What evolving Spravato coverage decisions mean for practice valuations

Spravato (esketamine) coverage has broadened steadily, with major payers now operating under formal medical policies rather than case-by-case determinations. For practice owners, the practical effect is predictability — and predictability is exactly what buyers pay for.

In current underwriting, a REMS-certified practice with established payer contracts for Spravato is typically valued on more durable revenue assumptions than an equivalent practice running entirely on cash-pay ketamine. The gap is not about which treatment is better; it is about how confidently a buyer can project the revenue forward.

Sellers with Spravato programs should document their payer mix carefully: which contracts sit at the group level versus the individual provider, current authorization approval rates, and any history of recoupment. These details increasingly move valuation conversations, not just diligence checklists.

Limneo perspective: if your practice holds REMS certification and group-level payer contracts, say so plainly in your listing materials — buyers are screening for exactly that.