Who qualifies for TMS, Spravato®, and IV ketamine?
The short answer: people whose depression hasn’t responded to standard antidepressant treatment. Fortifying Wellness is an adult outpatient clinic. Eligibility varies by treatment, device or protocol, clinical fit, and payer policy, so we confirm the applicable criteria during a consultation.
TMS therapy: typical candidacy criteria
TMS devices and protocols are FDA-cleared for specific depression indications and age ranges. Many commercial plans authorize treatment when the following are documented, subject to the member’s plan:
- A diagnosis of major depressive disorder; age eligibility depends on the TMS device and protocol, clinical fit, and payer policy
- Documented trials of antidepressant medication at an adequate dose and duration that have not brought sufficient relief
- A trial of psychotherapy (required by many plans)
- Screening for safety: metal or implanted devices near the treatment area, seizure history, medications, and other factors are reviewed individually during the medical evaluation
Spravato® (esketamine): who is eligible
Spravato® is FDA-approved for treatment-resistant depression: generally, depression that has not responded to two or more oral antidepressants at an adequate dose and duration. Eligibility usually looks like:
- Adults with treatment-resistant depression; Spravato may be used alone or together with an oral antidepressant, depending on the treatment plan
- Able to remain in the office for the required two-hour monitoring after each dose, with a ride home arranged
- Blood pressure and medical history reviewed and appropriate for treatment
- Prior authorization from your plan, which our team prepares and submits for you
IV ketamine: who it’s considered for
IV ketamine is FDA-approved as an anesthetic; its use for depression is off-label. At Fortifying Wellness it is physician-directed and considered when:
- Depression has not responded to standard treatments, or a rapid-acting option is clinically appropriate
- A medical screening (blood pressure, cardiac and psychiatric history) supports safe treatment
- The patient understands infusions are typically self-pay; we provide a written estimate and superbills for possible reimbursement
Not sure whether you (or your patient) meet criteria?
That’s what the free consultation is for. We review the treatment history, verify benefits, and give a straight answer about which options fit, including when the right next step is a medication change rather than an interventional treatment.
For referring clinicians
Print this page as a one-page reference. To refer a patient, use the provider referral form or call or fax us using the information below. Our team will contact your office to gather patient information through an appropriate channel. With patient consent, you receive evaluation findings and progress updates, and your patient stays your patient.
- Phone: (720) 432-0958 (clinician-to-clinician calls welcome)
- Fax: (720) 432-0978
- Email: care@fortifyingwellness.com for general questions only; do not include patient information · Online: fortifyingwellness.com/for-providers
- 7345 S. Pierce St, Suite 205, Littleton, CO 80128 · Eric Wagner, MD
Common Questions
Candidacy FAQs
How many antidepressants do I need to have tried before TMS?
Most commercial plans require documented trials of antidepressant medication at an adequate dose and duration, and many also ask for a trial of psychotherapy. The exact number varies by plan. We review your history during a free consultation and confirm your plan’s specific criteria before anything is scheduled.
Do I have to try oral antidepressants before Spravato®?
Treatment-resistant depression generally means depression that hasn’t responded adequately to two or more antidepressant treatments. For adults with treatment-resistant depression, the FDA-approved labeling permits Spravato® as monotherapy or together with an oral antidepressant. It is administered only in a certified health care setting with monitoring.
Do I have to stop my current antidepressant first?
Usually not. TMS, Spravato®, and ketamine are typically added alongside your existing medication, and we coordinate with your current prescriber or therapist whenever that helps your care.
Is IV ketamine covered by insurance?
Usually not. Because ketamine is used off-label for depression, infusions are typically self-pay, though some medical portions of care are sometimes covered. We provide superbills for possible out-of-network reimbursement and walk you through expected costs before you commit to anything. More on IV ketamine →
Related reading
Find out where you stand in one conversation
A free consultation with our Littleton team: your treatment history reviewed, your benefits verified, and a clear answer about which options you qualify for.
7345 S. Pierce St, Suite 205, Littleton, CO 80128 · Serving Littleton, Ken Caryl, Columbine, Highlands Ranch, Centennial, Lone Tree, Englewood, Lakewood & the south Denver metro