Does TRICARE Cover Spravato and Ketamine Therapy? A Colorado Springs Guide

With Fort Carson, Peterson and Schriever Space Force Bases and the Air Force Academy all nearby, TRICARE comes up in a large share of the calls we get about depression treatment. The two treatments people ask about most are Spravato and ketamine therapy, and TRICARE treats them very differently.

The short answer

• Spravato: covered, with prior authorization. TRICARE covers Spravato (esketamine) nasal spray for treatment-resistant depression and for major depression with suicidal thoughts or behavior. Every beneficiary needs prior authorization.
• Ketamine therapy: not covered. TRICARE lists psychedelic medications, including ketamine, among the mental health services it does not cover.

Colorado is in the TRICARE West region, which is run by TriWest Healthcare Alliance. The rules in this post come from TriWest’s behavioral health coverage guide, dated June 10, 2025. TRICARE policy does change, so we confirm coverage for each patient before treatment starts.

Who qualifies for Spravato under TRICARE

According to TriWest’s coverage guide, you need all of the following:

• You are at least 18 years old.
• You have treatment-resistant depression, or major depression with suicidal thoughts or behavior. Treatment-resistant usually means at least two antidepressants, taken at a proper dose for long enough, have not worked.
• Your provider is enrolled in the FDA’s Spravato safety program, known as REMS. Rivendell Health is REMS certified.
• Your prior authorization has been approved before your first session.

TRICARE covers Spravato only for these FDA-approved uses. It will not cover Spravato prescribed for another condition.

Do you need a referral?

It depends on who you are in the TRICARE system.

• Active duty service members need a referral from their primary care manager for outpatient mental health care with a civilian provider, along with a reason the care cannot be given at a military hospital or clinic, such as Evans Army Community Hospital at Fort Carson. Start with your PCM.
• Family members and retirees on TRICARE Prime do not need a referral for office-based mental health care, such as psychiatric evaluations and medication management, from a network provider.
• TRICARE Select members can see any TRICARE-authorized provider. Your costs are lower with a network provider.

A referral and a prior authorization are two separate things. Even when you do not need a referral to see us, Spravato itself still needs prior authorization.

Why TRICARE does not cover ketamine therapy

TRICARE generally covers mental health treatments that are FDA-approved for the condition being treated. Ketamine is FDA-approved as an anesthetic, and its use for depression and PTSD is off-label, so TRICARE excludes it however it is given.

That does not mean ketamine is off the table. Some TRICARE patients choose to pay for it themselves, particularly when Spravato has not worked or is not a fit. If your provider recommends ketamine therapy, our front office can tell you the cost per session. Our ketamine vs. Spravato guide explains how the two compare.

How to get started

1. Check which TRICARE plan you have (Prime or Select) and whether you are active duty. Your plan decides whether you need a referral first.
2. Active duty: ask your PCM for a referral to outpatient psychiatry with Rivendell Health.
3. Book an evaluation. One of our psychiatric providers reviews your diagnosis, the antidepressants you have tried and your medical history, and tells you whether Spravato fits.
4. We submit the prior authorization. Have your medication history handy: names, doses and roughly when you took each one. It speeds up the request.
5. Plan your rides. In the first month, Spravato sessions are twice a week, each with at least two hours of monitoring, and you cannot drive until the next day.

If your care comes through the VA rather than TRICARE, the process is different, and we will cover VA Community Care in a separate guide.

You can read more about Spravato on our Spravato and ketamine therapy page, or call our front office at (719) 726-6573 with questions about coverage.

If you are a service member or veteran in crisis, call 988 and press 1 for the Veterans Crisis Line, or text 838255. For any emergency, call 911.