This CPB has been revised to: (i) remove from the criteria of initial approval for esketamine therapy "member does not have a current or recent history (i.e., within the last 6 months) of moderate or severe substance or alcohol use disorder", and (ii) state that esketamine (Spravato) therapy is considered unproven and not medically necessary for members with TRD or MDD who have moderate or severe substance or alcohol use disorder that is currently not being treated or medically managed. This CPB has been updated with the following: (i) created subheaders, and (ii) reorganized the policy format and subheader locations.