FAQs for Providers
What is the advantage of referring a patient to the Dallas CADT?
You can offer your patient cutting edge treatments for difficult to treat illness without having to recreate the in-clinic, certified environment in your office.
Who is a good candidate for the treatment center?
The Dallas Center for Advanced Depression Treatments offers breakthrough therapies for treatment-resistant depression (TRD). A candidate for SPRAVATO or BrainsWay Deep TMS is a patient who has failed to respond to two or more antidepressants of adequate duration and dose, and has failed a trial of augmentation with atypical antipsychotics. Importantly, these therapies should not be viewed as “last option” treatments after everything else has failed.
Who decides which treatment modality my patient receives?
As the primary psychiatrist, you determine the treatment and we deliver it on your behalf in our center. We welcome your questions and consultation.
Will I lose my patient to the Dallas CADT?
Absolutely not. Dallas CADT is an ancillary service, delivering only the specific treatments requested. Importantly, for SPRAVATO, the primary psychiatrist will always be responsible for managing the antidepressant that is given in conjunction with SPRAVATO, as well as any other medications the patient may be taking.
Will you manage my patient’s depression/OCD/bipolar treatment?
No, the Dallas CADT will only be responsible for delivering one treatment modality, all other care will be referred back to your office.
Why is SPRAVATO considered a breakthrough treatment for TRD?
SPRAVATO trials have shown a robust efficacy and safety profile, and improvement can be evident within the first 24 hours. The treatment is non-invasive, not painful and causes minimal disruption to patients’ daily lives.
Do I need to write a prescription or manage any of the SPRAVATO?
No the Dallas CADT is responsible for SPRAVATO procurement for the patient.
How much does treatment cost?
Deep TMS and SPRAVATO are generally covered by insurance and will vary by benefit design. The actual cost of SPRAVATO is $10/per treatment for most patients (before or after manufacturer assistance), not inclusive of copay for the office visit. Intranasal ketamine is not covered by insurance and is an out-of-pocket expense.
Is Deep TMS for OCD covered by insurance?
Currently, OCD alone is not covered. However, if a patient presents with MDD and OCD, these two conditions can be treated simultaneously and the cost is mostly covered by insurance with an additional charge to the patient for use of the OCD device.
Who researches patient benefits and obtains treatment authorization?
Dallas CADT is responsible for contacting the patient’s insurance to verify benefits (medical, pharmacy, service delivery) and will obtain any required prior authorization.
What if my patient is not an appropriate candidate or insurance will not cover the treatment?
In this case, the patient will be informed by our office and you will be notified. We will discuss with you directly the options and any alternative therapy.
Will I be informed when my patient makes contact with the Dallas CADT or starts treatment?
You will be notified by fax when the patient schedules an initial consult, as well as when they begin treatment. We strive to reach out to the patient within days of receiving a referral, often the same day.
What can my patient expect on their first visit?
The first visit is a 45-minute initial consultation. We will ensure that treatment can be delivered appropriately and safely, and will answer patient questions. Insurance benefits will be verified and we will determine any requirements for prior authorization. For a SPRAVATO referral, the patient will be enrolled in the REMS program and will have a urine tox screen. Treatments are typically administered during the second visit.
How long does it take to start treatment?
Generally, it takes one to two weeks from the patient’s initial consultation to receive their first treatment.
What am I responsible for?
We ask that you provide patient contact information, a list of previously tried and failed treatments, as well as diagnosis and any medical issues you may feel would impact treatment. Progress notes are always appreciated.
How long is treatment?
For SPRAVATO, we ask all patients to commit to the full course of initiation, which is four (4) weeks. For Deep TMS, we ask patients to complete all prescribed sessions (36 for MDD, 18 for OCD).
Who sees my patient at their visits?
Dr. Bennett and/or psychiatric nurse practitioners see patients at every visit.
Who addresses any complications or side effects of treatment after hours?
The patient will have access to the Dallas CADT physician or psychiatric nurse practitioner on call after business hours.
How is treatment progress monitored?
All patients complete depression rating scales at each visit for SPRAVATO treatment and weekly for Deep TMS treatment.
What updates and communication can I expect?
We will regularly update you with the patient’s treatment outcomes for your records. Updates are sent by fax when a referral is received, when we have reached out to your patient, and when we have completed our initial consultation. For SPRAVATO treatment, updates are sent at the start of treatment, four weeks after induction, and at weeks eight and 16. Should patients continue maintenance treatment, updates are sent every three months. For Deep TMS treatments, updates are sent every three weeks and at the end of a Deep TMS course.
How long is a patient with TRD treated with SPRAVATO?
There have been no trials to demonstrate the exact length of time someone should be treated with SPRAVATO. Maintenance trials have demonstrated long-term efficacy. Much like augmentation with atypical antipsychotics, the length of time a patient receives SPRAVATO is determined by clinical results and provider judgement. Some patients stop treatment after a few months and resume if symptoms return, others continue with maintenance treatment as directed. Of note, open label maintenance studies of SPRAVATO are ongoing, and thus far have demonstrated safe, effective use of the medication in patients for over two years.
In order for SPRAVATO to be approved for MDD with suicidal ideation, is suicidal intent required?
No, SPRAVATO may be used sooner for those patients with MDD that have some form of suicidal ideation. SPRAVATO may be used in these severely depressed patients sooner in the treatment algorithm to improve their depressive symptoms rapidly, but should not be used specifically as a treatment for suicidal thinking. Those patients with active SI with intent may best be served with inpatient treatment.
May I discuss a patient before I make a referral?
Dr. Bennett welcomes questions to help make the process easy for you and your patient.