removed from public listings within 7 days. Full change history is available on request to journalists and researchers.
For journalists
Aggregate state-level counts and methodology are released under CC BY 4.0 - free to republish with attribution to LicensedPsychedelics. Recommended citation:
LicensedPsychedelics (2026). 2026 US Psychedelic Therapy Access Report. Retrieved 2026-04-19 from https://licensedpsychedelics.com/reports/2026-psychedelic-therapy-access
For comment, provider-level data, or pre-publication access to the July 2026 edition, contact press@licensedpsychedelics.com.
Browse the data
The 241-provider ledger is publicly searchable. Filter by state, modality, insurance, or metro.
Open the directoryHow were the 241 providers verified?
Every provider is cross-checked against the issuing regulator before appearing on the site: FDA REMS registry for Spravato, Oregon Health Authority for psilocybin service centers, Colorado DORA for Colorado healing centers, and state medical boards for off-label ketamine clinics. License numbers, expiry dates, and registrant names are re-verified on a rolling 90-day cycle. A provider is removed if a license lapses, surrenders, or is disciplined.
Why do some states show zero providers when they clearly have clinics?
This report counts only providers who passed our independent license verification as of April 2026. Ohio, New Jersey, and several other states have active clinics in our unpublished backlog awaiting re-verification; they will appear in future editions. The report reflects what is verifiable right now, not what exists in the marketplace broadly.
Does this include at-home telehealth ketamine?
No. This is an in-clinic and licensed-service-center report. Telehealth-only programs (Mindbloom, Joyous, Innerwell, Better U, Wondermed) operate a different regulatory model under individual state prescribing rules and are not included in the state-by-state counts. Those providers are covered in our at-home ketamine comparison.
Why is the Spravato count higher than IV ketamine in most states?
Spravato is an FDA-approved drug with an official REMS registry - so we can verify it to a single public source. Off-label IV and IM ketamine clinics verify against state medical boards, a slower and more fragmented process. The real ratio of IV clinics is higher than the published verified count; expect the ketamine IV number to climb materially in the next edition.
Can I republish this data?
Yes. The aggregated state-level counts and methodology in this report are released under CC BY 4.0 - free to republish, adapt, and analyze with attribution to LicensedPsychedelics. Individual provider records and license numbers are not covered by this license (those remain our copyrighted work).
How often will this update?
Quarterly. The next edition lands in July 2026 with the New Mexico medical psilocybin program rollout factored in and the Colorado cohort expanded to what we expect will be 110 plus providers.
LicensedPsychedelics is an independent, license-verified directory of US psychedelic therapy providers. We have no paid listings for medical providers. This report was compiled by our internal research team from public regulatory data and our in-house license verification pipeline. Nothing in this report is medical advice. Call 988 in a mental health crisis, or your provider or emergency services if you are in immediate danger.