Provider Reminder When Billing Administration and Observation Codes for Spravato

As of January 1, 2021, a new code was created for Esketamine (S0013), which is sold under the brand name Spravato. Esketamine is a medication used as a general anesthetic for adults with treatment-resistant depression.

When Esketamine is supplied by a pharmacy using S0013, providers administering and observing the member receiving Esketamine should be filing with Evaluation and Management (E&M) and prolonged service codes as necessary.

When Esketamine is supplied by the provider or same practice who is also administering and observing the member, providers should be filing with G2082/G2083.

These changes apply to all commercial providers and to the following lines of business: Administrative Services Only (ASO groups), fully insured membership, and the State Health Plan (SHP).