What your G2082 actually pays: Medicare's 2026 rate for Spravato induction

Esketamine visits do not look like any other code in behavioral health: one code covers the drug, the administration, and two hours of required monitoring in a single payment. Medicare raised the lower-dose version 15.4% for 2026, second only to its own higher-dose sibling among every code in this series.

The code, and why almost all of its value is the drug

HCPCS (Healthcare Common Procedure Coding System) code G2082 covers an office visit for esketamine administration and monitoring at a dose of 56 milligrams or less. Esketamine, brand name Spravato, is a nasal spray used for treatment-resistant depression, and the Food and Drug Administration (FDA) requires every dose to be given under a Risk Evaluation and Mitigation Strategy (REMS) program: the patient self-administers the spray under direct observation, then stays for a mandatory two-hour monitoring period before being cleared to leave, because dissociation, sedation, and blood pressure changes are common in the hours after a dose.

The code bundles all of it, the drug itself, the supervision, and the two hours of monitoring, into one payment. That structure shows up directly in how the payment breaks down: of G2082's total relative value units (RVUs, the units Medicare uses to calculate payment), the practice-expense component, which reflects the cost of supplying the drug and running the monitoring room, is nearly 40 times larger than the physician work component. Almost the entire payment is the drug and the room, not the clinician's time, a structure unlike any office visit or therapy code in this series.

What Medicare pays in 2026

Medicare pays $952.59 nationally for G2082 in 2026, up from $825.81 in 2025, an increase of 15.4%, the second-largest single-year percentage gain of any code in this series, just behind G2083 at 15.8%. That increase runs well ahead of the 3.26% rise in the Medicare conversion factor alone, which points to a specific update in the drug-cost input behind the code rather than the broader fee schedule mechanics that moved office-visit and therapy codes this year.

A note on billing this commercially

G2082 is a Medicare administrative construct. Commercial payers and many state Medicaid programs generally do not use it; they bill esketamine through a drug code (historically S0013, replaced for Medicare purposes by J0013 effective January 1, 2026, though J0013 itself is not payable by Medicare) alongside a separate monitoring or E/M code. PayerPrice, the commercial rate aggregator used elsewhere in this series, has no listing for G2082, which is expected given the code's Medicare-specific structure; we are not publishing a commercial figure for this code because no adequately sourced one exists. What is publicly reported is directional only: some billing consultancies describe commercial esketamine reimbursement running below the Medicare rate for a comparable visit, but without a verifiable, itemized source, that comparison is not one we will put a number on here.

The so-what

• Confirm which dose band you are billing. G2082 covers 56 mg or less; a higher maintenance dose moves the visit to G2083, which pays more, reflecting the higher drug quantity.
• Track the full two-hour monitoring window in the note. The REMS requirement is what justifies the bundled payment; a note that does not reflect the full monitoring period is missing the documentation the code is built around.