Is TMS Therapy Covered By Insurance?

Our goal is to make the cost of TMS as low as feasible so that as many patients as possible can benefit from it. Depending on your plan’s copay or coinsurance amount, you’ll pay anywhere from $10 to $70 per session if you’re paying with insurance.

How much is TMS out of pocket?

Cost/Insurance TMS sessions typically cost $400-$500 per session, for a total cost of around $15,000, depending on the provider. ECT costs roughly $2,500 per session, or $25,000 for ten sessions, including a one-week hospital stay in some circumstances.

Does insurance cover TMS for anxiety?

While TMS can be used to treat a variety of diseases outside depression, such as bipolar disorder, anxiety, ADHD, migraines, chronic pain, and others, most insurance coverage only cover it for individuals with moderate to severe Major Depressive Disorder (MDD). In addition to a diagnosis, you’ll need proof that you’ve taken at least two antidepressant drugs and found them to be ineffective. You’ll also need to establish that you’ve tried talking therapy to manage your depression but haven’t seen any progress as a result.

Will insurance cover a second round of TMS?

Yes, in a nutshell, but there’s more to the story. In most cases, insurance companies will not pay for a service or procedure unless it is deemed medically necessary or suitable.

Can TMS damage your brain?

Many people mistake TMS for ECT, or electroconvulsive therapy. These two treatments, however, are significantly different.

TMS uses brief magnetic pulses to stimulate parts of the brain that are underactive in depressed persons. These magnetic pulses cause a flow of extremely small electrical charges that the patient cannot feel. These electrical charges stimulate neurons to fire, which reactivates the targeted area and improves mood.

ECT is normally performed when the patient is under general anesthesia in a hospital setting. The method includes administering regulated electrical currents to the brain, which causes a brief seizure. Despite the fact that electroconvulsive therapy (ECT) was developed in the 1930s, doctors are still unsure how it works to alleviate depressive symptoms. They do know, however, that ECT normally works rapidly and does not cause structural harm to the brain.

TMS treatments, on the other hand, can be done as an outpatient procedure. A coil is put on the outside of the patient’s head during TMS treatment to deliver tiny magnetic pulses. The process is painless and requires no anesthetic. It also has no effect on intellect or memory, and it doesn’t cause a seizure. The patient is free to talk, listen to music, or watch television during the session.

Can TMS make you worse?

TMS has been observed in certain trials to enhance anxiety when used for depression. Repetitive transcranial magnetic stimulation (rTMS) generated increased anxiety levels in those with panic disorder, according to a 2011 study.

TMS does not create anxiety, according to the Mayo Clinic, and it only causes associated illnesses like mania or seizures in exceedingly rare circumstances. Headaches, lightheadedness, and skin tingling are all temporary adverse effects of TMS, but they usually fade after a few sessions.

Speak to your doctor if you have increased anxiety after starting TMS treatments. Your doctor may be able to modify your sessions to lessen the negative effects.

What are the dangers of TMS therapy?

It’s a noninvasive treatment that stimulates nerve cells with electromagnetic pulses, which may help with symptoms of neurological and mental health conditions.

TMS is primarily utilized in the treatment of depression. It’s proven to be effective in treating those who don’t react to antidepressants or psychotherapy. TMS was approved by the Food and Drug Administration (FDA) for this purpose in 2008.

TMS has also been shown to aid with other conditions such as anxiety and Parkinson’s disease.

TMS is also known as repeated transcranial magnetic stimulation because it involves repetitive electrical impulses (rTMS). The terms are frequently interchanged.

What is the success rate of TMS therapy?

TMS has a success rate of 70 percent to 80 percent, according to most TMS providers, which means that the vast majority of people have significant relief after treatment. After just one session of treatment, about half of patients report complete remission, which means that their depression symptoms have vanished.

To comprehend how effective TMS works, it’s necessary to comprehend how effective medicine is. The STAR*D research, a significant clinical trial funded by the National Institute of Mental Health, discovered that routinely prescribed drugs like selective serotonin reuptake inhibitors (SSRIs) are only effective 27.5 percent of the time. However, if the SSRI fails to function (as it does for many people with treatment-resistant depression), the medication’s success rate drops. By the time a person has tried four drugs, the likelihood of the next one working is less than 7%. We know that drug studies can take up to two months to determine whether or not an antidepressant would work for a patient. This means that many people waste 4 to 8 months trying multiple drugs when the chances of remission are slim to none. Furthermore, increased medicine use means a higher risk of harmful side effects from medications, such as:

Given this context, it is evident that people suffering from treatment-resistant depression require additional therapy alternatives. Much of the early clinical study using TMS focused on people who had a very poor chance of remission, and discovered that two-thirds of patients had a positive outcome after TMS. Researchers discovered that those who felt hopeless, suffered from anhedonia, and had tried everything else were able to get rid of their symptoms in just 6 weeks.

In mid-2020, we conducted independent study and discovered that our success rate was significantly higher than what had been previously disclosed. This could be because we specialize in both theta burst stimulation and a customized TMS method. We think that every brain is unique, and that there is no such thing as a “one-size-fits-all” approach to TMS treatment. Our most recent calculation yielded a 92.5 percent success rate.

What type of doctor does TMS?

Privileges to prescribe Deep TMS vary per state in the United States, for example. While psychiatrists are the only doctors who may administer Deep TMS, several states allow other doctors, such as nurse practitioners, physician’s assistants, and prescribing clinical psychologists, to do so as well.

Similarly, various insurance carriers may establish a distinct list of healthcare practitioners who can do Deep TMS treatment (and be compensated for it). This means that healthcare practitioners interested in prescribing or providing Deep TMS therapy should check with their customers’ insurance companies to see if their plans support Deep TMS therapy and if they will be reimbursed for the treatments they offer.

Deep TMS is FDA-approved in the United States to treat Major Depressive Disorder (MDD) and Obsessive-Compulsive Disorder (OCD), and it is CE-marked in Europe to treat these and a variety of other mental health issues. Due to its expanding popularity, several insurance firms are eager to give Deep TMS to their clients. Since a result, those who are not insured for the treatment may contact their insurance company and inquire about Deep TMS coverage, as single-case agreements may be achievable in some situations.