Medica policy
Intravenous, Intramuscular, and Subcutaneous Ketamine for Chronic Pain, Mental Health and Substance Use Disorders
Intravenous, Intramuscular, and Subcutaneous Ketamine for Chronic Pain, Mental Health and Substance Use Disorders is a public Medica policy (effective Sep 1, 2026). It lists 1 CPT or HCPCS code. Not a coverage decision; the payer's own document governs.
View the original policy (PDF) ↗
- Payer
- Medica
- Effective
- Sep 1, 2026
- Line of business
- Commercial, Medicaid
- Source
- partner.medica.com
Codes in this policy
The CPT and HCPCS codes the policy names. A policy can name a code it excludes.
| Code | Other Medica policies |
|---|---|
| J3490 | Policies naming J3490 |