Using an HSA for ketamine therapy, Spravato or TMS
Short answer: HSA and FSA funds can generally pay for medical care that diagnoses or treats a condition. That usually includes Spravato and TMS prescribed for depression. Ketamine treatment may also qualify when a licensed prescriber provides it to treat a diagnosed condition, but plans differ. Confirm with your plan.
Does Spravato qualify for HSA or FSA?
Spravato is FDA approved for treatment-resistant depression and depression with suicidal thoughts. Copays, coinsurance and cash prices for visits to a certified treatment center are typically eligible expenses.
Does TMS qualify?
Transcranial magnetic stimulation is FDA cleared for certain conditions. Sessions provided by a licensed clinic to treat a diagnosed condition typically qualify.
Can you use an HSA for ketamine therapy?
Ketamine is commonly used off label for depression. Treatment given by a licensed medical professional for a diagnosed condition is generally medical care. Because plan rules and documentation expectations vary, ask your administrator before relying on it.
What usually does not qualify?
- General wellness or optimization programs
- Treatment without a diagnosis
- Travel or lodging, unless specific rules allow it
- Supplements or at-home products not prescribed for a condition
What documentation should you keep?
- An itemized receipt with the provider's name, date, service and amount
- A diagnosis or statement of medical necessity
- Your prescription or treatment plan
Keep records in case your plan administrator asks or the IRS reviews an HSA withdrawal.
Can you use insurance and an HSA together?
If your insurance covers part of the cost, use HSA or FSA funds only for what you actually pay. Do not claim the same expense twice.
What about letter-of-medical-necessity promotions?
The IRS warned in 2024 that a doctor's note alone does not make general wellness spending eligible. For clinic-based psychiatric treatment, eligibility depends on the treatment being medical care for a condition.
Frequently asked questions
Can I use an HSA for a ketamine clinic membership?
Fees for medical treatment generally qualify. Pure membership perks may not. Confirm with your plan.
Do I need a letter from my doctor?
Not always, but a clear diagnosis and treatment plan help.
How Eligible helps
Eligible helps cash-pay practices accept HSA and FSA cards and issue receipts plans accept.
General information only, not tax advice.
For the broader eligibility rules, read whether therapy is HSA or FSA eligible. Keep claims moving with our HSA and FSA receipt checklist.