TMS and CareFirst BlueCross BlueShield
CareFirst is the BlueCross BlueShield licensee serving Maryland, Washington D.C., and Northern Virginia — the region Led Life Psychiatry calls home. CareFirst covers TMS therapy for major depressive disorder with prior authorization.
You'll need documentation that your depression is moderate to severe and significantly affects daily functioning, along with a record of prior antidepressant trials during your current depressive episode. The exact number of required trials can vary by plan.
TMS requires prior authorization from CareFirst. Our team submits the clinical documentation needed to support your request.
Since coverage details can vary by specific CareFirst account and contract, we recommend confirming your plan's TMS policy with CareFirst directly (1-866-773-2884) as well as with our office.
Your specific out-of-pocket cost depends on your CareFirst plan. We can help you confirm your benefits before your first session.
Spravato® and CareFirst BlueCross BlueShield
CareFirst covers Spravato® (esketamine) for treatment-resistant depression for Maryland, D.C., and Northern Virginia members when prior authorization criteria are met. Spravato® criteria are administered through CVS Caremark's Specialty Guideline Management program.
You'll generally need to be 18 or older, with a confirmed diagnosis of severe MDD verified by a psychiatrist using a standardized rating scale, and documentation of an inadequate response to two antidepressants from different drug classes, each used at the maximally tolerated dose for at least 8 weeks.
Initial authorization is typically granted for one month to begin treatment, with continuation authorized in three-month windows as your provider documents your progress.
Spravato® must be administered at a clinic certified under the FDA's REMS program. Led Life LLC is a certified authorized SPRAVATO® provider.
Cost depends on your specific CareFirst plan. We can help you check your benefits before treatment starts.
Coverage policies above reflect CareFirst's generally published guidelines and can change — we're happy to help confirm your specific benefits before your appointment.
Questions About Your Coverage
Contact our office to confirm your specific plan and benefits before your appointment.
Phone: (507) LED-LIFE
507-533-5433
Ellicott City (textable): 240-673-3236