Ketamine-Assisted Psychotherapy (KAP)
Frequently Asked Questions
Does insurance cover KAP?
Not at this time. KAP is a new treatment model not yet recognized by insurance companies. If requested, our office can provide you with a courtesy “superbill” to submit to your insurance company for out-of-network benefits. We are not familiar with your insurance plan and are not able to tell you what your plan covers.
What is a “superbill”?
A superbill is a document that outlines our professional information and a list of dates and services rendered while you are in the program. This list of codes corresponds to regularly recognized service codes in the insurance industry. Clients with health insurance may request a superbill to file for out-of-network benefits with their specific plans. A superbill is a document that includes 1) our pertinent professional information; 2) a list of received services/matching insurance codes; and 3) payment rendered by client. A client may request a superbill after each month of service, as insurance only reimburses completed sessions. We have no way to know what your insurance may reimburse.
If submitting a superbill to your insurance company, please be aware that an insurance company may only reimburse certain amounts for particular codes. Our integrative model of care is not based on insurance codes and a superbill is our best effort to assist you in seeking out-of-network reimbursement.
What is the difference between “bundled services” and “fee for service”?
Widening Circles offers bundled program services for a monthly fee. We do not charge “per service.” We created this treatment model to meet the clinical needs of our clients, not to line up with insurance company standards of reimbursement. The superbill may cause it appear that we are “fee for service” because each service code will list a cost. The superbill is reflective of our best effort to offer clients an approximation of the services you receive while in the program.
A “fee for service” program charges for each clinical service separately. For instance, when you see an individual therapist, the therapist charges you a fee per session. At Widening Circles, clients pay one fee each month that supports the entire program. We are a coordinated, multi-specialty, integrative treatment team of licensed and experienced professionals working in tandem to optimize your care. This is different from seeing individual practitioners who do not act as a communicative treatment team. This is part of what makes our program unique.
What are you doing to help increase accessibility?
In an effort to support financial accessibility, Widening Circles is currently working with leaders in the field to develop additional models of care that insurance may eventually potentially reimburse. We understand that this price point is out of range for many needing this level of care. We are committed to creating best practice models for KAP and other psychedelic therapies and are engaged in conversations around bringing this care to those who need it most.
One of our founders volunteers as a faculty trainee with the Psychedelic Research and Training Institute (PRATI) so that we can train other therapists in this model. Additionally, Widening Circles providers is partnering with The Pearl Psychedelic Institute here in Western North Carolina to support current MAPS MDMA for PTSD expanded access as this ground-breaking research continues to develop. Three of our providers are involved in MAPS MDMA for PTSD Expanded Access Program.
What makes your program unique?
Ketamine clinics and practices have proliferated in recent years with little solid framework in using this medicine for mental health and substance use disorder treatment. "Settings vary widely ranging from IV (or intranasal esketamine) administration without any psychotherapy to close integration of ketamine with psychotherapy during the same session."
(Handbook of Medical Hallucinogens, Ketamine chapter by Bravo, Grant and Bennett, 2021)
Some clinics are run by professionals with little to no experience or training in mental health and addictions. Our KAP program consists of licensed prescribers and psychotherapists who have been professionally trained to work with psychedelic medicine and non-ordinary states of consciousness. Consistent with our original established treatment program, we provide individualized, intensive treatment in an outpatient setting. Utilizing an innovative, multidisciplinary team approach, our team offers comprehensive assessment and nimble care tailored to the needs of each client.
How long are KAP sessions?
Generally, each KAP medicine session lasts approx 2-3 hours depending on the route of administration and individual sensitivity.
Will the prescriber be in every session with me?
The prescriber and therapist will be in the first KAP session with you. For subsequent sessions, the therapist will be with you and the prescriber will be available on-site.
Do I have to have a referral from a mental health provider?
Yes. We require a referral from a mental health provider. Often clients come to us after a series of other treatment experiences. It is important to us to coordinate care with your referring provider.
Can I come for one ketamine session rather than engage in the program?
No. Widening Circles provides high quality, integrative care. It is important to us that you have a solid experience with preparation and integration to optimize your treatment experience.
What is ketamine and why is it being used in mental health and substance use disorder treatment?
"Ketamine is a medication widely used in anesthesia and pain control, and considered a psychedelic in its mind-altering effects, has recently been found to have a proven and unique role in the treatment of depression, and there is promising evidence suggesting benefit for other psychiatric and psychological conditions." (Handbook of Medical Hallucinogens, Ketamine chapter by Bravo, Grant and Bennett, 2021)
Am I medically and/or psychiatrically eligible for KAP treatment?
Before participating, you will be carefully interviewed to determine if you are a good candidate for ketamine treatment. This will include discussing your medical and psychiatric history and a review of your medical and psychiatric records, if necessary. Some medical and psychiatric conditions need to be treated before you can safely take ketamine. These conditions include hallucinations, untreated mania, unstable angina (chest pain/heart disease), uncontrolled hyperthyroidism, increased intracranial pressure, or evidence of liver disease. A previously demonstrated allergy to ketamine excludes one from treatment. Pregnant women and nursing mothers are not eligible because of undetermined potential effects on the fetus or nursing child. Those with a primary psychotic or dissociative disorder or who are currently in a manic or mixed episode are not eligible for treatment with ketamine. Please consult your treating clinician if you are taking Lamotrigine (Lamictal) or an anxiety medication such as benzodiazepines, pregabalin, or gabapentin as they may blunt the antidepressant effects of ketamine.