Puerto Rico

Reimbursed Care Access

Puerto Rico, as a U.S. territory, generally follows U.S. federal controlled-substance scheduling while also maintaining its own territorial controlled‑substances code. FDA‑approved products (notably esketamine/Spravato) are available under the federal REMS/labeling framework and can be administered in certified healthcare settings in Puerto Rico; off‑label ketamine infusions are widely offered by private clinics but are generally not reimbursed by public insurance. Classical serotonergic psychedelics (psilocybin, MDMA, DMT, 5‑MeO‑DMT, mescaline, 2C‑series, ayahuasca, ibogaine) remain controlled and without authorized routine medical use outside approved clinical research. [https://law.justia.com/codes/puerto-rico/2023/title-twenty-four/part-v/chapter-111/subchapter-ii/2202/|Puerto Rico Controlled Substances Code] [https://www.fda.gov/drugs/human-drug-compounding/fda-warns-patients-and-health-care-providers-about-potential-risks-associated-compounded-ketamine|FDA: Ketamine & Compounded Products]