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Trauma-focused therapy is the first-line treatment for PTSD. When symptoms persist, we can help you find the next step.

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PTSD Treatment in Rochester, NY

Living with PTSD often means flashbacks, hypervigilance, and a nervous system that will not settle, sometimes years after the event that caused it. If trauma-focused therapy has helped but has not fully resolved your symptoms, or you want additional medical support alongside the therapist you already see, Nexus Neuropsychiatry can help. Our board-certified psychiatrists specialize in interventional psychiatry, and we work with your existing providers, not around them, to find the right next step.


Haven't started therapy yet? We'll talk through that first. Trauma-focused therapy remains the foundation of PTSD care.

PTSD Care Built Around Your History, Not a Standard Protocol

PTSD does not look the same from one person to the next, so your evaluation at Nexus starts with a full picture: what happened, what treatment you have already tried, what is and is not working, and what your current therapist or primary care provider already knows about your case. From there, we build a plan around the options below. You keep your therapist. We add what medicine can offer on top of that care.


IV ketamine therapy

IV ketamine is used off-label for PTSD, meaning it is not FDA-approved for this condition. The research so far is encouraging but comes from small trials, and your psychiatrist will go over what the evidence does and does not show before you decide. For some people whose symptoms have not fully responded to therapy or medication, it may be worth considering. Sessions can cause temporary dissociation and changes in blood pressure, so every infusion is monitored, and you will need someone to drive you home. You can read more on our IV ketamine therapy page.


Spravato® (esketamine)

Spravato® is FDA-approved for treatment-resistant depression, not for PTSD. Many people with PTSD are also living with depression that has not responded to standard antidepressants, and when that overlap exists, Spravato® may be part of the conversation. Spravato® is available only through certified healthcare settings under the FDA's REMS program. Learn more on our Spravato® treatment page.


Ongoing medication management

Medication management is part of every interventional psychiatry consultation. Your psychiatrist reviews what you take now, what you have tried before, and whether adjustments could help. This work runs alongside the trauma-focused therapy (EMDR, cognitive processing therapy, or trauma-focused CBT) that remains the first-line, evidence-based treatment for PTSD.

What to Expect, From Your First Call to Your First Follow-Up

Getting started is straightforward. Most new patients are seen within about a week of contacting us, once insurance authorization is in place.


  1. Call our Rochester office or submit a request online. Your therapist or primary care provider can also refer you directly, by phone, fax, or our website.
  2. Speak with our clinical coordinator. We confirm your information and verify your insurance benefits up front, so you know your expected cost before your first visit.
  3. Meet with an interventional psychiatrist. Your consultation covers your trauma history, prior treatment, and current symptoms in detail. We will discuss every option that fits your situation, including whether IV ketamine, Spravato®, or medication management makes sense as a next step, or whether a referral elsewhere is the better fit.
  4. Begin treatment, if it is right for you. If you and your psychiatrist decide to move forward with a treatment we provide in-office, we schedule you promptly.
  5. Stay in touch. You will have periodic follow-ups with your psychiatrist during treatment and a check-in afterward. We send a summary of care to your therapist and other providers so everyone stays coordinated.

Cost and Insurance for PTSD

What you pay depends on which path fits your case, because IV ketamine, Spravato®, and TMS are billed differently.


IV ketamine infusions are $500 per session, with no packages, memberships, or hidden fees. Because IV ketamine is used off-label for PTSD, most insurance plans do not currently cover it. Spravato® and TMS are FDA-approved for treatment-resistant depression, so coverage generally depends on that diagnosis rather than on PTSD.


We accept most major insurance plans, including Medicare, Excellus/BCBS, Aetna, Cigna/Evernorth, MVP, Carelon, Medicaid, Optum/UHC, VA Community Care Network (VACCN), and Tricare East. Our team handles prior authorization on your behalf. For self-pay treatment, we partner with CareCredit for patients who want a payment plan.


During your consultation, we will walk through your specific coverage and total expected cost before you commit to anything.

Why Rochester Patients Choose Nexus for PTSD Care

Nexus Neuropsychiatry is the largest interventional psychiatry practice in the Rochester region. We are physician-owned and operated by Shane Stegen, DO, and Nadine Mills, MD, both board-certified psychiatrists who specialize in interventional psychiatry.


We follow the consensus guidelines of the Clinical TMS Society and American Society of Ketamine Physicians, Psychotherapists, and Practitioners (ASKP3) for ketamine administration. Every infusion is monitored by a physician and a nurse trained specifically in ketamine care, with continuous vital sign monitoring throughout.


We provide advanced treatments and work alongside your existing care team, not replace it, so starting treatment here does not mean starting over with someone new.

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Related Ways We Can Help

If IV ketamine sounds like the right fit, read what a session involves on our IV ketamine therapy page. If depression is part of your PTSD symptoms, our Spravato® (esketamine) treatment page and TMS therapy page. cover those options in more depth.


Every path starts the same way: an interventional psychiatry consultation, where we review your history and build a plan together that fits your circumstances.


Ready to talk with someone who will listen to your full history before recommending a next step? Call (585) 201-8508 or request a consultation. We're open Monday through Friday, 10am to 7pm, by appointment.

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Questions About PTSD Treatment? We’re Here to Help.

These are the questions we hear most often. If you would rather talk it through, call us at (585) 201-8508.

  • What are the symptoms of PTSD?

    PTSD symptoms generally fall into four categories: re-experiencing the trauma through flashbacks or nightmares, avoidance of reminders of the event, negative changes in mood or thinking, and hyperarousal, such as being easily startled or constantly on guard. Symptoms can appear soon after a traumatic event or emerge months or years later. A diagnosis requires an evaluation by a clinician. The VA National Center for PTSD has a full symptom overview if you want to read more before your consultation.

  • Can ketamine therapy actually help with PTSD?

    The research is promising but early. A small randomized trial published in JAMA Psychiatry compared a single IV ketamine infusion with an active placebo (midazolam) in adults with chronic PTSD and found a rapid reduction in symptoms. A later small randomized trial in the American Journal of Psychiatry found that repeated infusions extended those improvements, although symptoms returned for some participants after the infusions ended. Response varies by individual, and our psychiatrists will walk you through what the evidence does and does not show for your situation.

  • Is ketamine FDA-approved for PTSD?

    No. IV ketamine is FDA-approved as an anesthetic, and its use for PTSD is off-label. That means your psychiatrist is relying on clinical judgment and the available research rather than an FDA-approved indication for this condition. We will review that with you before you decide on anything.

  • What are the risks and side effects of IV ketamine?

    Common effects during and shortly after an infusion include dissociation (feeling detached from your body or surroundings), dizziness, nausea, and a temporary rise in blood pressure and heart rate. Every infusion at Nexus Neuropsychiatry is monitored, and you will need someone to drive you home. Ketamine is not appropriate for everyone, so your psychiatrist will review your medical and psychiatric history before recommending it.

  • Do I need to stop seeing my therapist to start treatment here?

    No. We are not a replacement for trauma-focused therapy such as EMDR or cognitive processing therapy, which remains the first-line, evidence-based treatment for PTSD. We work alongside your current therapist and send treatment summaries to your care team so everyone stays informed.

  • Is TMS an option for PTSD?

    Traditional TMS is FDA-cleared for major depressive disorder and obsessive-compulsive disorder.  There are FDA approved protcols that use EEG specifically for PTSD but we do not yet have access to this protocl nor is it covered by insurance. If your PTSD occurs alongside treatment-resistant depression, TMS may be part of the conversation about your options during your consultation. We will always be direct with you about what is and is not backed by an FDA clearance for your diagnosis.

  • Will my insurance cover PTSD treatment at Nexus?

    It depends on the treatment. Spravato® and TMS can be covered when a treatment-resistant depression diagnosis applies. IV ketamine for psychiatric use is not currently covered by most plans. We accept Medicare, Excellus/BCBS, Aetna, Cigna/Evernorth, MVP, Carelon, Medicaid, Optum/UHC, VA Community Care Network (VACCN), and Tricare East, and we will confirm your specific benefits before you start.

  • How soon can I be seen?

    Depending on your situation and treatment recommendations some therapies can be started within a week of contacting us.  Often insurance authorization can delay this.  The good news is, once we have the necessary authorization, we generally start within a day or two, mostly depending on how soon you can get to our office. Whether treatment begins at that first visit depends on your evaluation and what you and your psychiatrist decide together.