Does treatment-resistant depression treatment qualify for Massachusetts PFML?

Yes. Treatment-resistant depression treatment qualifies as care for a serious health condition under Massachusetts Paid Family and Medical Leave when certified by a healthcare provider. Certification requires 2 or more treatments within 30 days, or 1 treatment plus an ongoing care plan. Maximum medical leave is 20 weeks per year, or 26 weeks combined with other PFML reasons. The 2026 maximum weekly benefit is $1,230.39.

Is esketamine (Spravato) covered by employer medical plans in Massachusetts?

Yes. Esketamine (Spravato) and intramuscular ketamine for treatment-resistant depression are billed under standard medical plans using HCPCS codes J0013, G2082, and G2083. Lumin Health is in-network with every major Massachusetts carrier, including Harvard Pilgrim, BCBS Massachusetts, Aetna, Cigna, UnitedHealthcare, Tufts Health Plan, and Mass General Brigham Health Plan. There is no new contract for benefits teams to negotiate and no pharmacy carve-out to design.

What is the FDA-approved next step when antidepressants don't work?

When standard antidepressant trials don't adequately work, the FDA-approved next step for treatment-resistant depression is esketamine (Spravato) or intramuscular ketamine. Both are administered under clinical supervision in a medical setting. Spravato is delivered nasally, intramuscular ketamine is delivered by injection — neither is administered intravenously.

How often does an employee need treatment for treatment-resistant depression?

Standard FDA protocol is 2 sessions per week during weeks 1–4 (induction), 1 session per week during weeks 5–8 (continuation), then 1 session every 1–2 weeks for maintenance. Each session is roughly 3 hours total — drug administration plus two-hours-or-more clinical observation per FDA protocol. Patients are cleared to drive 24 hours after each session.

Is Spravato administered intravenously?

No. Spravato (esketamine) is administered as a nasal spray under medical supervision. Intramuscular ketamine, the other FDA-pathway option for treatment-resistant depression at Lumin Health, is delivered by injection. Neither treatment uses an intravenous line.

Where does Lumin Health treat patients?

Lumin Health operates four Greater Boston medical practice locations: Newton (10 Langley Road, Suite 200), Cambridge (50 Church Street, 3rd Floor), Woburn (300 Tradecenter Drive, Suite 3400), and Brookline (1101 Beacon Street, Suite 4E). Lumin Health also operates a Bethesda, Maryland location serving the DMV area. For most Boston-area employees, a Lumin Health site is a 5–15 minute drive from home or work.

How quickly can an employee start treatment at Lumin Health?

Many patients begin treatment within about two weeks of inquiry at Lumin Health. The national average wait for an in-person psychiatric appointment is 67 days, and the national average for behavioral health intake overall is 6 weeks.

For HR & benefits leaders

Treatment-resistant depression is a workforce continuity problem your medical plan already covers.

A brief for HR and benefits teams. What the treatment is, what your medical plan already covers, what the leave mechanics look like, and what tends to change when it works.

Dr. Benjamin Yudkoff, MD, MA — Lumin Health

From Dr. Ben Yudkoff

Most benefits teams I talk to encounter treatment-resistant depression as an operational question with no clear playbook — an open disability claim, an employee struggling without a name on what's happening, a coverage utilization line they didn't expect. What's been hard to find is a single reference that puts the answer together: what the treatment is, what your medical plan already covers, what the leave mechanics look like, and what tends to change when it works. This page is that piece.

Dr. Benjamin Yudkoff, MD, MA

Co-Founder & Chief Medical Officer, Lumin Health · Instructor in Psychiatry, Harvard Medical School

Download the field guide Or read the field guide on this page ↓

Does Mass General Brigham Health Plan cover ketamine therapy?

Why this matters for benefits teams

Treatment-resistant depression is the population driving a prominent segment of mental-health disability claims.

Roughly 30% of medication-treated depression becomes treatment-resistant — the clinical population driving a notable amount of mental-health-related disability claims, presenteeism, and quiet attrition. Most benefits teams encounter this without a playbook. The treatment that addresses it is FDA-approved, processed under your standard medical plan, and in-network with every major Massachusetts carrier.

2.8M

U.S. adults with treatment-resistant depression today

37–48%

of workers with major depression experience short-term disability

2.2×

higher presenteeism rate vs. workers without depression (20.1% vs. 9.1%)

Sources: Analysis Group / Journal of Clinical Psychiatry (TRD prevalence); peer-reviewed workplace depression burden studies.

What tends to change when treatment works

Mean depression severity moves from moderate-to-severe into the mild range over a twelve-week arc.

Across our patient population, mean depression scores on the standard clinical scale (MADRS) start in the moderate-to-severe range at baseline. By twelve weeks of treatment, the mean has fallen into the mild range. Not every patient — some respond faster, some less, some take longer. The aggregate is a meaningful clinical move over an induction phase plus continuation. Operationally that translates to weeks of disability not lost, periods of presenteeism foreshortened, employees in functional ranges again. Spravato and IM ketamine work much more quickly and more predictably than standard medications alone — the comparison that matters when an employee has already cycled through first-line treatment without response.

The clinical next step

Esketamine (Spravato) or intramuscular ketamine.

When standard antidepressant trials don't adequately work, the FDA-approved next step for treatment-resistant depression is esketamine (Spravato) or intramuscular ketamine. These are administered under clinical supervision in a medical setting — nasal (Spravato) or intramuscular injection (IM ketamine), not intravenous.

Induction · Weeks 1–4

2 sessions per week

Continuation · Weeks 5–8

1 session per week

Maintenance · Week 9+

Every 1–2 weeks

Each session is roughly 3 hours total — drug administration plus two-hours-or-more clinical observation per FDA protocol. Patients are cleared to drive 24 hours after each session.

For the disclosure conversation

The manager script — what to say, what not to say.

An employee discloses they're starting treatment for treatment-resistant depression — esketamine (Spravato) or IM ketamine — and will need schedule adjustment. Keep this on file. Adapt as needed.

Thank you for telling me. I want to make sure we get this right.

I'll need a couple of basic things to help: a general sense of the treatment schedule, so we can plan around it. You don't need to share specifics.

Whether you want HR involved in the leave logistics, or want me to connect you with them.

I'll check in with you at a few points — not about the treatment, just about how you're doing on a human level. If anything changes about what you need from me, please tell me.

What not to say

"What's wrong with you?"
"Have you tried [a treatment / therapist / supplement]?"
"Just take all the time you need." (Well-meant but unhelpful — be specific about leave logistics.)
Anything that implies you've discussed it with someone else.

For the leave question

Massachusetts PFML typically covers TRD treatment.

Massachusetts Paid Family and Medical Leave typically covers treatment-resistant depression treatment as a serious health condition. Most HR teams haven't operationalized PFML for mental health treatment specifically — the certification path is straightforward, but the framework isn't widely documented.

Quick reference: MA PFML for TRD treatment
Does TRD treatment qualify?	Yes. Certified by a healthcare provider as a serious health condition — same framework as cancer treatment or dialysis (multi-treatment regimen under FDA protocol).
Certification requires	2 or more treatments within 30 days, or 1 treatment plus an ongoing care plan. Both fit how TRD treatment is scheduled.
Max medical leave	20 weeks per year (26 combined with other PFML reasons).
2026 max weekly benefit	$1,230.39
Where to apply	mass.gov/pfml

The federal FMLA framework also applies for employers with 50+ employees — providing job protection but unpaid. PFML and FMLA leave can run concurrently. Coordination with your short-term disability policy is plan-specific.

For employees at Lumin Health's Bethesda location: Maryland's FAMLI program (rolling out in 2026) and the District of Columbia's Paid Family Leave program (already in effect) provide parallel paid medical leave frameworks. Eligibility and benefit levels differ from MA PFML — confirm specifics with your benefits administrator or the relevant state agency.

For the leave question

Massachusetts PFML typically covers TRD treatment.

Quick reference: MA PFML for TRD treatment
Does TRD treatment qualify?	Yes. Certified by a healthcare provider as a serious health condition — same framework as cancer treatment or dialysis (multi-treatment regimen under FDA protocol).
Certification requires	2 or more treatments within 30 days, or 1 treatment plus an ongoing care plan. Both fit how TRD treatment is scheduled.
Max medical leave	20 weeks per year (26 combined with other PFML reasons).
2026 max weekly benefit	$1,230.39
Where to apply	mass.gov/pfml

For your specific population

Want this scoped to your company's carriers and population?

We can map your carrier coverage to a 3-month TRD treatment cost lookback for your employee population — what the in-network pathway looks like for an employee at a specific threshold, what the typical claim shape is, and where state paid medical leave interacts with your short-term disability policy. Our goals are the same: to get your members back to work safely, quickly, and durably.

Get in Touch Or call 617-863-8810

Replies come from Dr. Ben Yudkoff. Typical response time: 1 business day.

Ketamine treatment led by psychiatrists at Lumin Health – decades of experience, over 1,800 patients helped

Board-certified psychiatrists screen for medication interactions, monitor vitals, and coordinate with your existing care team.
We specialize in coordinating care for people with complex medical histories.

The Lumin Health medical team

Our team of academically-affiliated psychiatrists and clinicians are experts in ketamine and esketamine treatment. As specialists in esketamine (Spravato) and ketamine therapy, we provide safe, effective care with rigorous protocols and personalized treatment plans.

The Lumin Health concierge team

Our patient concierge team handles the entire process: insurance verification, scheduling, and intake. Our team looks forward to connect to answer your questions about ketamine and Spravato. We handle the details so you can focus on getting better.

Left arrow | Lumin Health | 5.0 star insurance-covered ketamine therapy for depression, anxiety and PTSD in Boston, MA and Bethesda, MD

Right arrow | Lumin Health | 5.0 star insurance-covered ketamine therapy and esketamine (Spravato) treatment for depression, anxiety and PTSD in Boston, MA and Bethesda, MD

Benjamin Yudkoff, MD, MA

Co-Founder

Chief Medical Officer

Instructor in Psychiatry

Harvard Medical School

Matthew Mosquera, MD, MS

Regional Medical Director

Boston, MA

Lecturer in Psychiatry

Harvard Medical School

Aakash Sathappan, MD

Site Medical Director

Brookline, MA

Instructor in Psychiatry

Harvard Medical School

SJ Fletcher, MD PhD

Site Medical Director

Woburn, MA

Instructor in Psychiatry

Harvard Medical School

Mona Itani MD, MS

Site Medical Director

Newton, MA

Taiwo Ayegbusi

Registered Nurse

Bethesda, MD

Kaylee Samuel

Office Manager

Bethesda, MD

Annie Hollyer

PMHNP

Cambridge, MA

Kiana Fussner

Psychiatric Physician Assistant

Bethesda, MD

Hannah O'Laoghaire

Intake Coordinator & Patient Concierge

Rebecca Nguyen

Office Manager

Brookline, MA

Klarissa Ramkissoon, MSN, FNP-BC

Family Nurse Practitioner

Woburn, MA

Chester Domoracki

Office Manager

Woburn, MA

Emily Brett, PA-C, CAQ-Psy

Psychiatric Physician Assistant

Brookline, MA

Kacey Malz, LCSW

Licensed Clinical Social Worker

Brookline, MA

Madison Chau, LCSW

Licensed Clinical Social Worker

Newton, MA

Kandace Small, RN

Registered Nurse

Woburn, MA

Rosie Cohen, Mental Health Counselor

Mental Health Counselor

Cambridge, MA

Sarojini Schutt

Office Manager

Cambridge, MA

Elizabeth Biondo, BSN, RN

BSN, Registered Nurse

Newton, MA

Tessa Rockwell, RN

Registered Nurse

Newton, MA

Sahana Heiderscheidt

Operations and Patient Concierge Manager

Terrin Gathers, PMHNP

Psychiatric Nurse Practitioner

Newton, MA

Taylor Brodersen, RN

Registered Nurse

Newton, MA

James "Matt" Neal, PMHNP

Psychiatric Nurse Practitioner

Newton, MA

Jess Mahoney

Office Manager

Newton, MA

Sabrina Nebiye, RN

Registered Nurse

Cambridge, MA

Alison Choate, RN

Registered Nurse

Cambridge, MA

Elaura Patton, PA-C, MA

Physician Assistant

Cambridge, MA

Meet the team

Lumin Health's comforting environment for ketamine therapy

Your ketamine treatment takes place in a private suite, where blankets, pillows, eyemasks, and refreshments are there when you want them. The environment is colorful and quiet by design — not to be ancillary to your ketamine treatment, but a core part of it. Research consistently shows that the physical environment shapes treatment outcomes, which is why we put thought into every detail.

You're here to receive top-quality treatment from psychiatrist-led ketamine programs. We make sure the space supports that.