Using HSA, FSA & Insurance for Ketamine Therapy
Most patients can use HSA or FSA funds to pay for ketamine therapy at Mosaic. Here's exactly how that works, what your insurance might cover, and how we can help you with reimbursement documentation.
A note on cost transparency
We charge a flat rate for ketamine therapy. Infusion with a provider visit is $450; infusion without a provider visit is $400. You can choose whichever fits your needs at any session. Some patients prefer a provider visit at every session for ongoing dose adjustment and check-ins; others use the $400 rate once their protocol is established. There are no facility fees, no infusion-time charges, no surprise add-ons. The price on our pricing page is what you pay.
We don't take insurance directly. That's because IV ketamine is prescribed off-label for mental health conditions and most insurance plans don't reimburse for it. Building our pricing around that reality lets us keep costs lower than clinics that have to negotiate with insurers, and it makes the financial side of treatment something you can plan for upfront.
But "we don't bill insurance" doesn't mean you have no options. Most of our patients use one of the following.
HSA & FSA: yes, ketamine therapy qualifies
If you have a Health Savings Account (HSA) or Flexible Spending Account (FSA) through your employer or insurance plan, you can almost certainly use those funds for ketamine therapy at Mosaic.
What qualifies
HSA and FSA funds are eligible for "qualified medical expenses" as defined by the IRS (Section 213(d)). Ketamine therapy for the treatment of depression, PTSD, anxiety, OCD, and other diagnosed psychiatric conditions falls within this definition when it's:
- ✓ Provided by a licensed medical clinician
- ✓ For the treatment of a diagnosed condition
- ✓ Not for cosmetic or general wellness purposes
Mosaic Infusions & Wellness meets all of these criteria.
How to use HSA/FSA funds with us
Pay directly with your HSA/FSA debit card.
If your HSA or FSA comes with a debit card (most do), you can swipe it at our clinic just like a regular credit card. The transaction goes through the same way and the funds come out of your pre-tax account.
Pay out of pocket and reimburse yourself.
Pay using a regular credit or debit card, then submit a reimbursement request to your HSA/FSA administrator with the documentation we provide (see below).
What about FSA "use it or lose it" rules?
FSAs typically require you to use your funds within the plan year. If you have a balance you'd lose otherwise, a ketamine series late in the year is an entirely reasonable use of those funds. Many of our patients book in November or December for this reason.
Insurance reimbursement after the fact
Some, not most, but some insurance plans will reimburse you for out-of-network mental health services after you've paid out of pocket. This depends entirely on your plan, and we can't predict what your insurer will approve.
If you'd like to attempt reimbursement, here's how it works:
- Call your insurance company. Ask: "What are my out-of-network mental health benefits? Will you reimburse me for IV ketamine therapy with CPT codes 96365 and 99214?"
- Get the answer in writing. Insurance phone reps can be inconsistent. A written response or recorded reference number protects you.
- After your session, we provide a superbill. This is the documentation your insurer needs to consider reimbursement.
- Submit the superbill to your insurer. They'll either reimburse a percentage or deny the claim.
We're happy to walk through this process with you before you decide whether to attempt it.
What is a superbill?
A superbill is a detailed receipt that includes everything an insurance company needs to process a reimbursement claim. We provide one on request. It includes:
- Your information: name, date of birth
- Date and duration of service
- Diagnosis code: the ICD-10 code for your condition (e.g., F33.2 for severe major depressive disorder)
- Procedure codes: CPT 96365 for the IV infusion, and CPT 99214 for the provider visit when applicable
- Provider information: name, NPI number, license
- Total amount paid
You don't need to know what any of this means. Your insurer's reimbursement department does. You hand them the document and they take it from there.
Tax-deductibility
Ketamine therapy expenses may be tax-deductible if your unreimbursed medical expenses exceed 7.5% of your adjusted gross income for the year. The superbills we provide can support this deduction on your tax return.
This is a question for your accountant or tax preparer. We're not in the business of tax advice, but we can provide the documentation you need.
Frequently asked questions
Will my insurance cover ketamine therapy?
Most won't. IV ketamine for psychiatric conditions is prescribed off-label, and most insurance plans exclude off-label prescriptions for mental health. That said, you can attempt reimbursement after the fact using a superbill (see above).
What about Spravato® (esketamine)? Doesn't insurance cover that?
Yes, in some cases. Spravato is FDA-approved for treatment-resistant depression, and some insurance plans cover it (with prior authorization requirements). It's a related but different medication delivered as a nasal spray. We don't offer Spravato, but if your insurance covers it, that may be worth exploring with a psychiatrist who does.
Can I use my HSA/FSA card to pay for a consultation?
Our consultations are free, so there's nothing to pay for. If you decide to move forward with treatment, your card works for all subsequent sessions.
What if my HSA/FSA debit card is declined?
Sometimes accounts have limits or restrictions. If that happens, you can pay with a regular card and reimburse yourself after. Just request a superbill at checkout.
Do you offer payment plans?
We work with patients on a case-by-case basis. If cost is a meaningful barrier to starting treatment, please reach out before scheduling. We want to make care accessible and will do our best to find a workable arrangement.
Can I split the cost of a series across multiple HSA/FSA plan years?
Absolutely. You don't have to pay for the entire series upfront. Each session is paid individually. So if your plan year resets mid-treatment, you can use this year's funds for some sessions and next year's for others.
Still have questions?
Talk to us. We're happy to walk through how the financial side of treatment would work for your specific situation before you commit to anything. There's no obligation, and we'd rather have the conversation upfront than have you back away because the cost feels unclear.