Spravato

Spravato

I. Medication

• Spravato is a carve out to MediCal Rx

• Providers should be referred to MediCal Rx on how to submit for treatment authorization request for these medications

II. Administration

• Spravato Administration can be billed to CenCal
• Does not require a referral or authorization
• Provider should use the appropriate E/M codes

III. Observation

• Spravato Observation can be billed to CenCal
• Does not require a referral or authorization
• Provider should use the appropriate CPT codes
• Providers should be advised that they are subject to audit to ensure members safety as referenced by direct supervision of the administration and observation of Spravato

CenCal Health covers limited substance use screening and treatment services provided at primary healthcare locations.