Once a decision has been made to prescribe SPRAVATO®
SPRAVATO withMe provides support so you can focus on your patients
SPRAVATO withMe provides support so you can focus on your patients
SPRAVATO withMe Support
Click on a section below to learn more.
Investigation (BI) & Prior Authorization (PA) Support*
SPRAVATO withMe Support
Tap on a section below to learn more.
Streamline the process by using the SPRAVATO withMe Provider Portal
- 2-way secure messaging with a Case Manager
- Streamlined patient enrollment
- Download of Savings Card upon patient enrollment in the SPRAVATO withMe Savings Program
- The ability to set up your own network in the system, where you can see savings status and add/or remove patients across all sites
or by faxing a program enrollment form to 1-844-577-7282.
Investigation (BI) & Prior
Authorization (PA) Support*
Once a decision has been made to prescribe SPRAVATO®
Get a full view of your patients’ coverage to help them get on treatment quickly by minimizing approval delays
BI and PA Support Resources
Payer Coverage Tool
Understand payer coverage with our Payer Coverage Tool.
or by faxing a program enrollment form to 1-844-577-7282.
REMS=Risk Evaluation and Mitigation Strategy.
*SPRAVATO withMe automatically provides Prior Authorization form assistance, including status updates. Within the Patient Enrollment Form, you may choose not to receive Prior Authorization form assistance from SPRAVATO withMe.
†We do not fill out any information that requires the medical judgment of the prescriber; only the prescriber can determine whether to pursue a prior authorization.
Commercially insured patients have 2 ways to save
Patients pay as little as $10 per treatment for SPRAVATO® medication
SPRAVATO withMe Savings Program
Treatment may include up to three devices administered on the same day. There are quantity limits and a maximum program benefit per calendar year. Offer subject to change or end without notice. Program does not cover the cost of treatment observation. Patients can participate without sharing their income information.
See program requirements.
Patients pay as little as $0 after rebate for observation of each treatment
SPRAVATO withMe Observation Rebate Program
There is a limit to savings each year. Offer subject to change or end without notice. Not valid for residents of MA, MI, MN, or RI. Patients may participate without sharing their income information.
See program requirements.
coverage (Medicare/
Medicaid)?
Affordability programs may be available.
SPRAVATO withMe can provide information about other resources that may be able to help your patients with out-of-pocket medication costs, such as:
- State Health Insurance Assistance Programs (SHIPs)
- State Pharmaceutical Assistance Programs (SPAPs)
- Medicare Savings Program
- Medicare Part D Extra Help
To learn more about eligibility and how these programs may help your patients pay for Medicare Part D products, visit medicare.gov/your-medicare-costs.
Your patient may be eligible for support.
Additional Affordability Support from Johnson & Johnson
Patient assistance from Johnson & Johnson is available if your patient is uninsured or has commercial, employer-sponsored, or government coverage that does not fully meet their needs. Your patient may be eligible to receive their medicine from J&J free of charge for up to one year if they meet the eligibility and income requirements for the Johnson & Johnson Patient Assistance Program.
See terms and conditions at PatientAssistanceInfo.com
or en español
at PatientAssistanceInfo.com/ES.
or by faxing a program enrollment form to 1-844-577-7282.
†Source: IQVIA LAAD data for new commercial patients starting between 2019 and Sept 2023.
Care Navigator
SPRAVATO withMe Care Navigators—dedicated support for your patients at every step of
the treatment journey
Our Care Navigators, healthcare professionals§ with mental health experience, can provide either:
§Care Navigators do not offer medical advice.
Option 1
Cost support PLUS complete treatment journey support
If you DO request a Benefits Investigation (BI) and the patient opts in to Care Navigator support, they will receive supplemental treatment preparation and motivational support, in addition to cost-focused support.
such as a starter kit
Option 2
Our Care Navigators, healthcare professionals‡ with mental health experience, can provide either:
Cost-focused support
If you DO NOT request a Benefits Investigation (BI), and the patient opts in to Care Navigator support, they will receive cost support and select resources
such as a starter kit
or by faxing a program enrollment form to 1-844-577-7282.
¶Source: IQVIA SPRAVATO® Abandonment and Persistency Study, November 2023.
The patient support and resources provided by SPRAVATO withMe are not intended to give medical advice, replace a treatment plan from the patient’s healthcare provider, offer services that would normally be performed by the provider’s office, or serve as a reason to prescribe SPRAVATO®.
or by faxing a program enrollment form to 1-844-577-7282.
Help avoid delays in fulfillment with direct specialty pharmacy (SP) engagement
2 ways to engage:
Johnson & Johnson has contracted with the specialty pharmacies# below to offer a dedicated toll-free number for any inquiries related to SPRAVATO®.
Your PAS can see the status of individual patients at each step of the process and contact specialty pharmacies directly to troubleshoot delays.
Specialty pharmacies listed below can process medical authorizations, which are required in acquiring SPRAVATO® for patients covered under a medical benefit.
Accredo Health Group, Inc.
Phone #: 877-861-8168
Fax #: 888-454-8488
Hours of operation:
8 AM–8 PM (ET), M–F
Genoa Healthcare
Phone #: 888-544-1329
Fax #: 317-800-7713
Hours of operation:
8:30 AM–4:30 PM (CT), M–F
Voicemails returned within
1 business day
Note: The above represents a partial list of specialty pharmacies supplying SPRAVATO®. It is not intended to serve as a comprehensive list.
#Johnson & Johnson does not endorse the use of any of the listed pharmacies in particular. The information provided represents no statement, promise, or guarantee of Johnson & Johnson, concerning levels of reimbursement, payment, or charge. Please consult specific payer organizations with regard to local or actual coverage, reimbursement policies, and determination process.
All trademarks belong to their respective owners.
Enhanced Specialty Pharmacy Resources
SPRAVATO® Enhanced Service Pharmacy Network Communication
Download PDFPathway to Acquire SPRAVATO® Through a National Specialty Pharmacy
Download PDFSPRAVATO® Patient Pharmacy Instructions Flashcard
Download PDFor by faxing a program enrollment form to 1-844-577-7282.
Enroll your patients in the SPRAVATO withMe support program
Streamline the process by using the SPRAVATO withMe Provider Portal
The Provider Portal features include:
Flexibility to initiate benefits investigations, prior authorizations, and/or Savings Program enrollment per your office needs
2-way secure messaging with a Case Manager
Instant download of Savings Card, upon patient enrollment in the SPRAVATO withMe Savings Program, and the ability to manage claims online
Visibility to see patient case details within multisite practice locations by your site or network administrator
A dashboard that gives patient-level visibility of the access process
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or by faxing a program enrollment form
to 1-844-577-7282.
For questions or more information, call 1-844-4S-WITHME (1-844-479-4846) Monday–Friday, 8:00 AM–8:00 PM ET.
Information about your patient’s insurance coverage, cost support options, and treatment support is given by service providers for SPRAVATO withMe. The information you get does not require you or your patient to use any Johnson & Johnson product. Because the information we give you comes from outside sources, SPRAVATO withMe cannot promise the information will be complete.
Support that’s tailored to your patients’ needs
SPRAVATO withMe can support your patients throughout their SPRAVATO® treatment journey to help them start and stay on therapy.
Click on each step to learn more.
Tap on each step to learn more.
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Patient REMS & SPRAVATO withMe Enrollment
- REMS Enrollment
- SPRAVATO withMe Enrollment
- Provider Portal
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Patient Coverage Evaluation &
Obtaining Access
- Access and Reimbursement Considerations
- Affordability Options
- BI and PA Support
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SPRAVATO® Prescription & Administration
- Drug or Product Procurement Channels
- Affordability Options
- Specialty Pharmacy Communication With Treatment Center
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Claims Management
- Submitting Observation Claims
- Procurement Codes
- Savings Claims Rebate Management
Patient REMS & SPRAVATO withMe Enrollment
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REMS|| and SPRAVATO withMe Enrollment
There are 2 programs to enroll your patient in:
- Submit patient REMS enrollment to SPRAVATOrems.com or via fax to 1-877-778-0091.
- Complete SPRAVATO withMe Program Enrollment Form (PEF) digitally via the Provider Portal or with a faxed paper form. With the portal, there is flexibility to opt in to 1 or all of the patient support resources:
- • Digital enrollment (SPRAVATOproviderportal.com)
- • With paper Enrollment Form (fax to 1-844-577-7282)
To be fully enrolled in SPRAVATO withMe, patients will need to sign the Patient Authorization Form included in the SPRAVATO withMe Program Enrollment Form.
Streamline the process by using the SPRAVATO withMe Provider Portal
The SPRAVATO withMe Provider Portal is a flexible tool that offers patient-level visibility into activity progress on:
Provider Portal features include:
- The ability to set up your own network in the system, where you can see savings status and add/or remove patients across all sites
- Download of Savings Card upon patient enrollment in the SPRAVATO withMe Savings Program
- Streamlined patient enrollment
- 2-way secure messaging with a Case Manager
REMS=Risk Evaluation and Mitigation Strategy.
||REMS patient enrollment is mandatory to obtain treatment (and can happen anytime before SPRAVATO® treatment), while SPRAVATO withMe enrollment is not required to obtain treatment.
or by faxing a program enrollment form
to 1-844-577-7282.
For questions or more information, call 1-844-4S-WITHME (1-844-479-4846) Monday–Friday, 8:00AM–8:00 PM ET.
REMS=Risk Evaluation & Mitigation Strategy.
Commercially insured patients have 2 ways to save–enroll in both today
Patients pay as little as $10 per treatment for SPRAVATO® medication
SPRAVATO withMe Savings Program
Treatment may include up to three devices administered on the same day. There are quantity limits and a maximum program benefit per calendar year. Offer subject to change or end without notice. Program does not cover the cost of treatment observation. Patients can participate without sharing their income information.
See program requirements.
Patients pay as little as $0 after rebate for observation of each treatment
SPRAVATO withMe Observation Rebate Program
There is a limit to savings each year. Offer subject to change or end without notice. Not valid for residents of MA, MI, MN, or RI. Patients may participate without sharing their income information.
See program requirements.
Patient under-insured or has no insurance?
Their Care Navigator can help them find other cost support options.
NO COMMERCIAL COVERAGE
Affordability support for patients with government coverage
Your patients with government coverage could still save on their SPRAVATO® treatment through programs like:
- State Pharmaceutical Assistance Programs (SPAPs)
- State Health Insurance Programs (SHIPs)
- Medicare Savings Program
- Medicare Part D Extra Help Low-Income Subsidy
Johnson & Johnson Patient Assistance Program
Patient assistance from Johnson & Johnson is available if your patient is uninsured or has commercial, employer sponsored, or government coverage that does not fully meet their needs. Your patient may be eligible to receive their medicine from
J&J free of charge for up to 1 year if they meet the eligibility and income requirements for the Johnson & Johnson Patient Assistance Program. See terms and conditions at PatientAssistanceInfo.com.
or by faxing a program enrollment form
to 1-844-577-7282.
For questions or more information, call
1-844-4S-WITHME (1-844-479-4846)
Monday–Friday, 8:00 AM–8:00 PM ET.
Resources
SPRAVATO withMe Patient Brochure
SPRAVATO withMe Affordability Brochure
SPRAVATO withMe Program Enrollment Form
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
Healthcare Provider Exceptions & Appeals Guide
SPRAVATO® Enhanced Service Pharmacy Network Communication
Frequently Asked Questions
SPRAVATO withMe Program
All individuals regardless of coverage status who are taking SPRAVATO® are eligible to enroll in SPRAVATO withMe Patient Support. Care Navigator, Insurance Coverage Support, Enhanced Pharmacy Services, and Patient Access Specialist Support are available to all individuals taking SPRAVATO®. Different types of affordability support are available based on coverage type.
Once you determine SPRAVATO® is right for your patient, you can enroll them by visiting SpravatoProviderPortal.com or by faxing a program enrollment form to 1-844-577-7282.
A patient is not required to enroll in
SPRAVATO withMe to start therapy, but it is recommended in order to have available information about the patient’s insurance coverage, affordability options, and covered dispensing pharmacies. Providers can enroll patients via the SPRAVATO withMe Provider Portal and by fax.
Yes. Once they are enrolled, they can opt out by calling SPRAVATO withMe and speaking with a Care Navigator.
A signed Patient Authorization Form, included in the SPRAVATO withMe Program Enrollment Form, is not required to enroll in the Savings Program. However, it is required if a provider intends to view and manage claims submissions through the SPRAVATO withMe Provider Portal.
If a patient does not want to sign the Patient Authorization Form located in the SPRAVATO withMe Program Enrollment form but does want to enroll in the Savings Program, you as the provider can go to Portal.JNJwithMe.com, select SPRAVATO®, select Healthcare Professional/Office Staff, Select Savings Program, Select Continue, Select SPRAVATO withMe Savings-Only Paper Enrollment Form, and download the form. Once the patient has signed the form, it can be uploaded to the Express Enrollment Site or faxed to 1-844-577-7282.
The SPRAVATO withMe suite of patient support resources includes a Care Navigator, cost support, an explanation of insurance coverage, enhanced specialty pharmacy services, and patient access support.
Care Navigator Support
Care Navigators provide 1-on-1 support to help patients with cost support, treatment journey support, and help finding resources.
If they have opted in to Care Navigator support, a Care Navigator will be assigned within 1 business day of completed enrollment. Care Navigators are available Monday–Friday, from 8:00 AM–8:00 PM ET.
Affordability
You can download a Savings Card upon patient enrollment in the SPRAVATO withMe Savings Program through the Provider Portal. Your patients will also be mailed a physical Savings Card.
If the patient is submitting a rebate request:
Patient will need to complete, sign, and submit a Rebate Request Form, including a copy of their Explanation of Benefits (EOB) from their primary insurance provider (as well as any secondary insurance provider, if applicable) and a receipt from their treatment provider indicating proof of payment of their out-of-pocket SPRAVATO® medication costs. Patients may submit rebate requests to the Savings Program by fax or mail.
If the provider is submitting a rebate request on behalf of the patient:
At your patient’s request, you may submit rebate requests to the SPRAVATO withMe Savings Program on their behalf if the Assignment of Benefits checkbox of the Program Enrollment Form (PEF) has been completed and is on file. Please ensure that your patient has completed their portion of the Program Enrollment Form (pages 3-6), including the Patient Authorization Form, and that you have faxed it to the number found on the form, or submitted it to the portal in order for SPRAVATO withMe to process a rebate claim.
Submitting a primary claim:
To submit a primary claim on behalf of the patient, providers must follow the instructions on the back of the SPRAVATO withMe Savings Program card to submit a CMS-1500 (HICF) or Uniform Billing
Form—CMS-1450 (UB-04)—through
their electronic billing system.
Submitting a secondary claim:
If you have submitted a primary claim and the claim has a remaining balance of $10 or more, you may submit a secondary claim. Before you get started, contact your clearinghouse to request that Payer ID# 56155 and 56165 be added to their system. If needed Submit secondary claim to SPRAVATO withMe Savings Program using CMS-1500 or UB-04 medical claim forms or electronic versions 837P or 837I (electronic submission is preferred).
You will need to submit the primary payer EOB along with the secondary claim form. To complete the form, you will need to use medical claims information from the front of patient’s Savings Program card. You will receive funds for approved claims by check, which will include information on setting up future payments via electronic funds transfer (EFT), if preferred.
NOTE: If you already receive funds via EFT, you will continue to receive payments that way.
