Statelayer started with a simple observation: the clinicians running ketamine clinics are very good at the medicine, and they’re being asked to run everything around the medicine on tools that were never built for it.
In 2025 we started sitting with ketamine clinics — in person, next to the people doing the work — and watching how a clinic actually runs day to day. Not the treatment itself; the clinics had that down. Everything around it: how a visit gets scheduled, how a claim gets out the door, how a prior authorization gets chased, how anyone knows whether the clinic actually got paid what it earned.
What we found, over and over, was a spreadsheet.
The spreadsheet behind every clinic
Every clinic had some version of it: a shared spreadsheet (sometimes several) holding the work that generic practice software couldn’t model. And once you look closely at how ketamine care runs, it’s obvious why the generic tools fall short.
A ketamine visit isn’t an appointment. It’s a dose plus a monitoring and recovery window, delivered by a specific provider in a specific room, usually as one session in a recurring series. A generic scheduler sees a 30-minute slot; the clinic has to hand-manage everything the slot doesn’t capture.
And a ketamine claim isn’t just a claim. It’s infusion CPT codes and modifiers, prior authorizations, superbills for out-of-network patients, and a mix of cash-pay and insurance that works differently for IV/IM ketamine than it does for Spravato. Each of those is a place where a claim can quietly pay less than it should — or never go out at all.
So clinic staff patch the gaps by hand. The patching costs real hours every week, and worse, it leaks revenue the clinic has already earned: sessions delivered, patients cared for, money never collected.
Why we deliberately didn’t build an EHR
The obvious startup move would have been to build “the EHR for ketamine clinics.” We chose not to, on purpose.
Clinics already have a system of record, and the single biggest reason clinic software goes nowhere is the fear of migrating off it. Asking a busy clinic to rip out its EHR is asking it to bet the practice on a vendor it just met. Most clinics — sensibly — say no.
So Statelayer works alongside the EHR a clinic already runs; we integrate with systems like Osmind rather than replacing them. The biller keeps doing what they do well, with claim queues and real-time visibility instead of a shared spreadsheet. Because nothing has to be ripped out, clinics go live in days, not months.
What Statelayer is today
Statelayer is scheduling and billing software built only for ketamine clinics, shaped around the patterns above:
- Intake & screening — guided intake, eligibility, and consent collected once, ready before the first visit
- Smart scheduling — provider, room, and monitoring time booked around real treatment and observation windows
- Coding & billing — ketamine-aware coding and claims, with AI-assisted checks that flag gaps before they go out
- Insurance & prior auth — authorizations tracked from request to approval
- Treatment ops — protocols, monitoring, and follow-up for every session
- Analytics & AI insights — billing, scheduling, EHR, and marketing data in one view, with plain-English questions answered in charts
Statelayer is HIPAA-compliant and signs a Business Associate Agreement before any protected health information is shared — more on how we handle data on our security page.
Where this goes
We’re starting with the sharpest pain — scheduling and billing — and expanding from there, in the order the clinics we work with need it. That’s the whole method: we build hand-in-hand with a handful of ketamine clinics from our home base in New York City, and every clinic we work with makes the product sharper for the next one. You can read more about how we work on our about page.
If you run a ketamine clinic and any of this sounds like your week — the spreadsheet, the claim chasing, the scheduling Tetris — we’d genuinely love to hear how your clinic runs today.