Please contact the clinic for information on our ketamine infusion rates.
Ketamine treatment begins with a psychiatric evaluation. Based on your needs, the doctors will recommend the number of infusions they believe are appropriate to treat your symptoms. Treatment usually begins with a series of six infusions. After your sixth infusion, you would meet with the doctor for a follow up visit to assess the results and develop a continuing treatment plan as necessary.
Though we aren't in network with any insurance companies for ketamine treatment, some may provide reimbursement directly to patients on a case-by-case basis. Since we are out of network providers, you will need to have out of network benefits through your plan to receive reimbursement. You must also meet a specific set of diagnostic criteria which you can call your insurer about and ask for directly. MassHealth, Medicare, and supplemental plans through these providers do not provide reimbursement for out of network providers.
Where appropriate, Cambridge Biotherapies can submit a prior authorization to your insurance provider following your evaluation. If the prior authorization is approved, this will increase your likelihood of getting reimbursed. You would pay out of pocket for each treatment, and then submit itemized receipts or superbills to your insurance company for reimbursement.
If you have questions about insurance coverage for ketamine, please first contact your insurance provider, ask if they have a formal policy about ketamine infusions for mental health, and then call the clinic with your questions.
The Cambridge Biotherapies TMS Clinic is in network with Blue Cross Blue Shield of Massachusetts. Pending that patients with this plan meet the necessary diagnostic criteria for rTMS treatment, they will be able to receive treatment at the in-network rate.
Many other health insurers in Massachusetts including Harvard Pilgrim, Tufts Health Plan, Aetna, and United Behavioral Health have policies for rTMS coverage. If you have one of these insurance plans, you will need to meet their diagnostic criteria and have out of network coverage in order to receive rTMS treatment at Cambridge Biotherapies.
Cambridge Biotherapies will either submit insurance claims on behalf of our patients or guide them through the submission process if they prefer to deal directly with their own insurance companies.
Unfortunately, we are not contracted with MassHealth plans, Medicare, or Medicare supplemental plans through private insurance companies. These types of insurance plans do not cover out-of-network treatment, therefore treatment at Cambridge Biotherapies would not be eligible for coverage or reimbursement. Please note that this includes BCBS of MA Medicare supplemental plans or 65+ plans.