Repetitive Transcranial Magnetic Stimulation (rTMS or TMS) is a treatment that is FDA-Approved for Major Depressive Disorder and Obsessive Compulsive Disorder (OCD). TMS Therapy involves a device, which is placed on a patient’s head, that is able to awaken parts of the brain that are underactive in individuals with depression and OCD. When TMS first became available to the public in 2008, it was a very expensive treatment. There was only one device available on the market (NeuroStar) which doctors could purchase, but was very expensive. Many doctors charged upwards of $16,000 for an entire course of treatment! Nowadays, there are significantly more options for TMS.
Historically, TMS was initially so expensive for a number of reasons. First, the cost of the machine was so exorbitant that most doctors could not afford to treat people for cheaper. Secondly, the first devices available to the public would charge the doctors between $60 – $100 per treatment. This meant that the doctors would have to make at least $60 – $100 per session, plus pay for a trained TMS technician as well as any related expenses before coming out ahead. Other devices eventually became FDA-Approved, such as Brainsway’s “Deep TMS” machine and MagVenture’s “MagVita” machine. Devices such as the MagVita machine and the CloudTMS machine allowed doctors the freedom to not have to pay for each treatment, which contributed to reducing the cost of treatment.
TMS is much more affordable now, and not that expensive anymore. Major insurance companies such as Aetna, Cigna, Blue Cross Blue Shield, Blue Shield of California (Magellan), Anthem Blue Cross, and Medicare eventually started paying for TMS in 2013. Now that insurance companies pay for TMS, the treatment is much more affordable for those in need. However, insurance coverage varies among each particular insurance company. For instance, some insurance companies require that the patient has tried at least 4 antidepressant medications in the past. Other insurance companies are much more lenient.
As of 2020, here are the following requirements from the major insurance companies:
- Aetna: 2 antidepressant medications in the past + 1 “augmentation” (timeframe of more than one medication taken concurrently)
- Anthem Blue Cross: 2 antidepressant medications in the past
- Blue Shield (Magellan): 4 antidepressant medications in the past
- Cigna: 2 antidepressant medications of 2 different classes (e.g., both can’t be SSRI’s)
- Medicare: 1 antidepressant in the past
- United Healthcare (Optum): 4 antidepressant medications in the past
Note that every one of these companies also requires at least two months of psychotherapy in the past. The easiest way to find out if your insurance will cover your TMS treatment is to fill out our treatment history form, and we will get back to you within 24 hours regarding whether or not your treatment will be covered.
The good news is that there can also be exceptions. For instance, we have a partnership with more immersive programs that include TMS, ketamine, and group therapy. Insurance is more likely to approve these bundled services together than separately.
As the leading provider for Express TMS in Southern California, we hope to reduce the cost of TMS even more. We believe that everyone deserves the best mental health treatment, regardless of their financial situation. If you or your loved one are interested in learning more about the cost of TMS, please schedule a consultation with us today.