Acquiring SPRAVATO®

Pathway to Acquire SPRAVATO® From an Authorized Specialty Distributor

SPRAVATO® Enhanced Services Pharmacy Network Communication

Complete List of Authorized SPRAVATO® Full-Line Wholesalers and Specialty Distributors

Acquiring SPRAVATO®
Through the Pharmacy
Channel

Assignment of
Benefits Form

Coverage & Reimbursement

Access, Coding, & Reimbursement Guide

Letter of Medical Necessity Template

Letter of Exception Template

Drug & Procurement Coding Overview
for SPRAVATO®

Evaluation & Management
(E/M)
Code Flashcard

Exceptions & Appeals Guide

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