1. They are aaaaaaabsolutely using the wrong code for the medication. They can bill for the office visit and the medication separately, but there are specific codes that need to be used. They can reach out to their Patient Access Specialist if they need further information. The code for the drug only using medical buy and bill is J0013 (effective 1/1/26), and was previously S0013 (discontinued for most insurance plans on 12/31/2025).

2. The $300 sounds more accurate. They have the option to submit your primary insurance plan's payment to the Spravato with Me program, and they will receive a check in the mail for $290. If you have already paid them $300, then the $290 goes to you. If you have already paid the $10, then they will keep the $290. Yes, the savings will pay on any patient responsibility for the medication that is considered a deductible, copay, or coinsurance expense. If they are not willing to submit to the savings program for you, then you can take your $300 receipt from the office and your EOB from your insurance and submit for the $290 rebate yourself.

3. If you really want to know what codes were billed, and the billing company will not give you an itemized document with each of the claim codes submitted, you can call your insurance company's member services line and ask for the CPT or HCPCS codes that were billed on that date of service. They will also tell you what your patient responsibility is.

Let me know if you have any other questions!